New med tech-related decision support documents published in Austria

On July 17, 2022, the Austrian Institute for HTA (AIHTA) published four decision support documents, which provide recommendations regarding the inclusion of new medical interventions in the catalog of individual medical services of the performance-oriented hospital financing (Leistungsorientierten Krankenanstaltenfinanzierung, LKF) model, as well as three updates to previous decision support documents. The decisions relate mainly to cardiovascular, peripheral vascular, neurology and neurosurgery, and neuromodulation technology groups.

The Austrian Ministry of Health annually proposes numerous new medical interventions for inclusion in the service catalog (so-called individual medical services, MEL) for reimbursement. The AIHTA provides a systematic assessment of the effectiveness and safety of these new interventions. The topics (interventions) are prioritized by the Ministry of Health. The assessments are based on systematic reviews for each intervention and a summary of the scientific evidence according to the GRADE scheme.

Some examples of published decision support documents are provided below:

• "Percutaneous aspiration thrombectomy for pulmonary embolism” summarized the evidence with regard to the comparative effectiveness and safety of percutaneous aspiration thrombectomy in patients with high-risk pulmonary embolism (PE) and intermediate-risk PE that have developed hemodynamic instability and who are contraindicated or have failed systemic thrombolytics. In the absence of robust comparative data, no conclusions can be made regarding the comparative effectiveness of aspiration thrombectomy compared with other procedures (such as catheter-based thrombolysis). Re-evaluation is recommended in 2025;
• “Transcranial magnetic resonance-guided high-intensity focused ultrasound treatment in patients with drug-resistant essential tremor” evaluated whether transcranial magnetic resonance-guided high-intensity focused ultrasound (tcMRgFUS) treatment is more effective and safer compared to sham treatment, deep brain stimulation (DBS), or radiofrequency thalamotomy in patients with drug-resistant essential tremor. Based on the results of this assessment, it was recommended reimbursement of tcMRgFUS with restriction to patients who are not eligible or not yet eligible for DBS and limited to specialized clinical settings;
• “Percutaneous mitral valve repair with a clip device in patients with mitral regurgitation” (the initial report was issued in 2010 and first updated in 2012) aims to compare the efficacy and safety of a mitral clip device to mitral valve repair or replacement surgery or optimal medical treatment in patients with moderate-to-severe or severe chronic mitral regurgitation. Evidence suggests that the mitral clip is less effective than surgical intervention. Compared to drug therapy, the studies showed different results, so based on the current evidence, it cannot be clearly determined whether percutaneous mitral valve intervention using a mitral clip is more effective than optimal drug therapy alone. Therefore, the inclusion of technology in the benefits catalog is currently not recommended. A re-evaluation is recommended in 2026;

The full details list of decision support documents in German and/or English can be found here.

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