New med tech-related decision support documents published in Austria

The Austrian Federal Ministry of Health (BMSGPK) every year receives numerous proposals for the inclusion of new medical interventions in the catalog of individual medical services (MEL) for reimbursement. The Austrian Institute for HTA (AIHTA) systematically assesses 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

On July 15, 2024, the AIHTA published three decision support documents for newly assessed procedures and two updates to previous decision support documents. The decisions relate to cardiovascular, peripheral vascular, interventional radiology, neuromodulation, and endocrine technology groups.

Some examples of published decision support documents are provided below:

• Caval valve implantation (CAVI) for severe tricuspid regurgitation evaluated the safety and effectiveness of CAVI compared to other transcatheter techniques or optimized medical treatment (OMT) in patients with symptomatic severe tricuspid regurgitation who are at high risk of or ineligible for surgery. The report concluded that it is still unclear whether CAVI offers enough benefit over OMT to justify the risks.
• Thermoablation of benign thyroid nodules evaluated the safety and effectiveness of thermoablation compared to conventional procedures, such as surgery or radioiodine therapy (taking a radioactive capsule). The evidence suggests that fewer complications occur after thermoablation than after surgery. However, based on the current evidence, it cannot be clearly determined whether thermoablation is more effective than conventional procedures. Ongoing studies are awaited that can provide meaningful evidence;
• Percutaneous transluminal coronary angioplasty (PTCA) with drug-eluting balloon (DEB) in patients with coronary artery disease (CAD) – update 2024 (the initial report was prepared in 2009 and updated in 2013 and 2016) evaluated the efficacy and safety of PTCA with DEB compared to uncoated balloon catheters or drug-eluting stents (DES) in patients with in-stent restenosis (ISR), de novo lesions, small vessel disease (SVD), or ostium stenosis. The report concluded that evidence of an additional benefit was found only in specific indications, especially in patients with ISR. A re-evaluation for de novo lesions and small vessel disease is recommended in 2027.

See the details in German and English here.

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