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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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NHS England launched nominations for High-Cost Drugs and Device List for 2020

A number of high-cost drugs and devices are paid for separately from the national tariff price for the related service. These drugs and devices appear on a high-cost list which is part of the national tariff.

NHS England is now inviting nominations for additions to, and removals from, the high-cost drugs and devices lists for the next national tariff, due to come into effect in April 2020.

When considering which items to include in the lists for the next national tariff, the guiding principle is that the drug or device should be high cost and represent a disproportionate cost compared to the other expected costs of care within the Healthcare Resource Group (HRG) or Treatment Function Code (TFC) which would affect fair reimbursement.

As for some new drugs or devices it can be challenging to produce cost and usage estimates, NHS England will consider all relevant information available that will help to inform recommendations. There may be circumstances where it is beneficial to the service to add or retain devices on the high-cost list in order to support procurement arrangements introduced by NHS England Specialised Commissioning.

All nominations must be submitted by 31 May 2019.

See full details here.

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