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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: May 2019 Prioritisation Decisions

In May and November each year, NHS England makes decisions on which new treatments should be included for routine commissioning. The decisions are taken by the NHS England Board based on recommendations from the Clinical Priorities Advisory Group (CPAG), which is made up of doctors, health experts, and patient representatives.

Treatments are grouped into five levels of priority, with those that have the highest relative clinical benefit for patients and the lowest relative cost classified as level one, and treatments with the lowest relative clinical benefit and highest relative cost are classified as level five. The ranking of treatments considered in the May 2019 prioritization round is set out below.

Level 1:

  • Treatment for defined patients with MDR-TB and XDR-TB including bedaquiline and delamanid (bedaquiline in patients aged six years and over, and delamanid in patients aged three years)
  • Percutaneous mitral valve leaflet repair for primary degenerative mitral regurgitation (adults)

Level 2:

  • Percutaneous patent foramen ovale closure for the prevention of recurrent cerebral embolic stroke (adults aged around 60 or under)
  • Lung volume reduction by surgery or endobronchial valve for severe emphysema in adults.

Level 3:

  • No items

Level 4:

  • Sapropterin for phenylketonuria (all ages)

Level 5:

  • No items

NHS England will fund as many of the treatments, by order of priority, as it can from the available budget at that time.

The policies for lung volume reduction and sapropterin will have the opportunity to be considered again at the next prioritization round in November 2019.

More information on the prioritization process can be found in this video: Making decisions about which new treatments to fund.

See full details here.

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