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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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NICE evaluated Axonics sacral neuromodulation system for treating refractory overactive bladder

On September 03, 2020, the National Institute for Health and Care Excellence (NICE) issued medical technologies guidance on Axonics sacral neuromodulation (SNM) system for treating refractory overactive bladder.

Axonics SNM system consists of the following parts:

  • Pulse generator that implanted subcutaneously in the upper buttock
  • Lead electrodes implanted through the corresponding sacral foramen that provides electrical impulses to the sacral nerves
  • Rechargeable battery
  • A handheld remote control that activates the stimulator, adjusts the amplitude, and checks the battery status
  • The wireless charger, attachable to the skin over the implanted stimulator

The innovative aspects of the Axonics SNM system are:

  • The long-expected life span of rechargeable battery - at least 15 years, which is longer than the comparable non-rechargeable device
  • Compatibility with MRI
  • Smaller size comparing with existing non-rechargeable SNM devices, making it more suitable for people with a low body mass index

The Axonics SNM device costs £9,660 for the permanent implant.

NICE concluded that evidence supports the case for adopting the Axonics sacral neuromodulation (SNM) system for treating refractory overactive bladder in the NHS, as it improves symptoms and quality of life. It also has a longer battery life than the non-rechargeable system used in NHS clinical practice.

NICE recommended considering the Axonics SNM system as an option when conservative or pharmacological treatment has not worked (in line with NICE's guidelines on urinary incontinence and pelvic organ prolapse, and lower urinary tract symptoms).

The cost analysis showed that using the Axonics SNM system may lead to cost savings if the battery is expected to last at least six years. Cost modeling estimates that over 15 years, the Axonics SNM system is cost-saving compared with the non-rechargeable system by about £6,025 per person.

See the full guidance here

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