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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 opens consultation on proposed changes in the selection of topics for the evaluation

On October 09, 2020, the National Institute for Health and Care Excellence (NICE) launched a public consultation on proposals for changing how it selects the topics for medicines, medical devices, and diagnostics guidance development.

The NICE Centre for Health Technology Evaluation (CHTE) issued proposals for change in topic selection processes and a public consultation initiated from October 09, 2020. The CHTE is responsible for developing the following guidance: diagnostics guidance (DG), highly specialized technologies guidance (HST), interventional procedures guidance (IPG), medical technologies guidance (MTG), and technology appraisals guidance (TA).

The proposed changes objectives are:

  • Consolidate existing identification, selection, and routing criteria to improve clarity
  • Align decision making and stakeholder engagement processes to improve efficiency and better describe governance arrangements to improve accountability
  • Better describe the topic selection processes and decisions to improve transparency

Topic identification criteria will be updated, so the number and type of topics considered for NICE guidance are increased (including previously considered out of remit). The proposed selection criteria will replace over 15 different criteria used by CHTE teams to identify if a topic requires NICE to assess the cost and effectiveness evidence.

A device or diagnostic is likely to be selected if:

  • It has benefits that are likely to be highly disruptive or lead to a stepwise change to an established care pathway in the UK; and
  • A systematic assessment of the cost and system impacts is needed. For example, because there is uncertainty about the likely cost or system impact, or because the costs and impacts are expected to be significantly cost incurring or cost-saving; and
  • The benefits are supported by:
    • Evidence of effectiveness (such as RCT, before/after studies, cohort studies, diagnostic test accuracy studies) that compares the technology to current practice in the UK health and care system or to an appropriate reference standard and
    • Information about the expected resource impact of adopting the technology that is directly applicable to the UK health and care system such as reports or studies describing the cost and system impact of implementing the technology, or an economic model and
    • Advice from experts (such as patients, carers, clinicians, and commissioners) that confirms the benefits are desirable and are likely to be realized when adopted in the UK health and care system

All new or significantly modified interventional procedures will be selected if they are available to the NHS or independent sector or about to be used outside of formal research.

The following changes proposed for routing the type of guidance (program):

  • All diagnostics, irrespective of the value proposition, will now be routed to the diagnostic guidance. Previously, diagnostics that require cost consequences analysis were routed to the medical technologies guidance, and those required a cost-utility health economic analysis were routed to the diagnostic guidance
  • Medical devices requiring a cost-effective analysis will continue to be routed to the technology appraisal program, but the Medical Technologies Advisory Committee will be an independent decision-maker

The consultation is open till November 19, 2020.

See more information here

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