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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 published an impact report on diagnostic pathology

In May 2021, NICE published an impact report on diagnostic pathology. NICE diagnostics assessment program produces guidance that evaluates innovative diagnostic technologies. NICE has a special adoption team that supports the uptake of new technologies recommended by NICE. They also support the NHS Accelerated Access Collaborative (AAC), which brings together industry, government, regulators, patients, and the NHS to remove barriers and accelerate the introduction of new treatments and diagnostics.

The report provides uptake data of the following NICE-recommended pathology diagnostics:

  • High-sensitivity troponin tests (AAC rapid uptake product):
    • 86% of eligible people had access to high-sensitivity troponin tests;
  • Placental growth factor (PIGF)-based tests for suspected pre-eclampsia (AAC rapid uptake product):
    • Only one hospital had access to PlGF-based tests in 2018/19 compared with 60 who had access to the tests in 2019/20;
  • Faecal immunochemical test (FIT) for colorectal cancer:
    • In June 2019, FIT became the primary test used in the bowel cancer screening program for people aged 60 to 74;
    • The uptake of the screening test increased from 56% in 2015/16 to 66% in 2019/20;
  • Faecal calprotectin tests for inflammatory diseases of the bowel:
    • After implementing the test, Yorkshire and Humber Academic Health Science Network successfully rolled out the pathway to 15 clinical commissioning groups (CCGs) by 2020. It was estimated that using the pathway CCGs would save approximately £220,000 a year by preventing unnecessary and expensive colonoscopies;
  • Prenatal testing for fetal RHD genotype:
    • University Hospitals Bristol NHS Foundation Trust implemented this test in 2017 and reduced anti-D immunoglobulin use by 29%;
    • Taunton and Somerset NHS Foundation Trust reported that adoption of prenatal testing resulted in a 40% reduction in anti-D immunoglobulin use;
  • Natriuretic peptide testing - B‑type natriuretic peptide (BNP) or N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) for heart failure:
    • There is a lack of uptake data;
  • Follicle-stimulating hormone (FSH) test for diagnosing menopause:
    • As an example, York Teaching Hospital NHS Foundation Trust implemented strategies to reduce inappropriate FSH requests for women aged over 45 recommended by NICE. FSH requests in women over 45 years had decreased by 34%, leading to a saving of around £7,500 in one year.

Furthermore, NICE provides its plans for improving pathology data and uptake of NICE-recommended diagnostics:

  • Make pathways consistent across providers, in line with NICE guidance;
  • Improve data collection to identify gaps in uptake.

See full details here.

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