Ongoing assessments within the Sensible Care Program of the Dutch Healthcare Institute

09

Nov 2020

In Sensible Care projects, the Dutch Healthcare Institute (ZIN), together with parties, is investigating the possibilities for improving care pathways for patients.

The ZIN launched the "Sensible Care" program in 2013, the systematic review of the diagnostic and treatment options within the current basic health insurance package to provide appropriate provision and use of medical care.

The method has four phases:

  • Screening phase: the ZIN examines with the parties involved which care is currently being provided and which subjects can be improved.
  • In-depth phase: ZIN determines for each topic what can be improved and discuss with the parties involved how they will achieve this
  • Implementation phase: the parties implement the improvements. The ZIN supports them where necessary
  • Evaluation phase: the final stage when ZIN checks whether the goals have been achieved.

As of early November 2020, there are 30 ongoing assessments at different phases:

  • Orthopedics
    • Sensible care in the treatment of knee and hip osteoarthritis (evaluation phase)
    • Sensible care in with rheumatoid arthritis (in-depth phase)
  • Blood and immune system
    • Sensible care for people with deep vein thrombosis and pulmonary embolism (in-depth phase)
  • Heart, lung, and vascular care
    • Sensible Care for people with asthma (in-depth phase)
    • Sensible Care for implantable cardioverter defibrillators (ICD) (in-depth phase)
    • Sensible Care for people with COPD (implementation phase)
    • Sensible Care for people with peripheral arterial vascular disease (PAD) (implementation phase)
    • Sensible Care for people with chest pain (suspected stable angina pectoris) (implementation phase)
    • Sensible Care for people with sleep apnea (in-depth phase)
  • Cancer
    • Sensible Care - End-of-life care for people with incurable colon cancer or lung cancer (implementation phase)
    • Sensible Care - Meaningful follow-up in women treated for breast cancer (implementation phase)
    • Sensible Care - Follow-up for people with non-melanoma skin cancer and actinic keratosis (implementation phase)
    • Sensible care - Sensible use of medicines in people with castration-refractory prostate carcinoma (evaluation phase)
  • Digestion and oral care
    • Sensible Care for people with stomach complaints (in-depth phase)
  • Metabolism and hormone balance
    • Sensible Care for people with osteoporosis (implementation phase)
  • Nervous system
    • Sensible Care for people with low back complaints (in-depth phase)
  • ENT and skin
    • Sensible Care for people with eczema (in-depth phase)
    • Sensible Care for people with macular degeneration (in-depth phase)
    • Sensible Care for people with middle ear infection (in-depth phase)
    • Sensible Care for people with psoriasis (in-depth phase)
    • Sensible Care for people with hearing impairment and deafness (in-depth phase)
    • Sensible Care for people with cataracts (deepening phase)
  • Pregnancy, childbirth, and gynecological disorders
    • Sensible Care for women with the cervical cytological abnormality (CIN) (implementation phase)
    • Sensible Care for women with pelvic floor complaints (in-depth phase)
  • Care for disabled people
    • Sensible care for people with mild intellectual disabilities and health problems (in-depth phase)
    • Sensible Care for people with intellectual disabilities and behavior problems (in-depth phase)
  • Mental health
    • Sensible Care for people with psychosis (in-depth phase)
    • Sensible Care for people with post-traumatic stress disorder (PTSD) (in-depth phase)

The full details in Dutch can be found here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues are available for download free-of-charge.

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06

Nov 2019

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In September 2019, CAMTÖ released a systematic review on SMS alerts to laypersons for cardiopulmonary resuscitation in out-of-hospital cardiac arrest (OHCA) that aimed to clarify SMS efficacy on survival after OHCA. Currently, the best available evidence does not support the use of SMS alarm to laymen as a means of improving survival after OHCA.

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04

Nov 2019

In early October 2019, the Health Evaluation and Quality Agency of Catalonia (AQuAS) published the assessment of cosmetic laser iridoplasty. The work revealed that it is recommended to undergo this intervention exclusively within clinical investigation settings and after getting approval by the ethics committee.

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31

Oct 2019

Reimbursement of optical coherence tomography (OCT) for diagnosis and therapy control in retinal diseases will be available from October 2019 via the EBM (Einheitlicher Bewertungsmaβstab, German Uniform Evaluation Standard).

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29

Oct 2019

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including peripheral vascular technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for peripheral vascular devices in Europe.

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29

Oct 2019

NHSX is working with the market at a national level to create a platform of digital tools like NHS Login that can be built on by digital health innovators.

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23

Oct 2019

In September 2019, Skåne Region released a report for ultrasound in symptoms of the acute scrotum that aimed to understand whether increased ultrasound use could improve the diagnostic of the studied condition. Although no studies investigating the direct benefit of ultrasound in patients with symptoms of acute scrotum were identified, its high precision, sensitivity, and specificity were outlined.

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23

Oct 2019

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including ophthalmology technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for ophthalmology devices in Europe.

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02

Oct 2019

In August 2019, the Norwegian Institute of Public Health has released an HTA report regarding the effectiveness of treatment for localized prostate cancer commissioned by the Centre for joint decision-making to summarize the findings regarding this method. The effectiveness of the several treatment methods is unknown due to the lack of evidence. There is little or no difference in survival after radical prostatectomy compared to low-dose-rate brachytherapy.

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01

Oct 2019

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including diagnostic imaging technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for cardiovascular devices in Europe.

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27

Sep 2019

In August 2019, the Norwegian Institute of Public Health (NIPH) has released a single technology assessment report for molecular profiling panel – Prosigna aimed to investigate its prognostic accuracy, clinical and cost-effectiveness in patients with breast cancer. It was outlined that it is uncertain to what extent Prosigna contributes prognostic information that turns into better clinical results; conclusions about the cost-effectiveness of Prosigna cannot be made due to the lack of existing information.

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26

Sep 2019

A positive conclusion regarding the model project “Rhineland-Palatinate breathes through - telemedicine for healthy lungs” (“Rheinland-Pfalz atmet durch – Telemedizin für eine gesunde Lunge”) was drawn by the Mainz Ministry of Health.

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24

Sep 2019

In August 2019, the National Institute for Health and Care Excellence published one new MedTech innovation briefings for vacuum therapy for colorectal anastomotic leakage and two new interventional procedure guidance for endovascular insertion of an intrasaccular wire-mesh blood-flow disruption device for intracranial aneurysms and the Papillon technique for locally advanced rectal cancer.

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16

Sep 2019

National Institute for Health and Disability Insurance (INAMI) is currently developing a framework for the reimbursement of telemedicine and health apps (mHealth).

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10

Sep 2019

At the beginning of August 2019, the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the applications of healthcare products and activities for conditional entry into the Basic Insurance Package. Two applications for heated intraperitoneal chemotherapy in ovarian cancer and GAG therapy in bladder pain syndrome were considered.

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06

Sep 2019

The Clinical Coding and Schedule Development (CCSD) group develop and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern hip replacement, endoscopic ablation, multiple arthroscopic operations on the ankle, collagen paste for closing an anal fistula and diagnostic codes for tests for next generations sequencing molecular intelligence, and others. The codes are introduced with a recommended adoption date being the 1st of November 2019. The documents also contain a list of textual changes in codes, inactivated codes, and an updated list of unacceptable combinations of codes.

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03

Sep 2019

In July 2019, the National Institute for Health and Care Excellence (NICE) published one new diagnostics guidance for therapeutic monitoring of TNF-alpha inhibitors in rheumatoid arthritis, two new interventional procedure guidance (for transurethral laser ablation for recurrent non-muscle-invasive bladder cancer and ultrasound-guided high-intensity transcutaneous focused ultrasound for symptomatic uterine fibroids), and one new MedTech innovation briefing for HemaClear for bloodless surgical field during limb surgery.

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21

Aug 2019

Zorg van Nu information team published a brochure with regulations for stimulating digital care in the Netherlands. The brochure with the description of 16 schemes clearly explains which regulations are applicable for which e-health innovations.

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09

Aug 2019

The Clinical Coding and Schedule Development (CCSD) group develop and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern mastectomy and immediate reconstruction of the breast, coronary intravascular lithotripsy, angioplasty, insertion of a stent, portal vein embolization, and others and diagnostic codes for tests for primary hyperoxaluria panel, myeloid panel, and hereditary angioedema. The codes are introduced with a recommended adoption date being the 1st of August 2019. The documents also contain a list of textual changes in codes and an updated list of unacceptable combinations of codes.

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01

Aug 2019

Predictive Analysis for Therapy (PATH) is a major collaborative project to optimize molecular predictive diagnostics in the Netherlands. The project focuses on the molecular analyses that are important for the treatment choice of cancer patients.

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12

Jul 2019

On the 11th of June 2019, the Dutch National Healthcare Institute (Zorginstituut Nederland, ZIN) has published a position regarding the positively assessed indications and the appropriate protocols for Hyperbaric Oxygen Therapy (HBOT) that have been included in the basic package since 2009 in order to promote the appropriate use of this care. Health insurers can include this information and the quality criteria of the protocols when purchasing HBOT.

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08

Jul 2019

At the beginning of June 2019, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare services, which were excluded or included with restrictions into Basic Insurance Package. Percutaneous liver perfusion with melphalan in patients with metastases from a uveal melanoma was included with restrictions, whereas CardioMEMS PA Monitoring was included in the context of research only.

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01

Jul 2019

Seminars on hospital reimbursement system for the Netherlands and Russia were added to the online school, as well as the webinar for the Austrian system. MTRC online school is the most cost-effective way to learn about reimbursement systems in a structured way.

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25

Jun 2019

The report presents a summary of the reimbursement situation for procedures of embolization of peripheral vessels (uterine fibroid, prostate, liver, arteriovenous malformations) in Europe. The report covers particles and fluid agents. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland. It is also possible to add analysis in the Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

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21

Jun 2019

The report presents a summary of reimbursement situation for invasive procedures for treatment of varicose veins of lower extremities in Europe. Procedure codes for the following interventions will be provided in the analysis: sclerotherapy; catheter-assisted procedures using radiofrequency ablation, laser ablation or mechanochemical ablation; high ligation and vein stripping; phlebectomy; endovenous ultrasound-guided obliteration using cyanoacrylate glue or other agents. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland. It is also possible to add analysis in Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

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13

Jun 2019

In March 2019, NICE published an updated version of its evidence standards framework for digital health technologies (DHTs) that sets out the evidence requirements for different types of DHTs.

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11

Jun 2019

The Clinical Coding and Schedule Development (CCSD) group develop and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern cytoreductive surgery for colorectal peritoneal carcinomatosis, cytoreductive surgery for ovarian malignancies, therapeutic sialendoscopy, intra corporeal salivary gland lithotripsy, and others and diagnostic codes for tests for common and rare mutations.

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05

Jun 2019

HealthTech Connect, a new online resource provided by NICE to help identify and support new health technologies as they move from inception to adoption in the UK health and care system, was formally launched April 29th, 2019. The system, which is free to use, will help companies to understand what information is needed by decision makers in the UK health and care system, and clarify possible routes to market access.

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29

May 2019

The report includes all published reimbursement decisions for IVD tests in 2018 in European countries with established frameworks for out-patient reimbursement laboratory tests (Belgium, France, Germany, Netherlands, Switzerland).

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28

May 2019

The report includes an overview of funding framework and all (as of May 2019) decisions from ultimate payers and decisions makers in England (NHS England, one CCG), Germany (G-BA), Netherlands (Zorginstituut Nederland), Norway (“New Methods” framework) and Switzerland (Federal Office of Public Health). More than 1000 decisions are included.

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30

Apr 2019

The Clinical Coding and Schedule Development (CCSD) group develop and maintains procedural and diagnostics nomenclature for private payers in England. New diagnostic codes concern circulating tumor DNA profile for the different type of cancers, myriad Prolaris test, PET Scan with florbetapir, etc. and a procedure code for robotic-assisted radical hysterectomy and lymphadenectomy. The codes are introduced with a recommended adoption date being the 1st of May 2019. The documents also contain a list of textual changes in codes and an updated list of unacceptable combinations of codes.

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26

Apr 2019

On the 14th of March of 2019, the Dutch National Health Care Institute has opened a project submission period in a framework of subsidy scheme called “Promising care.” This scheme makes it possible to obtain temporary financing for a maximum of 6 years for those treatment methods that look promising but are not yet reimbursed from the basic package. The period for submitting project ideas for promising care is from March 14 to May 14, 2019.

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22

Apr 2019

Danish Health Authority published new codes for the Health Care Classification System in April 2019, including twelve surgical, nine medical codes and two codes for imaging diagnostics. New codes include endovascular occlusion of intracranial vessels, creation of AV fistula, number of embolization procedures and some other codes.

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18

Apr 2019

The report presents a summary of reimbursement situation for diagnostic endoscopic procedures on the upper gastrointestinal tract for benign and malignant diseases in outpatient settings. The following procedures will be considered: esophagoscopy, gastroscopy, duodenoscopy. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

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16

Apr 2019

The 13 innovations joining the NHS Innovation Accelerator were announced on March 5, 2019, as part of an event to launch the fourth year of this award-winning national accelerator.

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22

Mar 2019

The Dutch Healthcare Authority (NZa) wants to contribute to stimulating the right care in the right place by making it possible to deploy e-health applications more broadly. In 2019 NZa will examine the possibilities for declaring e-health with the focus on district nursing and long-term care. Also, a large part of the e-health projects is in the pilot phase and the Dutch ‘Care for Innovation’ organization developed a step-by-step plan for a systematic approach for e-health introduction.

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05

Mar 2019

In mid-February 2019, the French High Authority for Health (HAS) has published the new guideline to clinical evaluation of connected medical devices in France.

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28

Feb 2019

In January 2019, the National Institute for Health and Care Excellence (NICE) published six new interventional procedure guidance, three medical technologies guidance, and three new MedTech innovation briefings for liver function capacity test, a functional electrical stimulation (FES) integrated cycling system used to start muscle contraction to stimulate trunk and limb muscles in people with spinal cord injury, laser shoe attachment used as a walking aid and is designed to help prevent freezing of gait in people with Parkinson's disease.

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22

Feb 2019

At the beginning of February of 2019, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities which were excluded or included with restrictions into Basic Insurance Package.

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18

Feb 2019

Promising care must find its way to patients more quickly through inclusion in the basic health insurance. That is why the Dutch Ministry of Health, Welfare and Sport has adjusted the promising care with the new subsidy scheme. Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) carries out the scheme in collaboration with the Dutch Organization for Health Research and Development (Nederlandse organisatie voor gezondheidsonderzoek en zorginnovatie, ZonMw). The scheme will replace existing procedure with conditional reimbursement of medical technologies.

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07

Feb 2019

The report presents a summary of reimbursement situation for implantable cardioverter defibrillators. Both Implantable Cardioverter Defibrillators (ICDs) and Cardiac Resynchronization Therapy Defibrillator (CRT-D) are considered. Use of ICD is considered for ventricular tachycardia and ventricular fibrillation. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

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07

Feb 2019

At the end of December 2018, the Federal Joint Committee (G-BA) decided that optical coherence tomography for the diagnosis and therapy control of several retinal diseases will be covered by the statutory health insurance.

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06

Feb 2019

The French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in January 2019. The decisions were made for eighteen medical devices.

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29

Jan 2019

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. In October/November 2018, five new procedure codes for laser correction of refractive error following non-refractive ophthalmic surgery, insertion of urethral catheterization device, injection of botulinum toxin for hyperhidrosis, laparoscopic and robotic-assisted pancreatoduodenectomy have been added to the CCSD Schedule.

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24

Jan 2019

Dutch Healthcare Authority (NZa) has released key features of the DRG package for 2020, including complex chronic lung failure, stem cell transplant care and indexation of DRG tariffs.

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22

Jan 2019

In mid-June, 2018, the Catalan Agency for Quality and Healthcare Evaluation, AQuAS, published the Clinical Practice Guidelines for open-angle glaucoma.

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16

Jan 2019

Report presents summary of the reimbursement situation in Europe for peripheral intravascular ultrasound. Analysis covers iliac, femoral and popliteal arteries. Analysis is provided for admitted and day case hospital care. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

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11

Jan 2019

Federal Department of Home Affairs (FDHA) released changes in coverage of medical procedures, IVD tests and medical aids in Switzerland. They include extension of coverage for neonatal screening to severe congenital immunodeficiencies, extension of coverage under restrictions for TAVI, gene test for breast cancer, PET, PET / CT, local superficial hyperthermia during tumour treatment, external defibrillator and coverage for sub-urethral tapes for the treatment of stress urinary incontinence in women. Also, changes in the coverage for neonatal screening were introduced.

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10

Dec 2018

At the end of September of 2018, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities, which were excluded or included with restrictions into Basic Insurance Package.

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20

Nov 2018

The Dutch Healthcare Authority advises to reward health care providers in specialist medical care on the basis of the health benefits for the patient.

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15

Nov 2018

Adding the MammaPrint® to the standard risk assessment in patients with early-stage breast cancer has not demonstrated health gains compared to the current way of determining whether a patient needs chemotherapy. Dutch National Health Care Institute has concluded that the test is not eligible for reimbursement from the basic insurance package.

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07

Nov 2018

On October 26, 2018, the European Network for Health Technology Assessment has published the final report of femtosecond laser-assisted cataract surgery (FLACS) for the treatment of age-related cataract. The authors of this report are a group of experts from the Italian region of Emilia Romagna, together with Health Austria (Gesundheit Österreich, GÖG).

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25

Sep 2018

The Innovation Credit focuses on the development of promising and challenging innovations with an excellent market perspective. This may involve the technical development of a new product or process or the clinical development of a drug or device. For technical development projects, there is still sample budget available and applications can be submitted.

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24

Sep 2018

On 20th of July, 2018, the Austrian HTA body, the Ludwig-Boltzmann Institute (LBI) released an assessment of the subcutaneous implantable cardioverter defibrillator to determine coverage of the service. Authors concluded that evidence is insufficient to make conclusions about the comparative effectiveness of subcutaneous and transvenous ICDs. However, a substantially lower risk for lead complications in patients treated with subcutaneous ICD.

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24

Sep 2018

The report presents a summary of reimbursement situation for placement of inferior vena cava filter to prevent pulmonary embolism. Permanent and optionally retrievable filters are considered. The only reimbursement within public / statutory health insurance systems is considered. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

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19

Sep 2018

In 2019 the regulation for “conditional reimbursement to the basic insurance” (Voorwaardelijke toelating tot het basispakket) will be replaced by the Subsidy Scheme for Promising Care. The goal is to make promising treatments, medical technologies, tools and medicines available for patients even faster. The Dutch Healthcare Institute is preparing for the implementation of the new subsidy scheme in the coming months.

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08

Aug 2018

In mid-June 2018, the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (REDETS) has published a report which analyzes transbronchial lung biopsy using cryoprobes in diffused lung diseases.

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26

Jul 2018

At the beginning of June 2018, the Federal Department of Home Affairs published an update of the Services Ordinance (Ordinanza sulle prestazioni, OPre). This update concerns many different fields, including the list of laboratory tests.

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16

Jul 2018

Starting with 19th of June, 2018, HIV self-test kits can be bought in pharmacies and druggists all over Switzerland.

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10

Jul 2018

During the last meeting of the Interterritorial Council of the National Health System in Spain (end of April) three decisions about coverage or new services or indications in the National Benefit Catalogue were announced. They concern hearing aids, micropigmentation of the nipples and continuous glucose monitoring. The changes are still due to be formalized in a form of a Royal Decree.

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12

Jun 2018

At the end of April, 2018, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities, which were excluded or included with restrictions into Basic Insurance Package.

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01

Jun 2018

European Med Tech and IVD Reimbursement Consulting Ltd. released a report, which identifies and provides an overview of the innovative payment schemes for medical devices and in-vitro diagnostic tests in European countries. The report was supported by the grant from the Med Tech Europe. Access the full version of the report at our web-site.

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25

May 2018

On the 26th of April of 2018, the Federal Joint Committee (G-BA) has announced the call for a tender for the pilot study “Transcorneal Electrical Stimulation in Retinitis Pigmentosa” in the Official Journal of the European Union. The deadline for the requests is the 22nd of June, 2018, 14:00

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24

May 2018

In mid-May 2018, the Andalusian Agency for Health Technology Evaluation, AETSA, has published a structured summary on 18F-FDG PET in the early diagnosis of degenerative diseases of the central nervous system.

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22

May 2018

Flash Glucose Monitoring (FGM) is covered care for four groups of diabetic patients who are already eligible for reimbursement of real-time continuous glucose monitoring (RTCGM). This is stated in the 'Flash Glucose Monitoring' assesement of the Dutch National Health Care Institute

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14

May 2018

Dutch Healthcare Authority (NZa) has published the DBC product structure and maximum tariffs for specialist medical care for 2019. Healthcare providers and health insurers can start using it for the contract negotiations for 2019. The most important changes include reimbursement for telemonitoring consultation and reimbursement tariffs

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04

May 2018

In late April 2018, AETSA, the Andalusian Agency for Health Technology Assessment, has published a report with the update of evidence regarding prognostic genomic tests in early breast cancer in Spain.

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01

May 2018

In mid-April 2018, the Basque HTA body (OSTEBA) has published recommendations of the clinical practice guidelines and use of the immunological faecal occult blood test for patients with symptoms compatible with colorectal cancer.

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28

Mar 2018

The Dutch Healthcare Authority (Nederlandse Zorgautoriteit) has published a draft version of the DBC package for specialist medical care for 2019 (RZ19a).

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12

Mar 2018

In November 2017, the Andalusian Agency for Health Technology Assessment (AETSA) published an evaluation report (assessed within literature review) on the utility of exome sequencing for diagnosed dysmorphic syndromes.

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06

Mar 2018

Within the Work Package 4 of EUnetHTA Joint Action 3, femtosecond laser-assisted cataract surgery (FLACS) is currently under assessment by a team led by Emilia Romagna Region.

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22

Feb 2018

In March 2013, the National Association of Statutory Health Insurance Funds requested a benefit assessment of surgical lung volume reduction in severe pulmonary emphysema. The Joint Federal Committee (G-BA) decided on February 15th 2018 that the method will remain a benefit in the inpatient sector in Germany. The was supported by a health technology assessment provided by the Institute for Quality and Efficiency in Health Care (IQWiG).

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19

Feb 2018

The deadline for acceptance of applications for conditional reimbursement in 2020 was announced by the is Zorginstituut Nederland, which is 15th of May 2018.

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14

Feb 2018

The Dutch Healthcare Authority (Nederlandse Zorgautoriteit) has published a draft version of the DBC package for specialist medical care for 2019 (RZ19a).

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05

Jan 2018

The generic quality framework and three modules of care describe the general requirements for medical devices for home-based application, included in the Health Insurance Act (Zvw). This framework is not intended for medical devices that fall under the Social Support Act (Wmo) and medical aids provided in intramural settings.

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21

Dec 2017

The Dutch National Health Care Institute (Zorginstituut Nederland) published a position paper with results of 4-years observation of transluminal endoscopic step-up approach in patients with infected pancreatic necrosis. In accordance to this document the procedure fulfils the criteria ‘state of science and practice’. The method can be reimbursed within basic health insurance.

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13

Dec 2017

The changes of the DBC package for specialist medical care in 2019 (RZ19a) will include pediatric oncology, proton therapy, and telemedicine.

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04

Dec 2017

The Dutch National Health Care Institute considered that application of one-way endobronchial valves for endobronchial lung volume reduction fulfills the criteria of “state of science and practice” for patients with severe emphysema and insufficiency of drug treatment. Therefore, this procedure can be included into a basic package for appropriate indication.

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24

Nov 2017

In the first half of November, HAS published a set of decisions about add-on reimbursement of medical devices that were evaluated by the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). These decisions concern orthopedic devices (double-mobility cup, meniscal repair system), electrodes for radiofrequency ablation, portable oxygen concentrator, drug–coated balloons and other devices.

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03

Nov 2017

In October, HAS published a set of decisions about add-on reimbursement of medical devices that were assessed by the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). These decisions concern orthopedic devices (foot prosthesis, bone graft substitute), TAVI using Sapien valve, liquid embolic system, remote monitoring system, wound dressing and home oxygen system.

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02

Nov 2017

Joint Federal Committee (G-BA) evaluated the use of diabetic foot syndrome with hyperbaric oxygen therapy (HBO) as a complementary treatment. Based on studies showing a faster healing process, the G-BA decided to include the method as a benefit in the outpatient sector and expand the indication for the method to a lower severity grade in the inpatient sector.

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25

Oct 2017

In accordance with Health Insurance Act (Zvw) and Long-term Care Act (Wlz) the basic package of insured health care includes only health care that fulfills the criteria of “state of science and practice”. In September 2017, ZIN published opinion paper on the basis of reevaluation of the procedure. It was only recommended for coverage for non-resectable colorectal liver metastases. Other indications were not approved for coverage.

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23

Oct 2017

On 13th of October of 2017, the Ministry of Health of Poland commissioned Agency of Health Technology Assessment and Tariff Systems (AOTMiT) to assess the benefit of angioplasty of arteries of lower extremities (femoral and popliteal) with drug-eluting balloons.

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20

Oct 2017

The analyses were performed on the 2015 data from 16 Regions, on the basis of 35 indicators. According to the score assigned, Regions were classified as “compliant” (i.e., score ≥ 160 or between 140 and 160 with no critical values in any of the indicators) or “non-compliant” (i.e., score < 140 or between 140 and 160 with at least one critical value in one of the indicators). Overall results showed that the Country is split into two sections: Regions in the north were all compliant while those in the south, with the only exception of Basilicata, showed suboptimal performances.

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17

Oct 2017

French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in September 2017. They include knee and hip prostheses, therapeutic shoes, coronary stents, heart valves, peripheral stents, and balloons.

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10

Oct 2017

At the beginning of August 2017, the French National Authority for Health (HAS) published a health technology assessment of systems for remote monitoring for implantable cardioverter defibrillators (ICD). The aim of this assessment was an update and clarification of arrangements for the provision of implantable cardioverter defibrillator systems (ICDS) to improve the quality of care for patients with ICD and to promote the deployment of effective solutions in the country.

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29

Sep 2017

After successful trial application by the manufacturer (Okuvision) of a stimulation technology (Okustim), the Federal Joint Committee (G-BA) decided on a trial guideline for a co-funded study defining the key points of the planned study, including type and time period of the study, target population and control intervention. Results from the trial will be evaluated and may lead to reimbursement of the method in both, the inpatient and outpatient sectors.

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28

Sep 2017

MTRC has analyzed timing of decision-making (negotiation about price, final ministerial decision and publication of the decision) after recommendation by CNEDiMTS about expected benefit (AS) and added clinical value (ASA) for invasive non-implantable medical devices reimbursed via LPPR list, title V. Since establishment of the title V program, 5 technologies were added to the List (stent retrievers for stroke; peripheral drug-coated balloons). Time from the recommendation by CNEDiMTS until the start of reimbursement varied from 7 to 13 months (9.4 months on average).

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21

Sep 2017

Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) released results of a re-evaluation of percutaneous volume reduction of the intervertebral disk with a focus on chemolucleolysis. Based on current evidence, chemonucleolysis was recommended for inclusion into health benefit catalogue in Austria while percutaneous nucleotomy and percutaneous laser disc decompression were currently not recommended.

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18

Sep 2017

Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) released results of re-evaluation of leadless pacemakers for right ventricular pacing. Due to lack of comparative evidence vs conventional pacemakers, leadless pacemakers were not recommended for inclusion into health benefit catalogue in Austria.

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06

Sep 2017

French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2017. They include different types of stents and stent-grafts for multiple indications (coronary, peripheral vascular), mechanical thrombectomy devices for stroke, medical devices applied for treatment of ulcer of venous origin, remote monitoring for Implantable Cardioverter Defibrillator Systems (ICDS).

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05

Sep 2017

Ludwig Boltzmann Institute HTA evaluated EST for GERD and found the current evidence insufficient to recommend its inclusion into health benefit catalogue. Reevaluation is recommended in 2022 when more evidence becomes available.

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04

Sep 2017

There is an ongoing process to change the structure of add-on reimbursement for peripheral vascular stents in France. In July 2017 CNEDiMTS issued additional clarifications about proposed reimbursement requirements for stents and stent-grafts. Read about proposed changes in our post.

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22

Aug 2017

The Clinical Coding and Schedule Development Group develops and maintains procedural and diagnostics nomenclature for private payers in England. New codes were added for video-assisted anal fistula treatment, infracoccygeal sacropexy using mesh to repair uterine and vaginal vault prolapse.

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17

Aug 2017

In 2017, PAE was evaluated by the Ludwig Boltzmann Institute – Health Technology Assessment (LBI-HTA) to define whether evidence for this minimally invasive procedure can be sufficient for inclusion into benefit catalogue. Within this research work, evidence in relation to efficacy and safety of PAE was assessed in comparison to transurethral resection of the prostate (TURP) and open prostatectomy. Based on the results of literature review, LBI-HTA did not recommend PAE for inclusion into benefit catalogue in Austria. LBI-HTA recommended re-evaluating PAE procedure in the 2021 year when new potential evidence is available.

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11

Aug 2017

In the Netherlands, there is a possibility to test novel ways of delivering health care services (e.g. mobile diagnostic modules, online counselling, telemonitoring, screening/diagnostic for some complex conditions in primary care etc.) by establishing short (3 years) experiments between health provider and insurance company. After completion of experiment, analysis shall be performed about effect of the intervention. If it works, a new model can be population as novel type of care service in broader settings. See full list of ongoing small-scale experiment projects, extracted by MTRC.

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08

Aug 2017

The Ludwig Boltzmann Institute – Health Technology Assessment (LBI-HTA) has published report with results of systematic literature review of application extracorporeal cytokine adsorption therapy (ECAT) for treatment and prevention of sepsis or systemic inflammatory response syndrome (SIRS). Considered evidence was assessed as insufficient to prove that ECAT is effective and safe procedure in patients with sepsis, septic shock and SIRS. Therefore, ECAT is currently not recommended for inclusion into the benefit catalogue.

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02

Aug 2017

Dutch National Health Care Institute (Zorginstituut Nederland) has confirmed scope of surveillance on implementation of radioembolization with Yttrium-90 microspheres as salvage therapy for patients with non-resectable liver metastases of colorectal cancer origin in the Netherlands. The focus will be on evolution of cost and volume of procedures, concentration of care in few designated centers and implementation of clinical protocol for use of procedure.

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28

Jul 2017

The Ludwig Boltzmann Institute – Health Technology Assessment (LBI-HTA) has published results of systematic literature review of evidence in relation to efficacy and safety of radiofrequency ablation for patients with metastatic spinal lesions. In conclusion, LBI-HTA recommended radiofrequency ablation of spinal metastatic lesions for inclusion in benefit catalogue with restrictions.

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21

Jul 2017

Dutch Health Care Authority (NZa) has been working on developing tariffs for diagnosis-related groups (DBCs) to reimburse special medical rehabilitation care (medisch-specialistische revalidatiezorg, msrz). Originally, it was planned to roll out new payment model (DRGs with national tariffs) in 2019, however, NZa decided that more time is needed to collect cost data to determine appropriate tariffs.

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19

Jul 2017

Researchers evaluated care process, access, administrative efficiency, equity and health care outcomes in 11 countries on the basis of published health care statistics for 72 indicators. The best overall performers among European countries were the UK (ranked 1st), the Netherlands (3rd), Norway (4th), Sweden and Switzerland (6th). Germany (8th) and France (10th) were low in the ranking.

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18

Jul 2017

The treatment with autologous fat transplantation (AFT) may be a part of the basic health insurance package under certain conditions, including defects of the head and / or neck region, HIV-associated lipoatrophy and, and fibrosis (scarring), as recommended by the Dutch Health Care Institute (Zorginstituut Nederland).

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14

Jul 2017

Report provides overview of procedure coding, payment mechanism, reimbursement tariffs and policy considerations for mechanical and pharmacomechanical (AngioJet, Boston Scientific) thrombectomy, catheter-directed and ultrasound-enhanced catheter-directed (EKOS, BTG) thrombolysis in iliac, femoral and popliteal veins in 11 European countries.

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06

Jul 2017

An assessment was initiated earlier this year. The Institute will evaluate compliance of dynamic fusion in lumbar spondylosis with the state of science and practice.

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23

Jun 2017

An assessment was initiated earlier this year on the request from Dutch Hypertension Society and umbrella organization of 9 health insurance companies Zorgverzekeraars Nederland. The Institute will evaluate compliance of baroreflex activation therapy (BAT) for treatment of resistant hypertension with the state of science and practice.

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21

Jun 2017

The deadline for acceptance of applications for conditional reimbursement in 2019 by the Care Institute Netherlands (Zorginstituut Nederland) is 29th of June 2017. Conditional reimbursement for the period of up to 4 years can be available for promising technologies, which did not meet criteria for “state of science and practice” in the assessments of Zorginstituut Nederland.

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13

Jun 2017

The Care Institute Netherlands (Zorginstituut Nederland) has released information that real-time continuous glucose monitoring is now included into the basic health insurance package for two additional groups of patients suffered from diabetes: women with diabetes who wish to become pregnant and patients with type 1 diabetes with repeated severe hypoglycemia.

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08

Jun 2017

Administrators of the “New Method” program, which is focused on managed introduction of innovations into Norwegian system, have initiated technology assessments of 10 technologies and now have requested manufacturers to make submission of clinical and economic evidence.

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10

May 2017

This post presents an extract from our reimbursement analysis for angioplasty of arteries of lower extremities with stenting using bare metal and drug-eluting stents for peripheral arterial disease in England, France and Germany. Procedure is reimbursed via combination of diagnosis-related group (DRG) and add-on reimbursement in England and France and solely via DRG in Germany.

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08

May 2017

Ministerial decree to enlist Medtronic's IN.PACT Admiral for the LPPR title V for add-on reimbursement was published on 6th of May 2017 in the Official Journal of French Republic. This is not only the first peripheral DCB on the List, but one of the first invasive non-implantable devices to get add-on reimbursement in France.

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01

May 2017

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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28

Apr 2017

Suggestions for change of DRG system will be accepted by Dutch Healthcare Authority (NZa) by 1st of June 2017. If accepted, changes will be implemented in 2019.

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