Orthopedic procedures

On July 30, 2021, the Swiss Federal Statistics Office (UFS) published the 2022 version of the procedure code (CHOP) nomenclature in the German language. The newly introduced codes concern various technology groups, such as cardiovascular, gastrointestinal, neurology, interventional radiology, orthopedics, gynecology, and others.

In July 2021, the Austrian Institute for Health Technology Assessment (AIHTA) published six new decision support documents and one update to a previous decision support document. The assessed topics included percutaneous left ventricular assist devices, liposuction for surgical therapy of lipoedema, triphasic biomaterial for augmentation of the osteoporotic femoral neck, endoscopic plication therapy in patients with gastroesophageal reflux disease (GERD), allogenic bone screw Shark Screw® in patients with hallux valgus or scaphoid fractures/pseudarthroses, and surgical interventions for the treatment of benign prostatic hyperplasia. The updated decision support document concerned implantable bulking agents for fecal incontinence.

In March 2021, the National Institute for Health and Care Excellence (NICE) published four new Interventional Procedure Guidance (transcervical ultrasound-guided radiofrequency ablation for symptomatic uterine fibroids, extracorporeal whole liver perfusion, free-functioning gracilis transfer to restore upper limb function, cytoreduction surgery with hyperthermic intraoperative peritoneal chemotherapy), two Medical Technologies Guidance (Danis stent for acute oesophageal variceal bleeding, Alpha-Stim AID for anxiety disorders), two Medtech Innovation Briefings (Sonata system for symptomatic uterine fibroids, Butterfly iQ+ for diagnostic ultrasound), and one Diagnostic Guidance (QAngio XA 3D QFR and CAAS vFFR imaging software for assessing coronary stenosis). Also, five clinical guidelines were updated.

In March 2021, the National Institute for Health Research (NIHR) in England released six MedTech-related reports in its Health Technology Assessment (HTA) Journal, which concerned sacral nerve stimulation and magnetic sphincter augmentation device for fecal incontinence treatment, patch augmentation surgery for rotator cuff repair, in-vitro diagnostics, and eHealth. HTA Journal publishes research reports on the effectiveness, costs, and broader impact of health technologies for those who use, manage, and provide care in the NHS and inform National Institute for Health and Care Excellence (NICE) guidance.

On October 30, 2020, the Swiss Federal Statistics Office (UFS) published the 2021 version of the procedure code (CHOP) nomenclature in French and Italian. The version in the German language was published in July 2020. The most important changes regard cardiovascular and peripheral vascular interventions.

In late September 2020, the Austrian version of the DRG system (LKF) 2021 model with the relevant supplementary documents was published in Austria. For 2021, the main changes include the addition of sixteen new procedure codes and the introduction of two new procedure codes for billing in the day-case settings, update of cases flat rates, and adjustments of the cases daily component calculation.

On behalf of the Federal Joint Committee (G-BA), the Institute for Quality and Efficiency in Health Care (IQWiG) investigated to what extent adults with symptomatic knee cartilage defect (but without advanced arthrosis) could benefit from autologous chondrocyte implantation (ACI) of different types: periosteal-covered (ACI-P), collagen-covered (ACI-C) or matrix-associated (M-ACI).

The HTA unit of the Lombardy region opens the possibility for the public to comment on the health technologies which are in the assessment phase. The call is open until February 28, 2020.

In December 2019, the Swiss Medical Tariff Commission (MTK/CTM) has published their recommendations regarding the knee Autologous Chondrocyte Implantation (ACI). The CTM recommends covering the costs of the implant for knee ACI until the end of 2024.

In late November 2019, new HTA activities were published on the website of regional HTA program of Lombardy Region, after a period of inactivity. Twenty-six (26) new technologies are currently in various stages of the HTA process, and they should all be completed in 2020.

In November 2019, the Skåne Region released an HTA report for arthroscopic subacromial decompression (ASD) in subacromial pain syndrome that aimed to evaluate the scientific evidence for the procedure. It was concluded that the degree of clinical evidence is limited due to lack of study quality; the certain safety conclusions cannot be drawn due to the data diversity.

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 orthopedics technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for orthopedics devices in Europe.