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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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Overview of Swiss HTA program released by the Swiss Federal Office of Public Health

In mid-November, the Federal Office of Public Health (FOPH) presented the Swiss HTA program in a poster presentation, “Bridging the Gap: How to Align HTA and Health Care Decision Making in Switzerland” at the Professional Society for Health Economics and Outcomes Research (ISPOR) conference. 

The Swiss HTA program is an innovative program that connects research with policy making. In 2017, an HTA unit was established within the FOPH following a decision by the Federal Council in 2015 to intensify efforts in HTA.

Health technologies covered by compulsory health insurance must be effective (E), appropriate (A), and economically efficient (E), alias the EAE criteria. New health technologies that do not meet the EAE criteria are not eligible for coverage. For health technologies that are already reimbursed, re-evaluation of the criteria can result in reimbursement arrest. The HTA program was developed to facilitate the evaluation of the EAE criteria in a systematic, reproducible, and transparent manner.

Discrepancies were found between the information reported in the HTA reports and the information requested by the policy makers. For example, 1) the policy makers often requested Swiss clinical expert opinions, despite the presence of higher-level quality evidence, 2) cost-effectiveness findings were requested by some, but not all policymakers, and 3) the length and the language used in the HTA reports were typically considered too long and too scientific.

Some modifications in the HTA process were implemented to address the discrepancies:

  • Engaging Swiss clinical experts early in the HTA process;
  • Organizing round table discussions between the assessment team, experts, and/or policy makers;
  • Developing survey questionnaires to collect direct Swiss patient data;
  • Introducing lay language summaries.

The authors concluded that the Swiss HTA program is an innovative program that is still exploring and testing alternative steps to minimize the gap between HTA and healthcare decision making.

See the details here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.