Peripheral vascular interventions

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in June 2021. Recommendations concern cardiovascular and peripheral vascular devices, orthopedic devices, liquid for embolization, and medical aids.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in May 2021. Recommendations concern orthopedic devices, cardiovascular, peripheral vascular, and neurovascular devices, medical aids, and pulmonary artery pressure sensor.

In April 2021, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedure Guidance (repetitive short-pulse transscleral cyclophotocoagulation for glaucoma, deep brain stimulation for chronic, severe, treatment-resistant obsessive-compulsive disorder in adults, and Melphalan chemosaturation for primary or metastatic cancer in the liver) and two Medtech Innovation Briefings (microINR for anticoagulation therapy and RenalSense Clarity RMS for acute kidney injury), and two clinical guidelines (for atrial fibrillation and chronic pain in over 16s).

On April 22, 2021, the List of reimbursable implants and invasive medical devices, maintained by the National Institute for Health and Disability Insurance (INAMI), was updated with the corresponding Nominative lists of brand-specific devices. Two new Nominative lists with reimbursable devices used for peripheral vascular interventions were introduced.

On January 29, 2021, the Institute for the Hospital Remuneration System (InEK) has published the List of the requests for innovation funding (NUB) that were submitted by the hospitals in 2020. The medical technologies belonging to the cardiovascular, ENT, eHealth, gastrointestinal, neuromodulation, neurovascular, orthopedic, and other technology groups obtained positive status 1.

On January 18, 2021, a new version of the List of Reimbursable Products and Services (LPPR) was published. It contains new devices included in the LPPR list in November-December 2020, as well as other modifications made during this period. Newly-introduced devices belong to the cardiovascular (coronary stents), orthopedic, neuromodulation (deep brain stimulation), peripheral vascular (stent-grafts to treat aortic abdominal aneurysm), and other areas of care.

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 Sensible Care projects, the Dutch Healthcare Institute, together with other parties, is investigating the possibilities for improving care pathways for patients. As of early November 2020, there are 30 ongoing projects, including two projects for assessing knee and hip osteoarthritis treatment and medicines for castration-refractory prostate carcinoma at the final evaluation phase.

The Health Institute Carlos III (ISCIII) in Spain analyzed the effectiveness and safety of the endovenous ablation of varicose saphenous veins with cyanoacrylate closure system in patients with moderate to severe chronic venous insufficiency compared to surgical procedures, as of saphenous vein stripping, and other endovenous ablation techniques. In the report, published on the website in 2020, it was outlined that despite the limitations found in selected studies, intravenous sealing with cyanoacrylates seems to be a promising alternative to existing treatments, especially in terms of less use of anesthesia and compression bandage, as well as shorter recovery time.

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In February 2020, CAMTÖ started its work on the assessment of peripherally inserted central venous catheter. After the completion of the evaluation process, the report would be published at the web-site of Örebro County Council.

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.

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.