Positive funding decision after benefit assessment of surgical lung volume reduction in severe pulmonary emphysema by G-BA

New methods and technologies are generally included in the inpatient benefits catalog in Germany, if they are not explicitly excluded. However, assessments of new methods can be requested by certain players of the healthcare system. In this case, the Joint Federal Committee (G-BA) determines whether a method is necessary for the sufficient, appropriate and efficient provision of health care to the insured, considering the generally accepted state of medical knowledge. As a result, the method can receive a positive funding decision, a government-co-funded study can be induced to create further evidence, or the method can be excluded from reimbursement the social health insurance (SHI) in Germany. The decisions by the G-BA are published in the directive for inpatient benefits.

In March 2013, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) requested the assessment of surgical lung volume reduction in severe pulmonary emphysema. The G-BA evaluated the method and concluded that it is with regard to the above-mentioned criteria and came to the conclusion that it is necessary for the sufficient, appropriate and efficient provision of care in Germany. Surgical lung volume reduction in severe pulmonary emphysema will therefore remain a benefit in the inpatient sector. This is manifested in Annex I of the inpatient benefit directive. The decision by the G-BA was supported by a health technology assessment provided by the Institute for Quality and Efficiency in Health Care (IQWiG).

The decision document and justifications of the decision here.

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