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Cost-efficient European adaptations of global health economic models

Experience with model adaptations in Austria, Belgium, France, Germany, Italy, Norway, Netherlands, Spain, Sweden, the UK

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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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Reduction of reimbursement tariffs for IVD tests registered in the NABM nomenclature in France

The National Convention for Laboratory Directors was concluded between, on the one hand, the national health insurance funds and, on the other hand, the Union of Biologists of France, the National Center of Biologists, and the National Professional Syndicate of biologists in 1994. This Convention and amendments published to it define, among other things, the value of coefficients, including coefficient B, that is used for the calculation of reimbursement tariffs for the tests registered in the main reimbursement catalog for IVD tests – Nomenclature of Medical Biology Acts (NABM).

The National Union of Health Insurance Funds (UNCAM) and associations of medical biologists signed Addendum 11 to this National Convention in January 2023. The Addendum aims to implement the financial measures provided for by the Social Security Financing Act, which will lead to cost savings in the medical biology sector.

On January 31, 2023, the Order approving this Addendum was published in the Official Journal of the French Republic. According to the Addendum, as of February 2023, the base-rate value with which the B-coefficient is multiplied to obtain reimbursement tariff in euros is reduced by one euro cent (for metropolitan departments – from 0,27 to 0,26), which leads to the reduction of tariffs for medical biology tests registered in the NABM.

Furthermore, one of the plans described in the Addendum is to build a multiannual framework for steering medical biology expenditure for the years 2024-2026. The following objectives are pursued:

  • Maintain a high level of support for medical biology examinations that are currently used;
  • Continue to support the tests related to Covid-19;
  • Ensure the dissemination of innovation and participate in the regulation of health insurance expenditure.

See the details in French 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). Contact us to get a free, three-month, no-obligation trial.