Reimbursement

In October 2021, the National Board of Health and Welfare released the Swedish version of the 2022 NordDRG. Six new DRGs were added, and they concern the cardiovascular area, vaccination, cochlear implants, and visits in primary care. Also, several changes in DRG content and logic were made.

In October 2021, NHS England issued an updated version of the National Genomic Test Directory for 2021/2022, which lists genomic tests commissioned by NHS England via Genomic Laboratory Hubs. Twenty new codes (test-indication combinations) were introduced in the cancer field, and 115 new codes were added for rare and inherited diseases.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on October 1, 2021. The most significant changes concern mainly IVD tests: extension of the newborn screening, the introduction of microsatellite instability testing, amendments of Oncotype DX® test reimbursement, the introduction of screening for hepatitis B and C as part of health check-up, as well as changes in reimbursement of radiation therapy services.

On September 27, 2021, the Decision Forum for "New Methods" decided not to introduce bronchial thermoplasty as a routine treatment of patients with severe asthma. The method should only be used within clinical trials.

On September 15, 2021, the Evaluation Committee (Bewertungsausschuss) has decided to introduce in the EBM (German Uniform Evaluation Standard) the new code for Oncotype DX® testing. This change is introduced in the updated EBM version, which was published on October 1, 2021.

On September 23, 2021, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system and associated tariffs for state and private laboratories to be implemented no later than November 01, 2021. NLK system has been used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018. Thirty-nine new codes were added in medical biochemistry, clinical pharmacology, and medical microbiology areas.

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 September 2021. In total, 58 recommendations for registration, modification of registration conditions, and removal of devices from the List of reimbursable products and services (LPPR) were published. Opinions concern cardiovascular, orthopedic, peripheral vascular, and other groups of devices, as well as medical aids.

On September 30, 2021, the 2020/21 National Tariff Payment System was published in England, and it came into effect on October 01, 2021. The publication has been delayed due to the COVID-19 pandemic.

On September 10, 2021, it was announced that the Government of Spain had increased the budget allocated to the Spanish Network of Agencies for the Evaluation of Health Technologies and Benefits (RedETS) by 48.2% (compared to last year) for the development of the annual work plan. In total, the 2021 budget for the evaluation of health technologies in the National Health System amounts to €6,149,510. As a consequence of the budget increase, the RedETS 2021 Work Plan has included three new lines of evaluation.

On August 26, 2021, the Dutch Healthcare Authority (NZa) published the fourth release of the DRG package for the year 2021 (RZ21d).

At the beginning of September 2021, the Government of the Russian Federation released the preliminary version of the Program of State Guarantees for the period of 2022-2024. Major changes concerned the High-End Medical Care (HEMC) list I, where two new procedures in the cardiovascular and neurovascular field were added. The HEMC list II was expanded with the procedures in the field of radiotherapy, neurology, and neurosurgery, surgical procedures. The final version is expected at the beginning of 2022.

On August 30, 2021, the Decision Forum for "New Methods" made a positive coverage decision for two methods: Transurethral Microwave Thermotherapy (TUMT) for benign prostatic hyperplasia treatment and organ donation using normothermic regional perfusion in patients with severe brain injury and who died of cardiac and respiratory arrest when life-prolonging treatment is discontinued.