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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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Resumption of assessments for two methods in the field of oncology by Joint Federal Committee (G-BA) in Germany

Following assessments are resumed by the Joint Federal Committee:

  • Interstitial low-dose rate (LDR) brachytherapy in localized prostate carcinoma
  • Positron emission tomography (PET); PET/computed tomography (CT) for malignant lymphomas in children and adolescents
  • Positron emission tomography (PET); PET/computed tomography (CT) for interim staging in Hodgkin's lymphoma at the intermediate or advanced stage after two to four cycles of chemotherapy to decide about the continuation of therapy

The assessment procedures for these methods were paused due to insufficient evidence and in expectation of relevant publications from ongoing studies at that time. The methods had therefore been listed in Annex II A for suspended investigation procedures in view of planned and ongoing studies of the directive methods of examination and treatment in hospital settings.

The decision for resumption by the Joint Federal Committee on September 21st, 2017 before the deadline was grounded on the estimation that sufficient evidence has been published to provide a sufficient decision basis.

LDR brachytherapy is assessed for the provision in both inpatient and outpatient sector while the assessment of PET and PET/CT only regards provision in the inpatient sector. For the evaluation of LDR brachytherapy, the Joint Federal Committee may request decision support by the Institute for Quality and Efficiency in Health Care (IQWiG). In case of a negative assessment of the available evidence, the methods will be excluded from social health insurance in Germany.

See the G-BA’s decision document regarding LDR brachytherapy here.

See the G-BA’s decision document regarding PET, PET/CT here.

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