Selective internal radiation therapy (SIRT)

In July 2024, the National Institute for Health and Care Excellence (NICE) published one new Diagnostics Guidance (CYP2C19 genotype testing to guide clopidogrel use after ischaemic stroke or transient ischaemic attack) and one Technology Appraisal Guidance (Selective internal radiation therapy with QuiremSpheres for treating unresectable advanced hepatocellular carcinoma).

In May 2024, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedures Guidance concerning selective internal radiation therapy for liver metastases, endoscopic duodenal mucosal resurfacing in type 2 diabetes, and image-guided percutaneous laser ablation for liver tumours, and one Diagnostics Guidance on tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer.

In late March 2024, NHS England released the amended 2023/25 NHS Payment Scheme (NHSPS) to come into force on April 1, 2024. No changes were made to the general payment model. Eight new items were added to the High Cost Devices List, and one new device was added to the MedTech Funding Mandate. New reimbursement codes and tariffs for three types of specialist radiotherapy were introduced. Furthermore, HRG tariffs were uplifted for 2024/25.

In February 2023, the Scottish Health Technology Group, SHTG, released three MedTech-related assessments: selective internal radiation therapies (SIRT) for treating primary hepatocellular carcinoma, Feeling Good app, store-and-forward teledermatology for triage of primary care referrals.

In Q1 of 2022, Health Technology Wales (HTW) published one MedTech-related guidance on transcranial magnetic stimulation in depression treatment. A total of eleven Topic Exploration Reports (TERs) were released in Q1. Based on the TERs conclusions, HTW's Assessment Group decided to proceed with developing an Evidence Appraisal Report (EAR) and Guidance on one topic only - radiofrequency renal denervation for the treatment of resistant hypertension.

On July 30, 2021, the Swiss Federal Statistics Office (UFS) published the 2022 version of the procedure code (CHOP) nomenclature in the German language. The newly introduced codes concern various technology groups, such as cardiovascular, gastrointestinal, neurology, interventional radiology, orthopedics, gynecology, and others.

On March 31, 2021, NICE published Technology Appraisal Guidance on selective internal radiation therapies (SIRT) for treating hepatocellular carcinoma (HCC). Technology Appraisal is the only NICE program that has a direct link with the acceptance of technologies by payers. Payers need to implement the recommended technologies within three months after the publication of the guidance. Medical devices are very rarely evaluated within the Technology Appraisal program. SIR-Spheres and TheraSphere were recommended to treat unresectable advanced HCC under certain conditions, while QuiremSpheres was not recommended.

On March 30, 2020, the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) announced five projects which received a subsidy under the "Subsidy scheme for promising care" in 2021: repetitive transcranial magnetic stimulation and in vivo exposure with response prevention in obsessive-compulsive disorder; MRI-guided laser-induced thermotherapy in glioblastoma; personalized treatment with selective internal radiotherapy in elderly or vulnerable colon cancer patients with liver metastases; structured, multidisciplinary and person-centered intensive care aftercare for patients at risk of health problems; Basophil Activation Test in children with possible IgE mediated cow's milk allergy.

In March 2020, the National Institute for Health and Care Excellence (NICE) published four new interventional procedure guidance (for bilateral cervicosacropexy or vaginosacropexy using mesh for pelvic organ prolapse, cyanoacrylate glue occlusion for varicose veins, MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy and selective internal radiation therapy for unresectable colorectal metastases in the liver) and five Medtech innovation briefings (for Cor-Knot for tying suture knots in valve surgery, artificial intelligence for analyzing CT brain scans and others).

The report presents a summary of the reimbursement situation for selective internal radiation therapy (SIRT) in Europe. Different types of microspheres for SIRT are covered in the report, including those use the radionuclide yttrium-90 and based on the radionuclide holmium-166. 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.

In October, the National Institute for Health and Care Excellence (NICE) published one new interventional procedure guidance for selective internal radiation therapy for unresectable primary intrahepatic cholangiocarcinoma, one updated medical technologies guidance endoluminal stent graft system designed for treating aneurysms and dissections of the thoracic aorta and one new medical technologies guidance for a titanium implant intended for use in people with chronic sacroiliac joint pain and three new medtech innovation briefings for device used for babies and children up to 30 kg who need mechanical ventilation, gammaCore for cluster headache and system that delivers warmed and humidified respiratory gases, including at high-flow rates.