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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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Seven technologies will be supported by the 2022/23 MedTech Funding Mandate in England

In early December 2021, NHS Accelerated Access Collaborative announced the technologies that will be supported by the MedTech Funding Mandate (MTFM) in 2022/23. The MTFM launched on April 01, 2021, to support NICE-approved and cost-saving devices, diagnostics, and digital products. It is mandatory for commissioners and providers to implement technologies included in MTFM.

Four technologies included in 2021/22 (placental growth factor-based testing, SecurAcath, HeartFlow, and gammaCore) will continue to be supported in 2022/23. MTFM technologies are reviewed annually to ensure that they meet the policy criteria.

Technologies that meet the following criteria will be supported by 2022/23 MTFM:

  • Effective: demonstrated through positive NICE Medical Technology Guidance (MTG) or Diagnostic Guidance (DG), published by June 30, 2021;
  • Cost-saving within three years of implementation: as demonstrated by NICE modeling and published in a NICE resource impact template;
  • Affordable to the NHS: the NICE budget impact analysis total costs should not exceed £20 million in any of the first three years.

The Innovation, Research, and Life Sciences (IRLS) team, together with NICE, assessed all available MTG and DG published by June 30, 2021, to choose technologies that meet the criteria. The technologies meeting the criteria for inclusion in the 2022/23 MTFM were categorized into two themes.

Four technologies were chosen for benign prostatic hyperplasia (BPH) treatment. These less invasive innovations allow patients with BPH to be treated as day cases. Providers will not be expected to implement all four technologies; instead, each would be expected to work with its Academic Health Science Network (AHSN) and the Getting It Right First Time (GIRFT) Urology Area Networks to understand its technology needs and the potential uptake locally.

  • UroLift, a system that lifts and holds the enlarged prostate tissue away from the urethra, relieving the compression of this organ. It can be performed under local anesthesia in an outpatient setting or ambulatory care center, and the patient can return home the same day without a catheter;
  • GreenLight XPS is cystoscopic photoselective laser vaporization that can be done as a day case procedure;
  • Rezum, a minimally invasive procedure that uses water vapour (steam), delivers targeted, controlled doses of stored thermal energy in water vapour directly to the region of the prostate gland with the obstructive tissue. Patients can be treated as outpatients;
  • PLASMA system, a bipolar electrosurgery system for transurethral resection and hemostasis of the prostate, helps to avoid the risk of transurethral resection syndrome. This procedure can be done as a day case.

Three products were chosen for improving the patient experience during procedures, as innovative alternatives that are either less invasive or use digital technology to increase efficiency and improve outcomes compared to current procedures.

  • The XprESS multi-sinus dilation system is a sterile, single-use device for treating chronic sinusitis. It can reduce the tissue lost compared to traditional functional endoscopic sinus surgery (FESS) procedures;
  • The Spectra Optia is an apheresis and cell collection platform for treating sickle cell disease. It separates and removes sickle red blood cells from the patient's blood using continuous flow and centrifugation in a typical exchange procedure. These are replaced with healthy red blood cells according to the user-defined software protocol;
  • Thopaz+ is a portable digital chest drain system that provides regulated negative pressure close to the patient's chest and continuously monitors and records air leaks and fluid drainage. Sensors in the system turn the pump on and off to ensure the pressure level set by the healthcare professional is precisely maintained.

In total, eleven technologies will be covered by MTFM in 2022/23. The final list of technologies will be included in the 2022/23 MTFM policy guidance to be published later this winter.

See the full details here

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