Spine procedures

On June 8, 2023, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) published an updated List of reimbursable devices and Nominative lists of brands to come into force on July 1, 2023. Three new material codes concerning cardiovascular and spinal procedures were introduced. Several new branded devices were registered on the Nominative Lists connected to new and already existing material codes.

The Dental and Pharmaceutical Benefits Agency is currently conducting several health economic assessments of products for electrical spinal cord stimulation. The assessments were commissioned by the Medical Technology Product Council as the first step of the national Orderly Introduction process for new medical devices. The evaluations are planned to be accomplished during 2023.

In April 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0183 and 0080 with changes to be implemented no later than June 14, 2022. Eleven new procedure codes and nine new diagnostic codes were introduced.

In mid-December 2021, the Danish Health Data Agency (Sundhedsstyrelsen) published the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: 41 new diagnosis codes and 21 procedure codes were added. The newly added procedure codes concern mainly spine area and orthopedic procedures.

On April 20, 2021, the Dutch Healthcare Institute (ZIN) published an annual report on the progress of the conditional reimbursement program. In 2020, there were 13 ongoing projects under the program, six of which concerned medical technologies. Furthermore, in 2020, percutaneous transforaminal endoscopic discectomy for the treatment of lumbosacral radicular syndrome in lumbar disc herniation was included in the basic insurance package as regular care.

In February 2021, the Health Technology Assessment Agency of the Health Institute Carlos III published the report for the efficacy and safety of robotic spinal surgery compared to manual surgery in spinal fusion.

The HTA body of the Tuscany Regional Healthcare issues two types of documents: HTA forms and motivational forms. With a regional decree 554 of January 18, 2021, Tuscany Regional Healthcare has published assessments of eight medical devices of various therapeutic areas, including devices for the treatment of cardiovascular conditions, personal diabetes management system, endoscopic devices, and pedicle screw system.

In Finland, the Health Care Services Selection Council (Terveydenhuollon palveluvalikoimaneuvosto, PALKO) is responsible for making recommendations regarding the research, treatment, and rehabilitation methods. Currently, the Council is working on assessments of chronic low back pain treatment and screening for severe combined immune deficiency in a neonatal heel sample.

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including spine technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for spine devices in Europe.

In Finland, the Health Care Services Selection Council is responsible for making recommendations regarding the research, treatment, and rehabilitation methods. Currently, PALKO is working on the only one assessment related to medical technologies - rehabilitation and treatment of lumbar spine dislocation. In the final report, the Council would conclude whether the procedure is a part of publicly funded services or not.

The report presents a summary of reimbursement situation for balloon kyphoplasty. The following indications will be considered: osteoporosis with pathological fracture, secondary malignant neoplasm of spine (breast cancer). 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.

The report presents a summary of reimbursement situation for percutaneous vertebroplasty. The following indications are considered: osteoporosis with pathological fracture, secondary malignant neoplasm of spine (breast cancer). 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.