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Cost-effective reimbursement analysis for medical technologies in Europe

Procedure coding, payment mechanism, reimbursement tariffs, policy, and HTA considerations in 34 EU countries

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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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The status of ongoing reform of the Belgian Nomenclature and planned next steps

On June 18, 2024, the Belgian National Institute for Health and Disability Insurance (INAMI/RIZIV) updated the information about the status of the ongoing structural reform of the Nomenclature started in 2019. INAMI/RIZIV reported on activities already completed as of June 2024 and announced further steps. 

INAMI/RIZIV Nomenclature (and Pseudo-nomenclature) is a coded list of medical services wholly or partially reimbursed by compulsory health insurance. The reform aims to restore a new logic and structure to the current Nomenclature. Only the part of the Nomenclature concerning physicians' services will be reformed. Articles for the services of other health professions (e.g., nurses) are not considered in this reform. The following changes are expected:

  • The current Nomenclature is linked to the medical profession/specialty. In the updated Nomenclature, a new classification will apply, which will be based on the anatomical principle rather than medical specialty;
  • The current Nomenclature codes composed of six digits will be replaced by seven-digit codes without any notion or reference to a profession.

The reform is scheduled into three phases:

  • Phase 1 "Restructuring and adapting the description of services" is completed;
  • Phase 2 "Establishment of relative value scales for the professional section" is currently underway;
  • Phase 3 "Development of fees" is the final phase, which will start after completion of Phase 2. In physician fees, the professional part (fees intended to cover all costs directly or indirectly related to the provision of medical services that are not covered by other sources) will be distinguished from the intellectual part (fees intended to cover the doctor's services).

See the full details in French and Dutch here and here.

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