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Health economic modeling for medical technologies in Europe

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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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Two new IVD tests will be reimbursed via the German Uniform Evaluation Standard (EBM) catalog

On August 24, 2023, the National Association of Statutory Health Insurance Physicians (KBV) informed that new services for serological diagnostics of Toxoplasma infection will be included in the German Uniform Evaluation Standard (EBM) catalog since October 1, 2023. In this regard, the following new codes will be introduced in the EBM catalog:

  • 32572 “Qualitative detection and/or quantitative determination of Toxoplasma antibodies of the immunoglobulin class IgM and/or IgG, also for monitoring purposes” with a tariff of €11.75;
  • 32573 “Surcharge for code 32572 for determining the avidity of Toxoplasma IgG antibodies as a clarification test after positive IgM antibody determination, in several batches, in total” with a tariff of €25.90.

The corresponding decision was made by the Evaluation Committee on August 18, 2023.

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalog (Einheitlicher Bewertungsmaßstab), updated once a quarter (four times a year). The adaptation timeframe of the EBM catalog for a specific code is around five years, but it varies depending on the evidence. The upcoming EBM catalog update is expected to come into force on October 1, 2023.

The full details in German can be found here and here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Contact us to get a free, three-month, no-obligation trial.