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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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Updates about screening programs in Germany

At the end of November 2018, the Federal Joint Committee (G-BA) has introduced an organized screening program for the early detection of cervical cancer. The first information letters for participation in the program will be sent by the health insurance companies beginning from 1 January 2020 to all insured women aged between 20 and 65. Among other changes, women aged 35 years and older will be offered a combined examination (co-testing) consisting of Pap smear and HPV test every three years instead of the current annual cytological examination.

The resolution supplementing the directive on organized cancer screening programs (oKFE-RL) will be submitted to the Federal Ministry of Health for review and will come into force in case of non-objection and publication in the Federal Gazette on 1 July 2019. Subsequently, within six months, the Evaluation Committee will decide on the reimbursement amount in the Uniform Evaluation Standard (EBM).

A month later, at the end of December 2018, at the request of the patient representatives, G-BA initiated a consultation procedure for the evaluation of a prostate cancer screening by means of a prostate-specific antigen (PSA) assessment.

Prostate cancer is the most common malignancy in men in Germany. The PSA test is the only screening method for prostate cancer so far. However, for early detection, the PSA test is not yet a benefit of the statutory health insurance, patients must pay the expenses for the testing themselves.

In its decision, the G-BA outlined that the Method Evaluation Subcommittee may commission the Institute for Quality and Efficiency in Health Care (IQWiG) to carry out the search, presentation and assessment of the current medical knowledge of prostate cancer screening by determining the PSA. The IQWiG preliminary report is expected to be ready in April 2020 and subsequently the final report to be available in September 2020.

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

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