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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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Updates in the coverage of medical services in Switzerland in 2024

On November 29, 2023, the Swiss Federal Office of Public Health published the changes that will occur to the Services Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The updates will enter into force on January 1 or July 1, 2024, and include the following: 

  • Minor changes in the Healthcare Benefit Ordinance (KLV/OPre), which relate to the provision of medical aids by chiropractitians, prophylactic vaccination, cancer prevention measures, such as risk-reducing mastectomy, and prenatal screening;
  • Changes in Annex 1 of the Healthcare Benefit Ordinance (list of explicitly evaluated services):
    • Detailed indications were provided for the spinal fusion using interbody cages or bone grafts;
    • Coverage of Evidence Development was extended for autologous fat transplantation for postoperative breast reconstruction and multigene expression test in breast cancer;
    • One new service was introduced to the section “Plastic, reconstructive and aesthetic surgery”;
    • One new service was added to the section “Cardiology”;
  • Changes in Annex 1a of the Healthcare Benefit Ordinance (outpatient-before-hospital services):
    • Many new CHOP codes were added to the chapters for vascular intervention and examinations and interventions on the uterus;
  • Changes in Annex 2 of the Healthcare Benefit Ordinance (List of Tools and Equipment):
    • The nerve stimulation device category was renamed and restructured with new devices added, e.g., trigeminal neuromodulation (e-TNS) device with consumables.
  • Changes in Annex 3 of the Healthcare Benefit Ordinance (List of Analyses):
    • Changes in prescription conditions concerning midwives;
    • Changes in conditions for the provision of various genetic tests and rare disease testing;
    • Two new tests for porphyria were introduced.

More details can be found here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.