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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 June 18, 2024, 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 July 1, 2024, and include the following:

  • Minor changes in the Healthcare Benefit Ordinance (KLV/OPre), which relate to the provision of vaccination, newborn screening tests, and other prophylactic measures;
  • Changes in Annex 1 of the Healthcare Benefit Ordinance (list of explicitly evaluated services):
    • Coverage with Evidence Development was extended for autologous chondrocyte transplantation, autologous fat transplantation for postoperative breast reconstruction, and proton radiotherapy in non-small cell lung cancer;
    • Coverage with Evidence development was granted for 177Lu-PSMA radioligand therapy for progressive PSMA-positive metastatic castration-resistant prostate cancer.
  • Changes in Annex 1a of the Healthcare Benefit Ordinance (outpatient-before-hospital services):
    • Peripheral laser angioplasty (CHOP code 39.75.12) was added to the chapter for vascular interventions.
  • Changes in Annex 2 of the Healthcare Benefit Ordinance (List of Tools and Equipment):
    • Extension of covered indications for the tumor treating fields;
    • Inclusion of several new medical aids;
    • Change of the prescription conditions for already covered medical aids.
  • Changes in Annex 3 of the Healthcare Benefit Ordinance (List of Analyses):
    • Changes in the scope of tests under code 1368.00 for newborn screening;
    • Changes in the limitations for genetic tests for hereditary breast and ovarian cancer (BRCA1 and BRCA 2 mutation).

The full details in Italian can be found here.

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