On the 1st of February, 2020, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-SV) have made the agreement for laboratory diagnostic clarification about the novel coronavirus. Afterwards, the statutory health insurance companies will cover the costs of the test for the novel coronavirus (2019-nCoV) if there are justified suspected cases.

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern repair of femoral hernia requiring removal of previously inserted mesh, transurethral non-ablative radiofrequency of bladder, minimally invasive mitral valve repair, two-stage revision of total hip replacement for infection and others. The codes are introduced with a recommended adoption date being the 1st of May 2020. The document also contains a list of textual changes in codes, unacceptable combinations, and inactivated codes. There were no changes to the CCSD Schedule of Diagnostic Tests.

On the 17th of February 2020, the Innovation Committee at the Federal Joint Committee (G-BA) invited external stakeholders to suggest topics and criteria for future funding. Moreover, the submission of proposals for members of the new pool of experts was announced.

The General Director of Lombardy Healthcare released a decree no. 916 of 29.1.2020. The decree contains several important notices, the most important one being that the “Rules of the regional HTA commission” was published. In the first half of February 2020, it was published on the website of the regional HTA program of the Lombardy region.

Changes of structure in Clinical Commissioning Groups (CCGs) in England were announced: in April 2020, 14 NHS England (Region, Local Offices) will be replaced by 42 sustainability and transformation partnerships as the Higher Level Health Authority in the organization reference data. The number of CCGs would also be changed (135 CCGs would leave).

The patients diagnosed with osteoporosis requiring medication will be able to receive care within a structured treatment program (disease management program, DMP). The Federal Joint Committee (G-BA) decided in mid-January 2020 the details of participation and the various aspects of care.

On the week of the 17th of February, MTRC published one post related to the involvement of industry in the reimbursement processes in Europe. Follow us on Instagram on @mtrc.market.access

Axonics sacral neuromodulation would be an option for people with symptoms of the overactive bladder who have not responded to conservative treatments or drug therapy. The Axonics could save the NHS around £6,200 per patient if the device lasts more than six years. Consultations are open to the stakeholders until March 13, 2020.

In late January 2020, the Charité - Universitätsmedizin Berlin and health insurance provider Barmer have signed an integrated care contract for the telemedical management of patients with chronic heart failure. Also, the benefit assessment process at the Federal Joint Committee (G-BA) has already started, and a result is expected in spring 2021.

On January 31, 2020, the non-statutory HTA body, Swiss Medical Board, published the results of the report in which they compared the surgical and non-surgical treatment of rotator cuff tears. Though the surgery is more effective, the traditional treatment demonstrated better cost-benefit results. Thus, the Swiss Medical Board recommends the rotator cuff surgery with limitations.

We have released the interview on the Market Access Insider channel on Youtube. The interview covered the role and activities of patient advocacy groups in Italy, typical issues facing by the patient organizations, role of patient organizations in development of the LEA catalog in Italy, access to stoma care across Italian regions, the importance of setting up patient registries to facilitate access to medical technologies.

NICE published a draft Diagnostic guideline on the Reveal LINQ monitor. The monitor can be recommended for routine adoption under certain clinical criteria. The expected publication date of the final guideline is 27 May 2020.