On December 2, 2021, the Digital Health Strategy of the National Health System (SNS) was approved by the Interterritorial Council of the National Health System (CISNS) with an endowment of more than €675 million within the Transformation, Recovery, and Resilience Mechanism of the Government of Spain. The Digital Health Strategy is expected to promote the SNS values such as equity, sustainability, and transparency and boost the transformation of the SNS care model in the upcoming years.

In 2015, the Federal Office for Public Health launched an HTA program intending to reassess the benefits already reimbursed by compulsory health insurance. The following ongoing re-evaluations are in progress: multigene expression tests in breast cancer, cardiac catheterization for coronary artery disease, invasive procedures for coronary artery disease, removal of osteosynthesis materials, etc.

In early December 2021, NHS Accelerated Access Collaborative announced seven technologies that will be covered by the MedTech Funding Mandate (MTFM) in 2022/23: four for benign prostatic hyperplasia treatment (UroLift, GreenLight XPS, Rezum, and PLASMA system), and three for improving the patient experience during procedures (XprESS multi-sinus dilation system, Thopaz+, and Spectra Optia). Four technologies included in 2021/22 (placental growth factor-based testing, SecurAcath, HeartFlow, and gammaCore) will continue to be supported.

In late November – early December 2021, the application period for 2023 ICD-10-GM (German modification of ICD-10 diagnosis codes), OPS (procedure codes), and DRG changes was opened by the Federal Institute for Drugs and Medical Devices (BfArM), and the Institute for Hospital Remuneration Systems (INeK), respectively.

The Dutch Organization for Health Research and Development (ZonMw), in collaboration with the National Health Care Institute (ZIN), initiated the new HTA Methodology Program for 2021-2024. On November 4, 2021, the ZonMw published the gap analysis of the needs of important stakeholders regarding HTA and formulated recommendations that can provide guidance for the 2021-2024 HTA Methodology Program.

In November 2021, the National Institute for Health and Care Excellence (NICE) published two new Interventional Procedure Guidance (percutaneous implantation of pulmonary artery pressure sensors in chronic heart failure and coronary sinus narrowing device implantation for refractory angina), one new Medical Technologies Guidance (Synergo for non-muscle-invasive bladder cancer), one new Diagnostic Guidance (SeHCAT for diagnosing bile acid diarrhea), and four new Medtech Innovation Briefings (clonoSEQ for minimal residual disease, CerebAir for continuous EEG monitoring, 24/7 EEG SubQ for epilepsy, Paige Prostate for prostate cancer). Also, three new clinical guidelines were published, and six were updated.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in November 2021. More than 15 recommendations were published in relation to the registration, modification of registration conditions, renewal of registration of devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, peripheral vascular, neurovascular, dermatological, and endocrine devices, as well as medical aids.

On November 9, 2021, the Belgian Health Care Knowledge Center (KCE) published the health technology assessment report "Remote monitoring of patients with cardiovascular implantable electronic devices (CIED)". Analysis of efficacy and safety of remote monitoring showed an advantage in various aspects. Cost-effectiveness analysis indicates that remote cardiac monitoring of ICDs and PMs is cost-effective compared to monitoring based on in-clinic visits.

On November 12, 2021, the Innovation Committee at the Federal Joint Committee (G-BA) has announced the selection of thirty project ideas for Innovation Funding of the new forms of care within the framework of the two-stage application process. A total of 123 project ideas were received, and only thirty were accepted.

On November 23, 2021, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system and associated tariffs for state and private laboratories to be implemented no later than January 01, 2021. NLK system has been used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018. Thirty new codes were added in medical biochemistry, immunology and transfusiology, and clinical pharmacology areas.

On November 18, 2021, Swedish Medical Technologies Product (MTP) Council recommended the use of gene expression analysis (Prosigna and OncotypeDX) for decision-making on the adjuvant breast cancer treatment. The technologies have been under evaluation within the Orderly introduction framework since 2020.

In late November 2021, the INeK (Institute for the Hospital Remuneration System) has published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and add-on reimbursement categories (ZEs) for 2022. Seven new DRGs and seventeen ZE categories were added to the catalog in 2022.