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Evidence gap analysis

Strategic analysis of the sufficiency of evidence to obtain reimbursement and HTA approval in Europe and recommendations about evidence generation

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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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The Institute for the Hospital Remuneration System (InEK) published the 2025 DRG catalog in Germany

On October 14, 2024, the Institute for the Hospital Remuneration System (InEK) published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and additional reimbursement categories (ZEs) for 2025.

The following changes were introduced:

  • Three new DRGs were introduced in the endoscopy and ophthalmology fields;
  • Nine new ZE categories (for drugs, none for medical technologies) were added to the catalog.

Moreover, the InEK published the list of the new diagnostic and treatment methods (NUB) with approved status (status 1), which were integrated into the DRG system for 2025 in the form of add-on reimbursement (ZE) categories. The list contains eight positions of drugs and no medical technologies. The list of the requests for NUB with the granted statuses for 2025 is expected to be available in January-February 2025.

The German Hospital Federation (DKG), the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), and the Association of Private Health Insurance Funds (PKV) agreed on the DRG catalog on October 7, 2024.

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