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Cost-effective reimbursement analysis for medical technologies in Europe

Procedure coding, payment mechanism, reimbursement tariffs, policy, and HTA considerations in 20 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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Ambulatory ECG monitoring
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EU HTA Publication Digest: Access in all areas? A roundup of developments in market access and health technology assessment: part 6

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. 

In a recent publication, Pannelay et al. explored the evolving challenges of implementing the EU Health Technology Assessment Regulation, highlighting the burden of aligning national PICO requirements across Member States. The study showed that up to 720 evidence analyses per product may be required ‒ covering various permutations of population, comparator, and outcome ‒ raising serious concerns about feasibility and submission quality. The article also presented a user guide for applying generalized cost-effectiveness analysis to better capture societal value and examined the ongoing debate over NICE’s implementation of the severity modifier tool in the UK.

Access the full-text article here.

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Publications Digest

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02
May 2025

Sustainability Publication Digest: The carbon footprint and energy consumption of liver transplantation

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its Sustainability Publications Digest. In a recent publication, De Simone et al. evaluated the environmental impact of liver transplantation procedures performed in Italy by a retrospective bottom-up approach. The authors assessed energy use, waste, anesthetic consumption, and units of blood products transfused for each transplant. The study revealed that each transplant procedure generated about 310 kg of CO₂ emissions, with operating room energy consumption contributing the largest share. The findings highlight the importance of engaging transplant clinicians, hospital administrators, policymakers, and patients in efforts to promote more sustainable practices.
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30
Apr 2025

Health Economic Publication Digest: Economic Considerations in Designs and Modifications of Multiarm, Multistage Adaptive and Adaptive Platform Randomized Controlled Trials: A Systematic Literature Review

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its Health Economic Publications Digest. In a recent publication, Kachapila et al. conducted a systematic review to investigate the integration of economic evaluations into multiarm, multistage, adaptive Randomized Controlled Trials. The review included 17 articles, with four reporting results of economic evaluations and 13 presenting economic evaluation protocols. Although costs and benefits could be estimated at interim stages in 14 studies, only five interim cost-effectiveness analyses were performed, and just three influenced decisions to drop or maintain trial arms. Overall, the use of economic evidence remains limited, despite its potential value in guiding adaptive decisions.
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29
Apr 2025

Publication Digest: A Systematic Literature Review of Important and Meaningful Differences in the EQ-5D Index and Visual Analog Scale Scores

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its Publications Digest. In a recent publication, Al Sayah et al. conducted a systematic literature review to summarize and evaluate minimally important difference (MID) estimates for EQ-5D instruments. The review included 90 studies reporting 840 MID estimates and revealed a wide variability in MID values depending on the population, estimation method, and EQ-5D version. The findings emphasize the need for context-specific MID selection when interpreting EQ-5D outcomes.
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28
Apr 2025

EU HTA Publication Digest: Mapping methods gaps between EU joint clinical assessments and local health technology assessment decision-making: an environmental scan of guidance in select EU markets and harmonization challenges

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. In a recent publication, Sarri et al. investigated the methodological alignment between EU joint clinical assessments and national HTA requirements in France, Germany, The Netherlands, and Spain. While the study found strong consensus on the need for systematic evidence generation, national agencies diverged in their guidance on evidence derived from indirect treatment comparisons. These findings highlight the challenges health technology developers face in meeting both EU-wide and local evidentiary demands.
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25
Apr 2025

Sustainability Publication Digest: The environmental impact of inhalers: a framework for sustainable prescription practices in Spain

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its Sustainability Publications Digest. In a recent publication, Garin et al. developed a framework to promote sustainable inhaler prescriptions in Spain. The authors created a national database and decision-making algorithm to integrate environmental impact into clinical decision-making processes. Their analysis found that targeted shifts from high-emission pressurized metered-dose inhalers to dry powder inhalers could yield substantial environmental benefits. The study offers actionable insights for aligning respiratory treatment practice with environmental sustainability.
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