Ablation of heart tissue for atrial fibrillation

Series
Interventions for arrhythmia
Status
Published
Date
Number of report
016

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The report presents summary of reimbursement situation for heart tissue ablation methods to treat atrial fibrillation.

Different types of ablation methods are considered in the report, including radiofrequency ablation, cryoablation, microwave ablation.

Report includes information about three types of access to perform ablation:

  • Transluminal access
  • Percutaneous thoracoscopic access
  • Open access

Procedures using transluminal and percutaneous thoracoscopic access are analyzed as stand-alone procedures. Ablation using open access is analyzed in conjunction with open heart surgery (coronary artery bypass grafting or aortic valve replacement).

Report includes essential information about reimbursement and national funding, including:

  • Brief overview of reimbursement system for medical devices
  • Procedure coding for technology
  • Diagnosis coding
  • Payment mechanism for technology
  • Reimbursement tariffs for technology
  • Restrictions in indications or scenarios for use of technology
  • Policy considerations by payers and policy-makers about technology

Reimbursement information is provided for the following geographies:

  • Austria
  • Belgium
  • Denmark
  • England (UK)
  • France
  • Germany
  • Italy
  • Netherlands
  • Norway
  • Sweden
  • Switzerland

It is also possible to add analysis in Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

Manufacturers of devices for ablation of heart tissue include:

  • Abbott (TactiCath Quartz ablation catheter, FlexAbility ablation catheter)
  • Access Point Technologies EP (Ablation catheters)
  • AFreeze (CoolLoop catheter)
  • AtriCure (Isolator Synergy Clamps, Isolator Synergy Access Clamp, COBRA Fusion 150 and 50 Ablation System, EPi-Sense Coagulation Device, Subtle Cannula, Coolrail Linear Pen, Isolator Linear Pen, Isolator Transpolar Pen)
  • Baylis Medical (NRG RF Transseptal Needle)
  • Biosense Webster (CELSIUS Diagnostic/Ablation Deflectable Tip Catheter, NAVISTAR Catheter, THERMOCOOL Catheter)
  • Biotronik (AlCath Gold FullCircle Ablation catheter, AlCath Flutter Gold Ablation catheter, AlCath Flux eXtra Gold Ablation catheter).
  • Boston Scientific (BLAZER PRIME Temperature Ablation Catheter, BLAZER II Temperature Ablation Catheter Family, BLAZER Open Irrigated Temperature Ablation Catheter, INTELLANAV OPEN-IRRIGATED, INTELLATIP MIFI OPEN-IRRIGATED Ablation Catheter, INTELLATIP MIFI XP Temperature Ablation Catheter)
  • CathRx (Khelix Ablation catheter)
  • Integer Holdings Corporation (EP ablation catheters)
  • Lepu Medical (Eel Cath EP ablation catheter)
  • MicroPort (FireMagic, FireMagic 3D)
  • Medtronic (RF Marinr MC catheter, RF Contactr ablation catheter, RF Enhancr II catheter, RF Conductr MC catheter)
  • OSCOR (Destine Reach)
  • Osypka Medical (Cerablate easy steerable ablation catheter, Cerablate cool steerable ablation catheter, Cerablate flutter steerable ablation catheter)

Table of content

1.    Introduction and summary
2.    Executive summary table
3.    Contents
4.    Methodology
5.    Reimbursement analysis in Austria

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
5.2.1.    Procedure coding
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.4.    Health technology assessments by LBI-HTA
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
6.2.1.    Procedure coding
6.2.2.    Diagnosis coding
6.2.3.    Payment mechanism and reimbursement tariffs
6.2.4.    Policy considerations
6.2.4.1.    Health technology assessments by KCE
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
7.2.1.    Procedure coding 
7.2.2.    Diagnosis coding
7.2.3.    Payment mechanism and reimbursement tariffs
8.    Reimbursement analysis in England
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
8.2.1.    Procedure coding 
8.2.2.    Diagnosis coding
8.2.3.    Payment mechanism and reimbursement tariffs
8.2.4.    Policy considerations 
8.2.4.1.    Specifics of commissioning of the procedure
8.2.4.2.    Health technology assessments by NICE
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
9.2.1.    Procedure coding 
9.2.2.    Diagnosis coding
9.2.3.    Payment mechanism and reimbursement tariffs
9.2.4.    Policy considerations by HAS
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
10.2.1.    Procedure coding 
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
11.2.1.    Procedure coding at national level
11.2.2.    Procedure coding at regional level (Emilia-Romagna, Lombardy, Veneto regions)
11.2.3.    Diagnosis coding
11.2.4.    Payment mechanism and reimbursement tariffs at national level
11.2.5.    Payment mechanism and reimbursement tariffs at regional level
12.    Reimbursement analysis in the Netherlands
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
12.2.1.    Procedure coding 
12.2.2.    Diagnosis coding
12.2.3.    Payment mechanism and reimbursement tariffs
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.4.    Policy considerations 
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs
14.2.4.    Policy considerations 
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for ablation of heart tissue for atrial fibrillation
15.2.1.    Procedure coding 
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs
15.2.4.    Policy considerations
16.    Disclaimer

05

Feb 2021

In January 2021, the National Institute for Health and Care Excellence (NICE) published two new interventional procedure guidance (self-expanding implant insertion into the intersphincteric space for faecal incontinence and minimally invasive radical hysterectomy for early stage cervical cancer), two new medical technologies guidance (the PLASMA system for transurethral resection and haemostasis of the prostate, and the VAC Veraflo Therapy system for acute infected or chronic wounds), and six Medtech innovation briefings (Optilume for anterior urethral strictures, AI in mammography, AI for analyzing chest CT images, AcQMap for mapping the heart atria to target ablation treatment, and others). Also, two clinical guidelines were updated.

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13

Oct 2020

On September 24, 2020, NHS England opened a consultation on clinical commissioning policy for the use of catheter ablation for paroxysmal and persistent atrial fibrillation. Comments can be submitted until October 24, 2020.

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13

Mar 2020

At the end of January 2020, the Decision Forum rejected Focal Impulse and Rotor Mapping ablation approach and workstation RhytmView for the treatment of atrial fibrillation and ex-situ perfusion platform for organ preservation after the brain death of the donor due to its insufficient efficacy evidence.

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06

Mar 2019

More than 50 new DRGs were introduced in the Swedish system in 2019, while two have been deleted. The changes affected nursing care, psychiatry, hospital and day case services of different major disease categories. Important changes relate to cardiac ablation, placement of neurostimulator.

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11

Jun 2018

On 11th May, the Italian Ministry of Health announced from its website that five new Med Tech-related HTA documents are available for public consultation. See the details in the MTRC post.

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