Angioplasty of arteries of lower extremities for peripheral artery disease

Series
Peripheral vascular interventions
Status
Published
Date
Number of report
012

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Report presents summary of the reimbursement situation in Europe for a group of angioplasty procedures of arteries of lower extremities for peripheral artery disease (plain and drug-eluting balloon angioplasty, stenting using bare metal and drug-eluting stents).

Analysis covers iliac, femoral and popliteal arteries.

Analysis is provided for admitted and day case hospital care.

The following clinical scenarios are considered:

  • Balloon angioplasty as stand-alone procedure
    • Balloon angioplasty using drug-eluting balloon
  • Balloon angioplasty in combination with percutaneous transluminal atherectomy
  • Balloon angioplasty in combination with insertion of stent
    • Insertion of bare metal stent
    • Insertion of drug-eluting stent

Report includes essential information about reimbursement and national funding for angioplasty, 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 catheters for plain balloon peripheral angioplasty include:

  • AMG International
  • Angiodynamics
  • Balton
  • Boston Scientific
  • BrosMed
  • Cook Medical
  • Cordis
  • CR Bard
  • Degania Silicone
  • Lepu Medical
  • Medtronic
  • Merit Medical
  • MicroPort
  • QTVascular
  • Spectranetics
  • Stron Medical

Manufacturers of catheters for balloon angioplasty using drug-eluting balloon include:

  • Aachen Resonance (ELUTAX SV)
  • B Braun (SeQuent® Please OTW)
  • Bard / Lutonix (LUTONIX Drug Coated Balloon Catheter)
  • Biotronik (Passeo 18 Lux)
  • BostonScientific (Ranger)
  • Cardionovum (Legflow)
  • Cook Medical (Advance 18 PTX)
  • Eurocor Endovascular (Freeway)
  • Medtronic (IN.PACT Admiral DCB)
  • Spectranetics (Stellarex)

Manufacturers of bare metal stents for peripheral stenting include:

  • Abbott Vascular
  • Alvimedica
  • AMG International
  • Andramed
  • B Braun
  • Balton
  • Bentley InnoMed
  • Biosensors International
  • Biotronik
  • Boston Scientific
  • Cook Medical
  • Cordis
  • CR Bard
  • Endocor
  • Eucatech
  • Hexacath
  • InSitu Technologies
  • IVascular
  • Jotec
  • Medinol
  • Medtronic
  • Meril
  • Optimed
  • Rontis
  • Stentys
  • Stron Medical
  • Terumo
  • Vascular Concepts
  • Veryan
  • W.L. Gore

Manufacturers of drug-eluting stents for peripheral stenting include:

  • Abbott Vascular (DYNALINK-E, Xience Prime)
  • Biosensors International (Biomatrix Flex)
  • Boston Scientific (Eluvia)
  • Cook Medical (Zilver PTX Drug-Eluting Peripheral Stent)
  • Cordis (SMART, Cypher)
  • Meril (Meres)
  • Stentys

If you are interested in other reimbursement reports in the peripheral artery field, please, visit report-specific pages for:

Table of content

1.    Introduction and summary
2.    Executive summary table

2.1.    Percutaneous transluminal angioplasty with plain balloon
2.2.    Percutaneous transluminal angioplasty with drug-eluting balloon
2.3.    Percutaneous transluminal angioplasty with insertion of bare metal stent
2.4.    Percutaneous transluminal angioplasty with insertion of drug-eluting stent
3.    Contents
4.    Methodology
5.    Reimbursement analysis in Austria

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
5.2.1.    Procedure coding
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.4.    Health technology assessment by LBI-HTA
5.2.4.1.    Percutaneous transluminal angioplasty with drug-eluting stent
5.2.4.2.    Percutaneous transluminal angioplasty with drug-eluting balloon 
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
6.2.1.    Procedure coding 
6.2.2.    Material coding
6.2.3.    Payment mechanism and reimbursement tariffs
6.2.4.    Brand-specific reimbursement for drug-eluting stents and drug-coated balloons
6.2.5.    Policy considerations
6.2.5.1.    Reimbursement framework for percutaneous transluminal angioplasty with insertion of drug-eluting stent determined by INAMI
6.2.5.2.    Reimbursement framework for percutaneous transluminal angioplasty with drug-eluting balloon determined by INAMI
6.2.5.3.    Health technology assessment by Belgian Health Care Knowledge Centre
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
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 percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
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.    National commissioning of percutaneous transluminal angioplasty with or without stenting by NHS England 
8.2.4.2.    Health technology assessment of percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease by NICE
8.2.4.3.    Clinical guideline for diagnosis and management of peripheral arterial disease by NICE
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
9.2.1.    Procedure coding 
9.2.2.    Diagnosis coding
9.2.3.    Payment mechanism and reimbursement tariffs
9.2.4.    Brand-specific reimbursement 
9.2.5.    Policy considerations
9.2.5.1.    Drug-eluting balloons
9.2.5.2.    Bare metal stents
9.2.5.3.    Self-expanding drug-eluting stents
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
10.2.1.    Procedure coding 
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
10.2.4.    Payment mechanism and reimbursement tariffs in day case
10.2.5.    Policy considerations
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
11.2.1.    Procedure coding 
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs at national level
11.2.4.    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 percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
12.2.1.    Procedure coding
12.2.1.1.    Procedure coding for intervention performed by surgeon
12.2.1.2.    Procedure coding for interventions performed by radiologist 
12.2.2.    Material coding
12.2.3.    Diagnosis coding
12.2.4.    Payment mechanism and reimbursement tariffs
12.2.4.1.    Payment mechanism and reimbursement tariffs for interventions performed by surgeon
12.2.4.2.    Payment mechanism and reimbursement tariffs for interventions performed by radiologist
12.2.5.    Policy considerations
12.2.6.    Health technology assessment by National Healthcare Institute
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
13.2.4.    Payment mechanism and reimbursement tariffs in day case
13.2.5.    Policy considerations
13.2.5.1.    Assessment within national framework of managed introduction of innovations 
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
14.2.4.    Payment mechanism and reimbursement tariffs in day case
14.2.5.    Policy considerations 
14.2.5.1.    Swedish Drug-elution Trial in Peripheral Arterial Disease trial (SWEDEPAD)
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for percutaneous transluminal angioplasty with or without stenting for peripheral arterial disease technologies
15.2.1.    Procedure coding 
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
15.2.4.    Payment mechanism and reimbursement tariffs in day case
15.2.5.    Policy considerations 
16.    Disclaimer

15

Jul 2021

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 June 2021. Recommendations concern cardiovascular and peripheral vascular devices, orthopedic devices, liquid for embolization, and medical aids.

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14

Jun 2021

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 May 2021. Recommendations concern orthopedic devices, cardiovascular, peripheral vascular, and neurovascular devices, medical aids, and pulmonary artery pressure sensor.

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28

May 2021

In April 2021, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedure Guidance (repetitive short-pulse transscleral cyclophotocoagulation for glaucoma, deep brain stimulation for chronic, severe, treatment-resistant obsessive-compulsive disorder in adults, and Melphalan chemosaturation for primary or metastatic cancer in the liver) and two Medtech Innovation Briefings (microINR for anticoagulation therapy and RenalSense Clarity RMS for acute kidney injury), and two clinical guidelines (for atrial fibrillation and chronic pain in over 16s).

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03

May 2021

On April 22, 2021, the List of reimbursable implants and invasive medical devices, maintained by the National Institute for Health and Disability Insurance (INAMI), was updated with the corresponding Nominative lists of brand-specific devices. Two new Nominative lists with reimbursable devices used for peripheral vascular interventions were introduced.

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08

Feb 2021

On January 29, 2021, the Institute for the Hospital Remuneration System (InEK) has published the List of the requests for innovation funding (NUB) that were submitted by the hospitals in 2020. The medical technologies belonging to the cardiovascular, ENT, eHealth, gastrointestinal, neuromodulation, neurovascular, orthopedic, and other technology groups obtained positive status 1.

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