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).

Sample pages are provided for an older version of the report. Before delivery to the client, the report is updated to the current state (e.g., 2022 coding, tariffs, and policy considerations). 

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

01

Jun 2022

The French National Authority for Health 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 in May 2022. Thirty-one recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services. Opinions concern cardiovascular and peripheral vascular, diagnostic imaging, interventional radiology, orthopedic, neurovascular and neuromodulation, endocrine and E-health devices, as well as medical aids.

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16

May 2022

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 April 2022. Thirty recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, neurovascular, and neuromodulation and other devices, as well as medical aids.

Read more

20

Apr 2022

In mid-March 2022, the Danish Health Data Agency (Sundhedsstyrelsen) published an update of the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: ten new diagnosis codes, two procedure codes, and 143 additional codes (Tillægskoder) were added. The newly added procedure codes concern gastrointestinal and peripheral vascular procedures.

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15

Apr 2022

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 March 2022. More than 15 recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, and neurovascular devices, as well as medical aids.

Read more

07

Apr 2022

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 February 2022. More than 25 recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration of devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, neurovascular, and neuromodulation devices, as well as breast implants and medical aids. Except for this, CNEDiMTS published two negative opinions concerning transitional coverage of devices.

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