Breast reconstruction

Series
Surgical procedures
Status
Published
Date
Number of report
082

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The report presents a summary of reimbursement situation for breast reconstruction after unilateral total mastectomy for breast cancer in European countries.

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). 

The following types of breast reconstruction will be considered:

  • with autologous tissue (myocutaneous flap of latissimus dorsi muscle, superior gluteal artery perforator flap, transverse rectus abdominis myocutaneous flap);
  • with the use of implant.

The only reimbursement within public / statutory health insurance systems is considered.

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 breast reconstruction include:

  • Allergan (Natrelle)
  • Baxter (Peri-Guard)
  • Cereplas (Cereform)
  • Establishment Labs S.A (Motiva Implants)
  • Ethicon (Vicryl)
  • GC Aesthetics (Impleo, CoGel, Round Collection, Matrix, Curveo)
  • GROUPE SEBBIN SAS
  • Guangzhou Wanhe Plastic Materials (Yulambe, Real, Bibo, Snow, Crystal Lambe, Lambe)
  • Hansbiomed (BellGel)
  • Ideal Implant Incorporated
  • Integra (SurgiMend)
  • Laboratoires Arion (Monobloc)
  • Mentor Worldwide (MemoryShape, MemoryGel, Spectrum, Mentor, FlexHD)
  • Novus Scientific (TIGR Matrix)
  • Pfm medical (TiLOOP)
  • POLYTECH Health & Aesthetics (SublimeLine, B-Lite, Microthane, Tissue Expanders - POLYsmoooth, POLYtxt)
  • RTI Surgical Holdings (Fortiva, Tutopatch)
  • Shanghai Kangning Medical Supplies (Round, Anatomical)
  • Sientra (Luxe, Curve)
  • Sofregen (Seri)
  • Stille

Table of content is not available at the moment. Report is still ongoing.

07

Mar 2023

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 2023. Twenty-eight 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, neurovascular, ophthalmological, spine, and orthopedic devices, surgical procedures, as well as medical aids.

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19

Jan 2023

On January 1, 2023, the annual update of the Finnish NordDRG system came into force. There are 947 DRGs in the 2023 DRG system, compared to 930 DRGs in 2022. Among other changes, 34 new DRGs were introduced, including the DRGs in the cardiovascular, endocrine, endoscopy, gastrointestinal, obstetrics and gynecology, orthopedics, peripheral vascular, surgical procedures, and some other fields.

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02

Jan 2023

On December 19, 2022, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The procedures that were newly introduced to the list concern gynecological and surgical procedures, as well as interventional radiology.

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30

Nov 2022

In November 2022, the National Board of Health and Welfare released the Swedish version of the NordDRG system to come into force in January 2023, including the list of DRG codes, names, and cost-weights. A total of 77 new DRGs will be implemented. Key new DRGs were introduced in cardiovascular, gastrointestinal, and endoscopy fields, also for breast reconstruction and bone-anchored hearing implants.

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26

Oct 2022

On September 22, 2022, the Dutch Healthcare Authority (NZa) published the second release of the DRG package for 2023 (RZ23b). Nineteen new procedure codes, eight new supplementary payments, and seven new DRGs will be implemented. These changes concern remote monitoring, molecular diagnostics, surgical procedures, gynecology and dermatology technology groups.

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