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.

13

May 2022

In April 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0183 and 0080 with changes to be implemented no later than June 14, 2022. Eleven new procedure codes and nine new diagnostic codes were introduced.

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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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28

Feb 2022

On February 15, 2022, the preliminary version of the DRG manual for 2022 was published in France. Introduced changes (new DRGs, change of DRG logic) concern surgical procedures on the breast, interventions for malignant skin tumors, interventions of excision and grafting on the skin and subcutaneous tissue, spondyloplasties.

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31

Jan 2022

On January 20, 2022, the Academy of Medical Royal Colleges (AoMRC) launched a consultation on the latest set of guidance (List 3) of the Evidence-based Interventions (EBI) Programme. EBI program develops guidance sets (Lists) for tests, treatments, and procedures based on recommendations from the Expert Advisory Committee and NICE assessments. Proposed List 3 covers 17 interventions across a range of medical specialties, including cardiology, ophthalmology, urology, and others. The deadline for comments submission is March 31, 2022.

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22

Dec 2021

The HTA body of the Tuscany Regional Healthcare issues two types of documents: HTA forms and motivational forms. With a regional decree 20520 of November 22, 2021, Tuscany Regional Healthcare has published assessments of seventeen medical devices of various therapeutic areas, including devices belonging to neurology, as well as gastrointestinal, urology, cardiovascular, orthopedics, peripheral vascular, and other fields of care.

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