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.

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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11

Aug 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 July 2022. Twenty 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, neurovascular and neuromodulation, orthopedic, endocrine, and ENT devices, as well as breast implants and medical aids. Except for this, CNEDiMTS published two positive and two negative opinions concerning transitional coverage of devices.

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15

Jul 2022

The HTA body of the Tuscany Regional Healthcare issues two types of documents: HTA forms and motivational forms. With regional decree 10778 of June 01, 2022, Tuscany Regional Healthcare has published assessments of nine medical devices in various therapeutic areas, such as cardiovascular and peripheral vascular areas, surgical procedures, orthopedics, and dermatology.

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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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