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.

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.

22

Jun 2021

In late May 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0177 and 0074 with changes to be implemented not later than August 01, 2021. Five new procedure codes related to diagnostic imaging, ENT, breast reconstruction, and gynecology, and nine new diagnostic codes were introduced.

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04

May 2021

In April 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0176 and 0073 with changes to be implemented not later than August 01, 2021. Four new procedure codes related to men's health and breast surgery and one new companion diagnostic code were introduced.

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29

Apr 2021

On April 20, 2021, the Dutch Healthcare Institute (ZIN) published an annual report on the progress of the conditional reimbursement program. In 2020, there were 13 ongoing projects under the program, six of which concerned medical technologies. Furthermore, in 2020, percutaneous transforaminal endoscopic discectomy for the treatment of lumbosacral radicular syndrome in lumbar disc herniation was included in the basic insurance package as regular care.

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16

Sep 2019

The report presents a summary of the reimbursement situation for for breast reconstruction after unilateral total mastectomy for breast cancer in Europe. The following types of breast reconstruction are 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 analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland. It is also possible to add analysis in the Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

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07

Aug 2019

The HTA center of Swedish Västra Götaland region has published a report for the impact of postmastectomy radiotherapy (PMRT) on complications and results of immediate breast reconstruction (IBR). PMRT compared with no radiotherapy (RT) results in a clinically significant increase of implant or tissue expander loss in patients undergoing IBR with moderate certainty of evidence. Other findings (decrease in patient satisfaction, an increase of re-operations or capsular contracture rate increase) gained low certainty of evidence.

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