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.

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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13

May 2019

On March 7, 2019, the Nomenclature was updated. The update brought changes in chapter V of Nomenclature, regarding the creation of new codes, deletion, and modification of existing codes. Changes mainly related to the in-vitro diagnostic testing.

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11

Jan 2018

The Clinical Coding and Schedule Development Group develops and maintains procedural and diagnostics nomenclature for private payers in England. In November new codes for reconstruction of breast, open adnexectomy, transoral laser microsurgery and surgical correction of hallux valgus were added to the CCSD Schedule.

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01

Nov 2017

Patients who have undergone mastectomy for the breast cancer or as a preventive measure can now benefit from better reimbursement of autologous tissue breast reconstruction if it is performed in a hospital that has an agreement with INAMI.

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