Mechanical thrombectomy for acute ischemic stroke

Series
Cerebral endovascular interventions
Status
Published
Date
Number of report
018

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Report presents summary of reimbursement situation for mechanical thrombectomy for acute ischemic stroke in European countries. Day case admissions are not considered in the report.  

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

Manufacturers of devices for mechanical thrombectomy for acute ischemic stroke include:

1.    Acandis (APERIO)
2.    Amnis Therapeutics (GOLDEN RETRIEVER)
3.    Anaconda Brain (Anaconda Biomed)
4.    Balt Extrusion (CATCH)
5.    DePuy Synthes (REVIVE SE)
6.    Medtronic (Solitaire; MindFrame Capture)
7.    Microvention (SOFIA PLUS, RIC)
8.    Penumbra (Penumbra System, Reperfusion Catheters ACE, Reperfusion Catheters MAX, 3D Revascularization Device, Pump MAX, Velocity) 
9.    Phenox (pRESET, pRESET LITE)
10.    Rapid Medical (TIGERTRIEVER) 
11.    Stryker (Trevo XP Thrombectomy catheter)

1.    Introduction and summary
2.    Contents
3.    Executive summary table
4.    Methodology
5.    Reimbursement analysis in Austria

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
5.2.1.    Procedure coding
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.4.    Policy considerations
5.2.4.1.    Health technology assessments by LBI-HTA
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
6.2.1.    Procedure coding
6.2.2.    Diagnosis coding
6.2.3.    Payment mechanism and reimbursement tariffs
6.2.4.    Policy considerations
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
7.2.1.    Procedure coding 
7.2.2.    Diagnosis coding
7.2.3.    Payment mechanism and reimbursement tariffs
8.    Reimbursement analysis in England
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
8.2.1.    Procedure coding 
8.2.2.    Diagnosis coding
8.2.3.    Payment mechanism and reimbursement tariffs
8.2.4.    Policy considerations 
8.2.4.1.    Specifics of commissioning of the procedure
8.2.4.2.    Health technology assessments by NICE
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
9.2.1.    Procedure coding 
9.2.2.    Diagnosis coding
9.2.3.    Payment mechanism and reimbursement tariffs
9.2.4.    Policy considerations by HAS
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
10.2.1.    Procedure coding 
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs
10.2.4.    Policy considerations
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
11.2.1.    Procedure coding 
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs at national level
11.2.4.    Payment mechanism and reimbursement tariffs at regional level
12.    Reimbursement analysis in the Netherlands
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
12.2.1.    Procedure coding 
12.2.2.    Diagnosis coding
12.2.3.    Payment mechanism and reimbursement tariffs
12.2.4.    Policy considerations by Dutch Healthcare Institute (CIN)
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.4.    Policy considerations 
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs
14.2.4.    Policy considerations 
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for mechanical thrombectomy in acute ischemic stroke
15.2.1.    Procedure coding 
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs
15.2.4.    Policy considerations
16.    Disclaimer

18

Jan 2018

A 62-page reimbursement report covers mechanical thrombectomy for stroke. 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.

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20

Nov 2017

Annual report from the Italian Society of Interventional Cardiology (GISE) shows increasing trends in procedural volume of percutaneous coronary interventions (PCI), transcatheter aortic valve implantations (TAVI), mitral clip implantations, closure of left atrial appendage (LAA) and patent foramen ovale (PFO).

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28

Sep 2017

MTRC has analyzed timing of decision-making (negotiation about price, final ministerial decision and publication of the decision) after recommendation by CNEDiMTS about expected benefit (AS) and added clinical value (ASA) for invasive non-implantable medical devices reimbursed via LPPR list, title V. Since establishment of the title V program, 5 technologies were added to the List (stent retrievers for stroke; peripheral drug-coated balloons). Time from the recommendation by CNEDiMTS until the start of reimbursement varied from 7 to 13 months (9.4 months on average).

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21

Aug 2017

New material codes for neurovascular self-expanding stent retrievers for clot removal (mechanical thrombectomy for stroke) and foam preparation for hysterosalpingosonography were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in July.

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24

May 2017

The National Board (Socialstyrelsen) has developed a new national guideline for the treatment of stroke with a significant focus on mechanical thrombectomy. MTRC provides an overview of key recommendations, which concern diagnosis and treatment phase using medical technologies.

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08

May 2017

French National Authority for Health (HAS) has initiated an assessment of organizational impact of mechanical thrombectomy on the system of stroke management in France with objective to find the most adequate way of further introduction of the method into French health care system.

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02

May 2017

The Forum of Norwegian payers made decision about introduction of three medical technologies: mechanical thrombectomy for stroke, baroreflex activation therapy for resistant hypertension and non-invasive prenatal testing for detection of trisomy 13, 18 and 21.

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13

Apr 2017

The procedure will be included into Prescribed Specialized Services. About 8000 patients can benefit from the treatment annually. Other stroke treatments are commissioned by Clinical Commissioning Groups.

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