Minimally-invasive replacement of mitral valve for mitral regurgitation

Series
Mitral valve procedures
Status
Published
Date
Number of report
005

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Report presents summary of the reimbursement situation for a minimally-invasive (transapical via mini-thoracotomy) replacement of mitral valve for mitral regurgitation.

Manufacturers and developers of the technology include:

  1. Abbott Vascular (Tendyne valve)
  2. Cephea
  3. Edwards Lifesciences (SAPIEN XT valve, CardiAQ-Edwards Transcatheter Mitral Valve, Fortis transcatheter mitral valve)
  4. Micro Interventional Devices (Permavalve)
  5. NaviGate Cardiac Structures (NAVI System)
  6. Neovasc (Tiara device)

Report includes essential information about reimbursement and national funding of the minimally-invasive replacement of mitral valve for mitral regurgitation, 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

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

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for minimally invasive replacement of mitral valve
5.2.1.    Procedure coding
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.4.    Health technology assessment by LBI-HTA
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for minimally invasive replacement of mitral valve
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for minimally invasive replacement of mitral valve
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 minimally invasive replacement of mitral valve
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.    National commissioning by NHS England
8.2.4.2.    Health technology assessment by NICE
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for minimally invasive replacement of mitral valve
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for minimally invasive replacement of mitral valve
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 minimally invasive replacement of mitral valve
11.2.1.    Procedure coding at national level
11.2.2.    Procedure coding at regional level (Emilia-Romagna region)
11.2.3.    Diagnosis coding
11.2.4.    Payment mechanism and reimbursement tariffs at national level
11.2.5.    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 minimally invasive replacement of mitral valve
12.2.1.    Procedure coding 
12.2.2.    Material coding
12.2.3.    Diagnosis coding
12.2.4.    Payment mechanism and reimbursement tariffs
12.2.5.    Policy considerations
12.2.6.    Health technology assessment by National Healthcare Institute
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for minimally invasive replacement of mitral valve
13.2.1.    Policy considerations 
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for minimally invasive replacement of mitral valve
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for minimally invasive replacement of mitral valve
15.2.1.    Procedure coding 
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs
16.    Disclaimer

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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04

May 2017

Check out reimbursement summary for the most established transcatheter mitral valve repair procedure in England, France and Germany. Reimbursement is established in Germany and France (for one indication). It is in process to be established in England and in France (for other indications).

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25

Apr 2017

The procedure can be coded in Austria, Denmark, England, Germany, Italy, Netherlands, Norway, Sweden and Switzerland, so payment mechanism is in place, even with an inadequate tariff in some countries. In countries where the procedure is not coded, it cannot be reimbursed. Despite available reimbursement mechanism, funding has not been established yet in majority of geographies.

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10

Apr 2017

Reports presents summary of the reimbursement situation in Europe for all developed or currently under development minimally invasive (transapical approach via mini-thoracotomy) and transcatheter mitral valve repair and replacement procedures for mitral regurgitation.

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15

Mar 2017

MTRC is working on release of 9 reimbursement reports for medical technologies during March 2017, including report for transcatheter aortic valve replacement and eight minimally invasive mitral valve repair and replacement procedures.

Read more
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