Proton Therapy

Series
Radiotherapy
Status
Published
Date
Number of report
029

Ask the expert

(we accept only company emails)

The report presents a summary of reimbursement situation for proton therapy 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 analysis covers the application of proton therapy in ocular tumors in adults and pediatric medulloblastoma.

The analysis is provided for the session and out-patient treatment,  including both preparation and delivery of proton therapy. The only reimbursement within public / statutory health insurance systems is considered.

The report includes essential information about reimbursement, including:

  • Brief country-specific overview of reimbursement system
  • Procedure coding for technology
  • Diagnosis coding
  • Payment mechanism for technology
  • Reimbursement tariffs for technology
  • Restrictions on indications or scenarios for the 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)
  • Finland
  • France
  • Germany
  • Italy
  • The Netherlands
  • Norway
  • Sweden
  • Switzerland

It is also possible to add analysis in Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

Manufacturers of equipment for proton therapy include:

  • Hitachi Medical Systems (PROBEAT-RT)
  • IBA (Proteus ONE, Proteus Plus)
  • Mevion (MEVION S250)
  • Sumitomo Heavy Industries (HM series)
  • Varian Medical Systems (ProBeam, ProBeam Compact, ProBeam Multi-Room)

Table of content 

1.    Introduction and summary
2.    Executive summary table
3.    Contents
4.    Abbreviations
5.    What’s new
6.    Methodology
7.    Reimbursement analysis in Austria

7.1.    Overview of the reimbursement system
7.2.    Reimbursement for proton therapy
7.2.1.    Policy considerations
7.2.2.1.    Health technology assessments by LBI-HTA
8.    Reimbursement analysis in Belgium
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for proton therapy
8.2.1.    Procedure coding
8.2.2.    Policy considerations by the INAMI/RIZIV
8.2.3.1.    Health technology assessments by KCE
9.    Reimbursement analysis in Denmark
9.1.    Overview of the proton therapy
9.2.    Reimbursement for intensity modulated radiotherapy
10.    Reimbursement analysis in England
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for proton therapy
10.2.1.    Commissioning of proton therapy 
10.2.2.    Health technology assessments by NICE
11.    Reimbursement analysis in Finland
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for proton therapy
12.    Reimbursement analysis in France
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for proton therapy
12.2.1.    Procedure coding 
12.2.2.    Diagnosis coding
12.2.3.    Payment mechanism and reimbursement tariffs
12.2.4.    Policy considerations by HAS
13.    Reimbursement analysis in Germany
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for proton therapy
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.4.    Policy considerations by G-BA
14.    Reimbursement analysis in Italy
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for proton therapy
14.2.1.    Procedure coding
14.2.2.    Payment mechanism and reimbursement tariffs 
14.2.3.    Policy considerations
15.    Reimbursement analysis in the Netherlands
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for proton therapy
15.2.1.    Procedure coding 
15.2.2.    Payment mechanism and reimbursement tariffs
15.2.3.    Policy considerations by Dutch Healthcare Institute (ZIN)
16.    Reimbursement analysis in Norway
16.1.    Overview of the reimbursement system
16.2.    Reimbursement for proton therapy
16.2.1.    Procedure coding 
16.2.2.    Diagnosis coding
16.2.3.    Payment mechanism and reimbursement tariffs
16.2.4.    Policy considerations 
17.    Reimbursement analysis in Sweden
17.1.    Overview of the reimbursement system
17.2.    Reimbursement for proton therapy
17.2.1.    Procedure coding 
17.2.2.    Diagnosis coding
17.2.3.    Payment mechanism and reimbursement tariffs
17.2.4.    Policy considerations 
18.    Reimbursement analysis in Switzerland
18.1.    Overview of the reimbursement system
18.2.    Reimbursement for proton therapy
18.2.1.    Procedure coding 
18.2.2.    Diagnosis coding
18.2.3.    Payment mechanism and reimbursement tariffs
18.2.4.    Policy considerations
19.    Summary of procedure codes
20.    Summary of reimbursement codes and tariffs
21.    Disclaimer

23

Jun 2022

On May 31, 2022, Regional Cancer Centers collaboration (RCC) updated the national care program for breast cancer. New and updated recommendations concerned genetic testing, molecular diagnostic, de-escalation of surgical treatment for certain patient groups, radiotherapy regimens, and pharmacotherapy. A new chapter was added on breast cancer in men.

Read more

17

Jun 2022

On May 31, 2022, it was announced by the Ministry of Health that the Council of Ministers authorized the distribution of almost €400 million for the renovation of high-tech equipment in the National Health System (SNS) through the High-End Technology Equipment Investment Plan (INVEAT) of the SNS.

Read more

26

May 2022

In April 2022, the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) announced two projects which received a subsidy under the "Subsidy scheme for promising care" in 2022 for research of a transcatheter tricuspid valve repair in severe leakage of the tricuspid valve and precision radiation in epilepsy. In total, five projects will receive a subsidy in 2022.

Read more

21

Apr 2022

On March 16, 2022, the Swedish Medical Technologies Product (MTP) Council released recommendations for SpaceOAR Hydrogel and Barrigel used to reduce the side effects of radiotherapy in prostate cancer. MTP Council recommended the regions wait with the use of technologies until more knowledge is available or use them only within the clinical trials.

Read more

24

Feb 2022

On January 18, 2022, the Ministry of Health has awarded the Framework Agreement for the acquisition of 81 linear accelerators included in the High-End Technology Equipment Investment Plan. Furthermore, the National Institute of Health Management (INGESA) has also initiated the processing of the Framework Agreement that will facilitate the acquisition of the equipment in the fields of interventional cardiology, interventional vascular radiology, interventional neurovascular, digital brachytherapy, computed tomography, magnetic resonance imaging, PET-CT, SPECT-CT.

Read more
(we accept only company emails)