Ventricular assist devices for circulatory support

Series
External life support
Status
Published
Date
Number of report
033

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The report presents a summary of reimbursement situation for ventricular assist devices for circulatory support.

The report includes all types of the ventricular assist devices: intra-, para- and extra-corporeal. Openly and percutaneously placed devices are considered. Veno-arterial ECMO for circulatory support is not considered in this report.

Bridge-to-decision, bridge-to-transplant and destination therapy indications are considered.

The following clinical situations are considered: deterioration of chronic advanced heart failure, post-cardiotomy cardiogenic shock, post-myocardial infarction cardiogenic shock.

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

Manufacturers of ventricular assist devices for circulatory support include:

  • Abbott (CentriMag, Thoratec PVAD, HeartMate PHP, PediVas, Heartmate II left ventricular assist system, Heartmate III left ventricular assist system)
  • Abiomed Inc. (Impella)
  • Berlin Heart (EXCOR ADULT, Incor)
  • Jarvik Heart (Jarvik 2000)
  • LaunchPoint Technologies Inc. (Streamliner VAD)
  • LivaNova (TandemHeart)
  • Medtronic (BPX-80 BIO-Pump Plus, HeartWare HVAD System)
  • MITIheart (MTIHeartLVAD)
  • ReliantHeart (HeartAssist5)
  • Ventracor (VentrAssist)
  • Xenios (Icor)

Table of content
 
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 ventricular assist devices for circulatory support
5.2.1.    Procedure coding
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.4.    Policy considerations
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for ventricular assist devices for circulatory support
6.2.1.    Procedure coding
6.2.2.    Material 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 ventricular assist devices for circulatory support
7.2.1.    Procedure coding 
7.2.2.    Diagnosis coding
7.2.3.    Payment mechanism and reimbursement tariffs
7.2.4.    Policy considerations
8.    Reimbursement analysis in England
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for ventricular assist devices for circulatory support
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 ventricular assist devices for circulatory support
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 ventricular assist devices for circulatory support
10.2.1.    Procedure coding 
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs
10.2.4.    Policy considerations by G-BA
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for ventricular assist devices for circulatory support
11.2.1.    Procedure coding
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs
11.2.4.    Policy considerations
12.    Reimbursement analysis in the Netherlands
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for ventricular assist devices for circulatory support
12.2.1.    Procedure coding 
12.2.2.    Material codes
12.2.3.    Diagnosis coding
12.2.4.    Payment mechanism and reimbursement tariffs
12.2.5.    Policy considerations
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for ventricular assist devices for circulatory support
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 ventricular assist devices for circulatory support 
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 ventricular assist devices for circulatory support
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

Jun 2018

The report includes all types of the ventricular assist devices: intra-, para- and extra-corporeal. Openly and percutaneously placed devices are considered. Bridge-to-decision, bridge-to-transplant and destination therapy indications are considered. 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.

Read more

10

Apr 2018

New material codes for Ventricular Assist Device and Aortic Endoprotheses were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in April 2018.

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24

Jan 2018

In December, HAS published a set of decisions about add-on reimbursement of medical devices that were evaluated by the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). These decisions concern respiratory prostheses for total laryngectomy, mandibular advancement devices, some cardiovascular devices (transcutaneous bioprosthetic aortic heart valve, ventricular assist device, etc.) and other devices.

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14

Aug 2017

In the first half of 2017, Galician Agency for Health Technology Assessment (AVALIA-T) published 4 HTAs for medical technologies and procedures including Impella ventricular assist device in cardiogenic shock, microwave ablation for tumors of the liver, microsurgery in limb lymphedema and intravitreal injections. Read high-level conclusions from these assessments.

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11

Jul 2017

Recently, CNEDiMTS at HAS issued positive recommendation for inclusion of HeartMate 3 ventricular assist device into add-on reimbursement catalogue (LPPR title III). No added value was established vs earlier version of device (HeartMate II), despite better safety profile demonstrated in the randomized controlled trial.

Read more
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