Bariatric surgery

On August 8, 2024, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 197 and 093 with changes to be implemented no later than October 4, 2024. Thirteen new procedure codes related to cardiovascular, endoscopy, gastrointestinal, interventional radiology, neurology, gynecology, orthopedics, spine, and robotic surgery areas, and four new diagnostic codes were introduced.

The Danish Health Authority has initiated a process of assessing the national clinical recommendations. Work is set to start in 2024. Recommendations in diagnostic imaging, endoscopy, endocrine, ENT, gastrointestinal, nephrology and urology, neurology and neurosurgery, neuromodulation, obstetrics and gynecology, ophthalmology, orthopedics, pulmonary and airways, radiotherapy, spine, and some other fields are considered for reassessment.

In February 2024, the National Institute for Health and Care Excellence (NICE) published one new Interventional Procedures Guidance on endoscopic sleeve gastroplasty for obesity. Furthermore, one Health Technology Evaluation using early value assessment (digitally enabled therapies for adults with depression) was updated.

In January 2024, the National Institute for Health and Care Research (NIHR) in England released one Med Tech-related assessment in its Health Technology Assessment (HTA) Journal, which concerned bariatric surgery in adults with severe obesity in Scotland. HTA Journal publishes research reports on the effectiveness, costs, and broader impact of health technologies for those who use, manage, and provide care in the NHS and informs National Institute for Health and Care Excellence (NICE) guidance.

In June 2023, the National Institute for Health and Care Excellence (NICE) published one new Interventional Procedure Guidance (irreversible electroporation for treating prostate cancer) and one new Diagnostic Guidance (AI-derived computer-aided detection (CAD) software for detecting and measuring lung nodules in CT scan images). Also, three clinical guidelines were updated.

In June 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 190 and 086 with changes to be implemented no later than August 4, 2023. Fourteen new procedure codes (concerning cardiovascular, diagnostic imaging, endocrine, endoscopy, gastrointestinal, orthopedic and spine, peripheral vascular, robotic surgery, men's health, and radiotherapy fields) and six new diagnostic codes were introduced.

On May 31, 2022, the French National Authority for Health (HAS) published the final positive opinion on the coverage of the endoscopic gastroplasty with the ENDOMINA triangulation platform under the Innovation package (Forfait innovation).

On April 25, 2022, the Decision Forum for "New Method" did not prioritize any surgical procedure in the treatment of morbid obesity. Available evidence in the complete method assessment shows minor or no difference in weight loss, diabetes control, or health-related quality of life when using various surgical procedures. The comparative effect on the risk of early mortality, progression of obesity, and obesity-related comorbidities was not possible to determine. The cost differences are non-significant. Further research was recommended.

On January 20, 2022, the Academy of Medical Royal Colleges (AoMRC) launched a consultation on the latest set of guidance (List 3) of the Evidence-based Interventions (EBI) Programme. EBI program develops guidance sets (Lists) for tests, treatments, and procedures based on recommendations from the Expert Advisory Committee and NICE assessments. Proposed List 3 covers 17 interventions across a range of medical specialties, including cardiology, ophthalmology, urology, and others. The deadline for comments submission is March 31, 2022.

At the beginning of August 2021, the European Network for Health Technology Assessment, EUnetHTA, released a final report on the surgical procedures for the treatment of obesity. The results suggest little or no difference in the effects of different bariatric surgery procedures on weight loss and diabetes control. However, the results are based mainly on low to very low certainty evidence, with few or even single studies providing data for many of the comparisons.

In July 2021, the Austrian Institute for Health Technology Assessment (AIHTA) published six new decision support documents and one update to a previous decision support document. The assessed topics included percutaneous left ventricular assist devices, liposuction for surgical therapy of lipoedema, triphasic biomaterial for augmentation of the osteoporotic femoral neck, endoscopic plication therapy in patients with gastroesophageal reflux disease (GERD), allogenic bone screw Shark Screw® in patients with hallux valgus or scaphoid fractures/pseudarthroses, and surgical interventions for the treatment of benign prostatic hyperplasia. The updated decision support document concerned implantable bulking agents for fecal incontinence.

The French Ministry of Solidarity and Health constantly announces the new experiments initiated under Article 51 of the Social Security Financing Act. These experiments are focused on various topics concerning medical technologies and organization of care. Eleven new experiments were initiated in the fourth quarter of 2020. The experiments concern areas of diabetes, nutrition, home monitoring of patients on oral cancer drugs, bariatric surgery, and others. More details about each of the experiments initiated in the fourth quarter of 2020 is provided in this article.