Key topics
There is only one key theme describing market access for medical technologies in the Czech Republic:
- Reimbursement: payment mechanism via the DRG-adjusted budget system, case-by-case reimbursement according to CZ-DRG
Reimbursement
Hospital care is predominantly financed via a global budget adjusted for activity based on DRGs. However, other payment mechanisms (such as case-by-case reimbursement via CZ-DRG, individually agreed payment mechanisms and reimbursement amounts between hospitals and insurance companies) can also be used to pay for hospital care. The payment mechanisms and reimbursement tariffs are defined annually in the “Reimbursement Directive”.
CZ-DRGs are determined by the combination of a procedure code (SZV) and a diagnosis code (ICD-10). The SZV nomenclature is maintained by the Ministry of Health, but is expected to be replaced soon by a new classification, the Classification of Hospitalization Procedures (KHP). The CZ-DRG system is maintained by the Central Institute of Health Information and Statistics (UZIS) and is updated annually.
Some (but not all) materials and devices can be considered as “separately billed materials” (ZUM). In outpatient settings, their cost can be billed separately, on top of the fee for the procedure. However, In hospital settings, the ZUM materials are not reimbursed separately; rather, the costs of medical devices are covered by the DRG tariff, but the presence of the ZUM material can impact the DRG allocation.
Specifics for IVD tests
IVD tests provided in outpatient specialist settings are reimbursed on a fee-for-service basis via the SZV nomenclature.
How can MTRC help?
Development of reimbursement analysis (procedure coding, payment mechanism, reimbursement tariffs, policy and HTA considerations)
Development of reimbursement strategy
Adaptation of the global health economic model to the Czech settings
Access to an educational seminar on the Czech reimbursement system
Get in touch
Contact us to discuss your needs and learn about our services