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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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The G-BA Innovation Committee recommends transfer to standard care for another three projects in Germany

On October 16, 2023, the Innovation Committee at the Federal Joint Committee (G-BA) published the decision recommending the transfer to standard care for another three completed projects. Two projects evaluated the effects of psychotherapy structural reform. The third project analyzed the health risks of long-term use of proton pump inhibitors (drugs that reduce stomach acid production).

In 2017, with the psychotherapy structural reform, the G-BA introduced new outpatient care elements, including psychotherapeutic consultation hours. This low-threshold offer is intended to identify the disease requiring treatment at an early stage, diagnose it, and provide acute treatment (if needed) in the short term.

The project “PT-REFORM – Evaluation of the Psychotherapy Structural Reform” in Rhineland-Palatinate examined the effects of the new care elements and possible obstacles to their establishment from the perspective of the respondents using specific research questions.

The project “ES-RiP - Evaluation of the structural reform of guideline-based psychotherapy - Comparison of patients with complex and non-complex diseases” evaluated retrospectively the care provided before and after the structural reform for the period from 2015 to 2019.

Considering that the respective results are not representative and there is a high risk of bias, the findings obtained in the projects will be forwarded to the G-BA's subcommittee on psychotherapy and psychiatric care. The subcommittee is asked to examine whether findings from the projects can be used to further develop the psychotherapy guidelines. In addition, the project results will be forwarded to the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the German Society for General Medicine and Family Medicine (DEGAM) for information.

The “RiDe-PPI – Health risks and determinants of long-term use of proton pump inhibitors (PPI)” project researched whether long-term use of the above-mentioned drugs is associated with increased risks of dementia, myocardial infarction, or strokes. Billing data from AOK Bayern and the Association of Statutory Health Insurance Physicians in Bavaria were evaluated for this purpose. The Federal Institute for Drugs and Medical Devices (BfArM) is asked to check whether the results can be included in the data-supported risk signal detection and benefit/risk assessment of the PPIs.

The full details in German can be found here, here (decision and the results of the PT-REFORM project), here (decision and the results of the ES-RiP project), and here (decision and the results of the RiDe-PPI project).

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Contact us to get a free, three-month, no-obligation trial.