Transcatheter Aortic Valve Implantation (TAVI) in Europe - European Reimbursement Report

  • ID: 4231948
  • Report
  • Region: Europe
  • European Med Tech Reimbursement Consulting AB
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Essential Information about Reimbursement and National Funding for TAVI

FEATURED COMPANIES

  • Boston Scientific (Lotus)
  • Colibri Heart Valve
  • Direct Flow Medical
  • JenaValve
  • Medtronic (CoreValve)
  • Symetis
  • MORE

This report presents a summary of the reimbursement situation in Europe for transcatheter aortic valve implantation (TAVI) for aortic stenosis. Use of both transfemoral and transapical TAVI is reviewed.

TAVI is a well established technology with reimbursement available in all studied European countries. The main payment models are diagnosis-related group (DRG) for entire hospitalization, add-on reimbursement (England, France, Italy in some regions) and fee for procedure and material (Belgium). All countries, except Italy, have specific procedure codes for TAVI. Brand-specific reimbursement is only available in Belgium and France, while in other countries reimbursement is established for the class of devices.

Reimbursement differs for different types of access for procedures only in France, Germany and Switzerland. In Germany and Switzerland procedures with transapical access has higher reimbursement.

Complications or strokes specifically do not impact allocation to DRG and reimbursement levels in any of the studied countries, with the exception of France.

Almost every country has implemented certain restrictions to provision of TAVI, which are limited to inoperable or operable patients at high surgical risk in the majority of studied countries.

Report includes essential information about reimbursement and national funding for TAVI, 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
  • Summary of the reimbursement hurdle for medical technology
  • Potential further developments of the reimbursement

Reimbursement information is provided for the following geographies:

  • Austria
  • Belgium
  • Denmark
  • England (UK)
  • France
  • Germany
  • Italy
  • Netherlands
  • Norway
  • Sweden
  • Switzerland
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FEATURED COMPANIES

  • Boston Scientific (Lotus)
  • Colibri Heart Valve
  • Direct Flow Medical
  • JenaValve
  • Medtronic (CoreValve)
  • Symetis
  • MORE

1. Introduction and summary

2. Executive summary table

3. Methodology

4. Reimbursement analysis in Austria
4.1. Overview of the reimbursement system
4.2. Reimbursement for TAVI
4.2.1. Procedure coding for TAVI
4.2.2. Diagnosis coding
4.2.3. Payment mechanism and reimbursement tariffs
4.2.4. Policy considerations for TAVI
4.2.4.1. Health technology assessments by LBI-HTA

5. Reimbursement analysis in Belgium
5.1. Overview of the reimbursement system
5.2. Reimbursement for TAVI
5.2.1. Procedure coding for TAVI
5.2.2. Payment mechanism and reimbursement tariffs
5.2.3. Reimbursement framework for TAVI determined by INAMI
5.2.4. Brand-specific reimbursement for TAVI systems

6. Reimbursement analysis in Denmark
6.1. Overview of the reimbursement system
6.2. Reimbursement for TAVI
6.2.1. Procedure coding for TAVI
6.2.2. Diagnosis coding
6.2.3. Payment mechanism and reimbursement tariffs

7. Reimbursement analysis in England
7.1. Overview of the reimbursement system
7.2. Reimbursement for TAVI
7.2.1. Procedure coding for TAVI
7.2.2. Diagnosis coding
7.2.3. Payment mechanism and reimbursement tariffs
7.2.4. Policy considerations for TAVI
7.2.4.1. National commissioning of TAVI by NHS England
7.2.4.2. Health technology assessment of TAVI by NICE
7.2.5. Upcoming changes in TAVI reimbursement

8. Reimbursement analysis in France
8.1. Overview of the reimbursement system
8.2. Reimbursement for TAVI
8.2.1. Procedure coding for TAVI
8.2.2. Diagnosis coding
8.2.3. Payment mechanism and reimbursement tariffs
8.2.4. Brand-specific reimbursement for TAVI in France
8.2.5. Policy considerations for TAVI
8.2.5.1. Health technology assessments by HAS

9. Reimbursement analysis in Germany
9.1. Overview of the reimbursement system
9.2. Reimbursement for TAVI
9.2.1. Procedure coding for TAVI
9.2.2. Diagnosis coding
9.2.3. Payment mechanism and reimbursement tariffs
9.2.4. Policy considerations for TAVI
9.2.4.1. Quality assurance framework for TAVI, determined by G-BA

10. Reimbursement analysis in Italy
10.1. Overview of the reimbursement system
10.2. Reimbursement for TAVI
10.2.1. Procedure coding for TAVI at national level
10.2.2. Procedure coding for TAVI at regional level
10.2.3. Diagnosis coding
10.2.4. Payment mechanism and reimbursement tariffs at national level
10.2.5. Payment mechanism and reimbursement tariffs at regional level

11. Reimbursement analysis in the Netherlands
11.1. Overview of the reimbursement system
11.2. Reimbursement for TAVI
11.2.1. Procedure coding for TAVI
11.2.2. Diagnosis coding
11.2.3. Payment mechanism and reimbursement tariffs
11.2.4. Policy considerations for TAVI

12. Reimbursement analysis in Norway
12.1. Overview of the reimbursement system
12.2. Reimbursement for TAVI
12.2.1. Procedure coding for TAVI
12.2.2. Diagnosis coding
12.2.3. Payment mechanism and reimbursement tariffs
12.2.4. Policy considerations for TAVI
12.2.4.1. Assessment of TAVI within national framework of managed introduction of innovations

13. Reimbursement analysis in Sweden
13.1. Overview of the reimbursement system
13.2. Reimbursement for TAVI
13.2.1. Procedure coding for TAVI
13.2.2. Diagnosis coding
13.2.3. Payment mechanism and reimbursement tariffs
13.2.4. Policy considerations for TAVI
13.2.4.1. Recommendations for TAVI in the national clinical guidelines

14. Reimbursement analysis in Switzerland
14.1. Overview of the reimbursement system
14.2. Reimbursement for TAVI
14.2.1. Procedure coding for TAVI
14.2.2. Diagnosis coding
14.2.3. Payment mechanism and reimbursement tariffs
14.2.4. Policy considerations for TAVI
14.2.4.1. Restrictions for TAVI in the Health Benefit List

15. Disclaimer

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  • Abbott (previously - St. Jude Medical) (Portico)
  • Boston Scientific (Lotus)
  • Colibri Heart Valve
  • Direct Flow Medical
  • Edwards Lifesciences (Sapien)
  • JenaValve
  • Medtronic (CoreValve)
  • Symetis
  • Transcatheter Technologies
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