Reimbursement Analysis for Medical Devices in Europe

This includes specifics of the technology and procedure (mechanism of action, surgical access, duration of procedure, imaging required, pre- and post-procedure requirements, length of hospital and Intensive Care Unit stay, cost of device/procedure), and specifics of analysis (e.g., characteristics of patients, the necessity of day case or admitted hospital analysis)

Procedure coding is important as it defines payment mechanism and tariffs in any healthcare system. Our teams use official nomenclatures and coding manuals from coding/reimbursement authorities. Where possible, the findings are validated with other sources

This is another crucial step in the analysis. Payment model can vary significantly and can include reimbursement via Diagnosis-Related Groups (DRG), add-on reimbursement, innovation funding, unbundled (top-up DRGs), fixed payment for procedures, amongst others

Once the payment mechanism is clear, it is possible to define reimbursement tariffs. Both national and regional systems are analysed, where relevant (e.g., in Finland and Italy)

Reimbursement works hand in hand with funding and advisory frameworks in individual countries. For example, Diagnosis-Related Groups (DRG) and a good tariff can be in place, but authorities restrict the use of the method to a certain population. MTRC analyses the necessary policy frameworks, clinical guidelines by governmental bodies, and health technology assessments

Our teams always propose a free-of-charge teleconference to discuss the findings of reimbursement analysis, since results in multiple countries could be very complex and hard to understand. We offer the interpretation and inform the client about the existence of reimbursement barriers in particular countries 

The next step would be to work on reimbursement strategy in the situations where payment, coverage, or HTA barriers have been identified for technology in individual markets