Artikel
Access of innovative medical technologies to compulsory health insurance reimbursement in Germany and other countries by example of tumour treating fields (TTFields)
Zugang innovativer Medizintechnik zum Leistungskatalog gesetzlicher Krankenversicherung in Deutschland und anderen Ländern am Beispiel der Tumortherapiefelder (TTFields)
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Autoren
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Christina Proescholdt
- Novocure GmbH, Root, Switzerland
| Veröffentlicht: | 26. Juni 2020 |
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Gliederung
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Objective: To highlight the challenges and differences in access of breakthrough medical device technologies to the compulsory health insurance in Germany and other countries, by example of a novel cancer treatment using Tumor Treating Fields (TTFields).
Accesschallenges for innovative medical devices vary by country.Common issues for novel device technologies are the difficulties to classify the treatment in the respective country's health care system and the according ability to develop a value-based reimbursement pathway.
Methods: We reviewed accesspathways and reimbursementdecisions of payers in several countries. We assessed their classification of the device delivering TTFields in the respective country, the flexibility of their health care framework and the way the technologywas implemented.
Results: All countries were able to implement the novel technology delivering TTFieldstheir respective health care systems. 3 countries consider the technologyto be an outpatient treatment delivered by durable medical equipment, one country classifies it a hospital dispensed medical device, one country as an extended medical service and the last country as rehab services.
The differential fitting of the novel technology in the respective country’s health care system allows each of the countries to take a positive, value-based reimbursement decision for this breakthrough technology. Generally, the speed of payer adoption varied based on the ability of the healthcare system to evaluate the clinical data supporting its use, rather than focusing on more technical aspects of how the device is delivered to patients.
Conclusion: Classification of a breakthrough technology delivered through a medical device in the traditional framework of health care systems is challenging and handled differently by each country. All countries with a flexible approach regarding this novel oncological treatment modality however, were able to reach positive reimbursement decisions by classifying the technology in the category most suitable in the respective country's health care system.
