Business Monitor International


Medical Devices Pricing & Reimbursement 2014

Published 20 March 2014

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Medical Devices Pricing & Reimbursement 2014

Medical device manufacturers are faced with a number of market access challenges, including an increasing trend towards health technology assessment (HTA) and the need to demonstrate value for money as well as clinical benefit in order to qualify for reimbursement funding. For health payers, cost-containment has long been an issue with regard to pharmaceuticals. However, various pricing and reimbursement controls for pharmaceuticals have become well established and payers are turning their attention to medical devices.

Whether through direct or indirect measures, the prices of medical devices are being squeezed in order to provide healthcare systems with the best quality of care for the lowest cost. The key trend is value-based healthcare. Value is defined in terms of clinical efficacy as well as cost-effectiveness. HTA is increasingly being employed as part of the reimbursement decision-making process. While the majority of markets do not yet directly link the outcome of HTA to reimbursement, in some countries, notably France and Australia, a positive HTA is required prior to listing for reimbursement. Particularly in advanced healthcare markets where costs are constrained and growth is slow, demonstrating value to HTA agencies has never been more important for medical device manufacturers. In emerging markets, formal HTA policies are in their infancy. However, HTA is becoming more important around the world, with countries such as Brazil, South Korea, Chile and Colombia all having introduced HTA policies over the last few years.

Different procurement and reimbursement strategies are often employed for inpatient and ambulatory care. Tendering systems are commonly employed for medical devices used in hospitals and group-purchasing agencies are increasingly being employed to drive down costs. In Europe in particular, the use of diagnosis related groups (DRG) for inpatient treatment means that medical devices form part of a defined care package. In practice, this...

Provides insight into medical device pricing and reimbursement systems and latest regulations across 17 key countries!

This guide provides everything you could need to know about medical device pricing and reimbursement in 17 established and emerging economies. It examines the increasing role that health technology assessment plays in the reimbursement decision-making process and procurement strategies - both of which have a direct impact on device pricing.

Countries covered in this report:

  • Asia/Pacific: Australia, China, Japan and South Korea
  • European Union: Belgium, France, Germany, Italy, The Netherlands, Spain and United Kingdom
  • Latin America: Brazil, Chile, Colombia, Mexico and Peru
  • USA

Health Technology Assessment (HTA) plays a key role in the increasing trend of value-based care.

Whether through direct or indirect measures, the prices of medical devices are being squeezed in order to provide healthcare systems with the best quality of care for the lowest cost. The key trend is value-based healthcare. Value is defined in terms of clinical efficacy as well as cost-effectiveness. HTA is increasingly being employed as part of the reimbursement decision-making process. While the majority of markets do not yet directly link the outcome of HTA to reimbursement, in some countries, notably France and Australia, a positive HTA is required prior to listing for reimbursement.  Particularly in advanced healthcare markets where costs are constrained and growth is slow, demonstrating value to HTA agencies has never been more important for medical device manufacturers.  In emerging markets, formal HTA policies are in their infancy.  However, HTA is becoming more important around the world, with countries such as Brazil, South Korea, Chile and Colombia all having introduced HTA policies over the last few years.

Key questions answered in this report

  • Which countries use reference pricing for medical devices?
  • What strategies are being employed to indirectly regulate prices?
  • Which countries have positive lists for reimbursement?
  • What have diagnosis related groups got to do with medical device reimbursement?
  • Is there a national standard for HTA in the USA?
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