German reimbursement system for medical devices and IVD tests

This online on-demand 30-minute seminar gives a comprehensive understanding of the hospital reimbursement landscape for medical devices in Germany. Additional modules cover reimbursement of IVD tests and screening methods

Available as pre-recorded webinar or full presentation in Acrobat PDF

Germany is one of the key markets for medical devices in Europe. Many medical devices companies start commercialization of their products in Germany.

Hospital care is the most attractive segment for the introduction of medical technologies. All hospital care (except capital equipment) is funded via diagnosis-related groups (DRGs). Most procedures can be initially coded using existing procedure codes and receive some reimbursement. Update of the DRG system is a clear and straightforward process, administered by InEK. While the development of DRG reimbursement is in process, innovative expensive devices and procedures can utilize innovation funding via NUB.

However, for some high-risk medical devices NUB pathway became complicated due to the “early benefit assessment” process of the Federal Joint Committee (G-BA). Also, many companies fail NUB process due to a lack of understanding of key criteria for granting innovation funding. Decisions of G-BA about coverage of hospital procedures within statutory health insurance is another important, but not a well-understood aspect of market access in Germany.

It is essential for medical device and IVD companies to understand the pathways to the ultimate goal of reimbursement (integration into DRG and add-on reimbursement) and opportunities and requirements for innovation funding in Germany. We offer a seminar on critical elements of the hospital reimbursement system for medical devices that can guide your decision-making in this complex country.

What topics are reviewed?

Key stakeholders and their role in reimbursement processes

Key stakeholders are reviewed, including payers, number of policy-makers, advising organizations (IQWiG), manager of procedural classification (DIMDI) and DRG system (InEK)

Money flow, hospital payment system, the process of development of the DRG system, innovation funding

Money flow and distribution of funds, an overview of the hospital payment system (DRG system), add-on reimbursement (ZE), innovation funding (NUB), and process of development of DRG system

Coverage of services within the statutory health insurance

Overview of a general funding framework in German system, role of G-BA in deciding about coverage of devices within statutory health insurance, summary of key directive of G-BA about hospital coverage (in accordance with § 137c of the Social Code Book V), “early benefit assessment” process in connection with innovation funding for high-risk medical devices (§137h of the Social Code Book V)

Additional modules

Reimbursement system for in-vitro diagnostic tests

A separate comprehensive overview of the reimbursement system for IVD tests in Germany

Organization and financing of screening methods

 A separate comprehensive overview of the organizational and financing framework of screening methods (e.g. breast and cervical cancer screening) in Germany

What topics are not covered?

Some topics are not specifically covered in this seminar: reimbursement model in out-patient settings, reimbursement for medical aids (devices for home use), funding of capital equipment, government co-sponsored studies according to the §137e of the German Social Code Book V, Innovation Fund at the Federal Joint Committee (G-BA)

 The introductory presentation also does not include details of reimbursement application processes (for example application form, requirements, details of the process for the creation of OPS code, DRG change or obtaining innovation funding)

 Topics that are not covered in this seminar will be included in the future courses. You can subscribe to our newsletter and inform us about your particular interests at the main page of the Market Access Academy

How seminar is delivered?

Option #1: Pre-recorded webinar

One option is to watch the seminar, which is provided as a pre-recorded webinar. The duration of the webinar is 32 minutes. Seminar is available for 6 months

Option #2: Presentation in Acrobat PDF

You can also access just the educational material - the full presentation of the seminar in Acrobat PDF

View extract from the seminar

This 1-minute extract presents overview of two aspects of market access in Germany

 

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