Mapping the pathways enabling market access to innovative medical procedures and technologies

Posted on 23.11.2022

MedTech Europe and Med Tech Reimbursement Consulting (MTRC) completed a mapping of reimbursement and funding of medical procedures and technologies. MTRC analysed all these pathways by screening the situation in 32 European countries between July and October 2022. The result is an overview of all the current payment schemes for innovative medical technologies and procedures. The mapping also presents the current concrete initiatives aimed at transforming healthcare systems and/or reimbursement and funding systems already implemented by some European countries.

The results show that in Europe these pathways are conceived and provided independently by each country. Every country has a specific system resulting from its political, administrative, and constitutional structure. This has led to, amongst others, a significant disparity across European countries. Differences are in the number and use of pathways that enable timely market access to innovative medical technologies (digital health technologies, medical devices, in vitro diagnostics) and procedures.

All European patients need early access to these promising technologies and procedures to improve their quality of life. These pathways also benefit the providers and healthcare professionals by improving effectiveness, quality of care and clinical outcomes. They help the healthcare systems and payers in optimising the use of healthcare resources and providing societal value. Finally, they encourage the industry to develop new technologies. Some of the major outcomes of the project are described below.

Innovative payment schemes (IPSs) for medical technologies in Europe

To date, only a limited number of European countries have introduced and administer IPSs covering digital health technologies, medical devices, in vitro diagnostics, or medical procedures. Indeed, out of the 32 European screened countries, 24 did not possess any of these IPSs and a total of 21 IPSs were identified in the 8 countries (Austria, Belgium, England, France, Germany, the Netherlands, Spain, and Switzerland – see Annex 1). It is however essential to note that the existence of (a) scheme(s) in a country is not automatically a guarantee of improved and timely access to medical technologies. In fact, only those schemes which are adequately designed, implemented and managed will offer such access.

Initiatives to transform healthcare systems and/or reimbursement and funding systems 

An overarching barrier to patient access to medical technologies is the overall limited political commitment to change the systems. However, some European countries are now taking concrete initiatives in this direction. Indeed, the screening of the 32 countries led to the identification of 33 ongoing initiatives in 17 countries and regions with 16 initiatives in Belgium, France, Italy, and the United Kingdom (where those related to England and Scotland only have been added) (see Annex 2). It is however important to note again that even in countries conducting concrete initiatives, reimbursement and funding systems of medical technologies might still be challenging.

Recommendations 

We must develop, implement and administer improved and timely access to promising digital health technologies, medical devices, in vitro diagnostics and medical procedures. We also need appropriate coverage schemes across all European countries. In addition, timely and ambitious political initiatives focused on improving healthcare systems’ quality and delivery of care through optimal reimbursement and funding mechanisms must be put in place in these countries.

By completing the mapping of European countries having pathways enabling market access to innovative medical procedures and technologies, MedTech Europe has made the first step in this direction. Now is the right time to work together on defining an action plan to:

• clarify what works well and what needs to be improved in the current IPSs and political initiatives. Indeed, as indicated before, the mere existence of a scheme or initiative is not automatically a guarantee of improved/faster access. In fact, some of these schemes/initiatives might not be appropriately designed, implemented or administrated;
• identify the reasons behind these successes and shortcomings;
• establish best practices for developing, implementing and running optimal schemes or initiatives for improved/faster patient access to innovative procedures and technologies.

MedTech Europe invites all key European decision-makers including policymakers and payers to join this endeavour. It is crucial to ensure a commitment to safeguarding reimbursement and equitable patient access to innovative value-added technologies. Therefore, it is crucial to implement throughout Europe holistic pathways which are appropriate to medical technologies, reward their reimbursement and funding in line with the value provided, and ensure their uptake.

Payers and national/regional policymakers interested in obtaining a free copy of the mapping report, learning about the activities MedTech Europe is planning on this topic or discussing how to work together on the next steps are welcome to contact Sophie Koettlitz, Manager VIA.