Reimbursement

A typical starting point for the development of a German Market Access strategy for medical devices is the Reimbursement analysis. This analysis answers typical questions concerning your product or therapy:

Does a Reimbursement for the method performed with your product already exist? Is there a specific OPS-code? Which are the typical costs for cases treated with your therapy based on the national benchmark data? Which are the incentives for users and purchasing decision makers?

In 2003, the G-DRG-system was implemented as a measurement for the remuneration of hospital treatments in Germany. It serves as a distribution tool of the available money for in-patient services on hospitals.

On the one hand, this implementation induced an economic competition between the hospitals, on the other hand, the hospitals were also put under economic pressure.

Therefore, hospitals strive for the performance of therapies with a positive profit contribution and at the same time lead to a specific patient need/demand (e.g. due to quality of results). According to our experience, the treatment quality has a minor role, the costs and the Reimbursement of a therapy are at least on the same level for decision making processes for or against a therapy. If innovative therapies additionally lead to an improved use of resources (e.g. in the OR, of nursing staff, length of stay, use of ICU or other resources), they are more than interesting for hospitals in Germany in this context.

As a result, the Reimbursement of therapies and products is of significant importance on the German market. A Reimbursement analysis is therefore a typical and highly recommended start for the development of a Market Access strategy.

There are different possibilities to increase the attractivity of products and therapies for hospitals in the German market. The analysis of economic challenges for hospitals is one of the important starting points for the development of a Market Access strategy. If the economic challenges are understood by the industry, they can directly be faced by solutions based on the value message of the therapy. Therefore, a Reimbursement analysis is the typical basis for a Market Access strategy. Relevant questions to answer are for example:

Which are the OPS-codes for the product and method? Are there realistic possibilities and chances for a specific OPS-code? Is the therapy already represented in the G-DRG-system? Are proposals (e.g. OPS, NUB) appropriate for achieving a better Reimbursement for the therapy? Which kind of support is necessary? Which are the next action points or projects to benefit from all these possibilities?

To answer the questions above and further for the development of a Market Access strategy, a complete analysis of your Reimbursement status is necessary within the scope of a Reimbursement analysis.

We are more than happy to support and perform your Reimbursement analysis. Do not hesitate to contact us.

E-Mail: info@healthcareheads.com

Phone: +49 431 800 147 0