Authors' recommendations: It should be noted that the aim of this study was not to analyze the effectiveness and cost-effectiveness of autologous breast reconstruction interventions compared to alternatives as it is usually done in classical health technology assessments (HTA). The clinical part on the effectiveness and safety of these procedures compared to alternatives as well as the description of the current practice in Belgium (including some cost data) were rather presented to set the frame of the medical context around autologous breast reconstruction. As stated above, the scope of this report was not to put in question the reimbursement decision of autologous breast reconstruction techniques but rather to provide objective data for potential re-evaluations of the current reimbursement tariffs. This is also why the cost study was limited to the "surgeon cost" for the initial breast reconstruction episode, also without taking into account long-term complications. Important variations were found in the results, also depending of methodological choices. For unilateral DIEP interventions for example, results ranged from € 1125 (which is below the current RIZIV-INAMI fee of € 1527) to € 2344 depending on the scenario. This amount further increases when taking into account start and stop activities (up to € 2584) or by adding secondary interventions (i.e. immediate or delayed adjustments). Due to the long list of limitations described above, the current analysis must be used with caution and can only serve for a temporary revision of the fees for autologous breast reconstruction techniques with flap, awaiting a more global re-evaluation across and within medical specialties. The big challenge in the future will be to define what would be a fair and reasonable base hourly income for a physician.

Project Status: Completed

Year Published: 2015

URL for published report: https://doi.org/10.57598/R251C

URL for additional information: https://kce.fgov.be/en/publications/all-reports/autologous-breast-reconstruction-techniques-after-mammary-resection-time-measurements-for-a

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Belgium

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: <p>Belgian Health Care Knowledge Centre (KCE)</p>