The reimbursement coverage decisions and pricing rules for medical devices in Taiwan

Tsai HY, Huang YW, Chang SY, Huang LY, Lin CJ, Lee PC
Record ID 32018002655
English
Original Title: A comparison of the reimbursement policy and insurance payment systems for medical devices in different countries
Authors' objectives: This study aims to review the literature on medical device insurance payment systems and its decision-making processes in different countries, and to investigate the health utilization and outcome of patients who underwent hip arthroplasty with different types of hip prosthesis and who underwent percutaneous transluminal coronary angioplasty (PTCA) with different types of stents.
Authors' results and conclusions: The payment systems on medical devices in public healthcare insurance are usually DRG or FFS in other countries, which is similar to that in Taiwan. In Japan, Korea, and Taiwan, medical devices are reimbursed based on functional categories.
Authors' recommendations: The payment systems on medical devices in public healthcare insurance are usually DRG or FFS in other countries, which is similar to that in Taiwan. In Japan, Korea, and Taiwan, medical devices are reimbursed based on functional categories. This article is expected to contribute to providing references to new reimbursement coverage decision-making and pricing rules.
Authors' methods: Medical devices insurance payment system and decision-making process in different countries: The systematic review was conducted to identify and synthesize the available health technology assessments and available literature on published websites for medical device insurance payment systems and decision-making processes concerning these systems in different countries. Part 2: Clinical outcomes and economic evaluation of special materials The real world data National Health Insurance Research Database (NHIRD) was used to analyze the utilization, clinical outcomes, and medical cost of hip arthroplasty and PTCA with different types of devices. Moreover, take PTCA as an example, we build a pilot payment model to access the claim reimbursement.
Authors' identified further research: In considering to the amount of medical device use during PTCA treatment depends on patient condition and it was with large variety. An expert committee to be set up was suggested and a further assessment is necessary.
Details
Project Status: Completed
Year Published: 2022
URL for published report: https://www.egms.de/en/journals/hta/
URL for additional information: English (Abstract and published paper); Full HTA report in Chinese (Mandarin)
English language abstract: An English language summary is available
Publication Type: Full HTA
Pubmed ID: 35360087
DOI: 10.3205/hta000134
MeSH Terms
  • Insurance, Health, Reimbursement
  • Reimbursement Mechanisms
  • Costs and Cost Analysis
  • Biomedical Technology
  • Comparative Study
  • Equipment and Supplies
  • Angioplasty
  • Arthroplasty, Replacement, Hip
  • Hip Prosthesis
Keywords
  • reimbursement
  • medical devices
  • payment system
Contact
Organisation Name: Center for Drug Evaluation
Contact Address: 3F.,No.465, Sec.6, Zhongxiao E. Rd., Taipei 11557, Taiwan. R.O.C.
Contact Name: Li Ying (Grace) Huang
Contact Email: lyhuang277@cde.org.tw
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.