Thursday, December 10, 2015

Next Gen Reimbursement in Germany Crazy in its Own Way

Two years ago, Genomeweb reported briefly on kerfuffles in the German health care system over whether next gen sequencing methods were reimburseable or not under their policies and procedures.

In December, 2015, Genomeweb provides its readers with a deep dive update showing there is still a tempest raging over this issue in Europe's largest economy, and it's gotten bigger, not smaller.   Julie Karow's article here (subscription).

Like the US code system "CPT," the Germans have a procedure code system (Operationen- und Prozedurenschluessel, OPS) and a payment system (Einheitlicher Bemessungsmasstab, EBM).  (Read more at the Deutsches Institute fur Medizinische Dokumentationen und Information, DIMDI here and via ISPOR, here.)

The tempest this winter has to do with use of Sanger sequencing vs NGS sequencing, slow-moving burocrats, battling stakeholders, and all the other complexities of genomics test policy.  Karow writes,
"Praxis für Humangenetik Tübingen, a medical genetics practice closely aligned with molecular diagnostics firm CeGaT, is now suing its regional administrator, Kassenärztliche Vereinigung Baden-Württemberg (KVBW), which has refused to pay for more than 1,000 Sanger-based diagnostic tests that were followed by free NGS panels."
See the original article for the full story.

Also, for Genomeweb's recent story on NIPT in Germany, here.