Good practice in reimbursement of cardiac implant Telemonitoring – lessons from 5 member states

  • Posted on 05.09.2012

Good practice in reimbursement of cardiac implant Telemonitoring – lessons from 5 member states

Ralf Baldeweg

Ralf Baldeweg

Senior Manager - PwC


Martin Schloh

Partner Pharma & Healthcare Consulting - PwC

2007-05-30 European flag

This week a very interesting group of people met in a small conference room on the last day of the ESC Congress (European Society of Cardiology) in Munich. Representatives of the Eucomed CRM Telemonitoring Working Group, individual member companies and leading representatives of the ESC came together under the chairmanship of the European Heart Rhythm Association (EHRA) to officially launch the White Paper “Moving towards good practice in reimbursement of CIED Telemonitoring”.

When we were first approached by Eucomed’s CRM Telemonitoring Group back in January 2012, we were asked to develop a White Paper which summarises the current state of reimbursement for the remote monitoring of implanted cardiac devices (or to use the exact terminology: Cardiac Implantable Electronic Devices Telemonitoring). In which European countries is what being reimbursed? Or is there no reimbursement at all? These were all questions we wanted to see answered in the White Paper.

A great project for us as a consultant to the industry, we all had some idea of what we needed to include, describe and develop in terms of recommendations in this White Paper. The secret is of course to align all client expectations! We were well aware that we were sitting in front of 5 client companies as well as Eucomed instead of “just one” which we are used to. And it became great fun to have joint meetings and telcos with tight time management and very constructive outcomes!

Initially, we focused on Germany, Italy, Spain, UK (England) and The Netherlands in order to make our observations as specific and detailed as possible.  Of course, the ultimate goal of this research is to think of potential scenarios for good practice reimbursement and to provide an unbiased platform to discuss with all stakeholders. As Eucomed highlighted in its press release on the occasion of the launch, Telemonitoring offers great benefits to patients, who are highly satisfied with the possibilities that remote monitoring solutions have to offer. Some benefits that come to mind include fewer tedious scheduled hospital visits, faster response in case of an adverse event and overall better quality of life. And yet, the “real world” implementation will only succeed if appropriate reimbursement systems would be in place.

The CRM Telemonitoring Group requested a White Paper that was…

  • inspiring: Evaluating new pathways to reimbursement of cardiac telemonitoring
  • practical: Suggesting concrete reimbursement models
  • flexible: Making it relevant for a broad range of countries with country-specific descriptions
  • realistic: Considering all parties involved.

Needless to say that this has been a very exciting project which saw our local teams in each of the five countries step up to the plate. Moreover, we had to think through the basic principles of what makes a reimbursement policy really good. To do so, we conducted more than 50 interviews with all relevant stakeholder groups like hospitals, physicians, insurance companies or regulators. Some stakeholders we interviewed several times to challenge our ideas and proposed reimbursement solution.

The overarching finding (reimbursement is a national competence) was that the three key stakeholders at European level, industry, providers and patients, have to pull their weight: industry by developing even more investment-friendly solutions, providers by advocating the benefits of remote monitoring and patients by showing willingness to adopt these technologies where appropriate. More specific findings are available in the freely downloadable White Paper. From our personal view, finding future reimbursement solutions really depend on defining the right target groups, and on the involvement of all stakeholder groups mentioned before. All successful examples which we have found base on a joint approach.

Obviously the work is not done with this week’s meeting. The next step will be to set up focus groups at national level consisting of EHRA representatives, industry and patient groups. Being more vocal at national level means being better equipped to bring the benefits routine CIED telemonitoring to more people in Europe.

Martin Schloh, Partner Pharma & Healthcare Consulting, PwC

Ralf Baldeweg, Senior Manager, PwC

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