UK
Reimbursement
Understanding your market access journey
Market access can be started at any stage. But the earlier a strategy is implemented, the sooner a new technology or treatment method can be appropriately adopted. Each European country has its own unique healthcare system that is locally managed and structured.
Use our interactive map below to learn more about the UK reimbursement pathway and understand how your technology may gain reimbursement.
Does your technology have an existing OPCS-4 code?
Does your technology have an existing OPCS-4 code?
If your device has been designed alongside an innovative procedure that is not described in an existing OPCS-4 code the procedure will need to be appraised by NICE under the Interventional Procedure Guidance program or a new OPCS-4 code applied for. You will need to demonstrate safety and efficacy of the new surgical intervention with patient reported outcomes initially, followed by demonstration of value and cost effectiveness.
Contact us to understand which route is best for your technology / new procedure and how to prepare for a submission, or view our services for more information.
Does your technology fit into the OPCS-4 tariff (or is it more expensive)?
Does your technology treat a rare condition?
Does your technology treat a rare condition?
The NHS has several mechanisms to support the adoption of innovative high cost technologies that do not fit into an existing OPCS-4 tariff. The first is the High-Cost Tariff-Excluded Devices (HCTED) list and the second an Innovation Technology Payment (ITP).
Contact us to understand if your technology is suitable for either payment and the next steps or view our services for further information.
Does your technology treat a rare condition?
Technologies that are designed to treat rare conditions are often prohibitively expensive. If a technology has demonstrated its value to the NHS (often through a health technology assessment with NICE) it may be considered for specialist reimbursement by NHS England allowing its adoption by 'specialist providers'.
Contact us to find out if your technology is suitable for specialist reimbursement and if so how to prepare a submission , or view our services.
Does your technology fit into the OPCS-4 tariff (or is it more expensive)?
As your technology fits into a procedural tariff described by an OPCS-4 code and is no more expensive than current treatment methods it may be possible to gain immediate reimbursement.
Contact us to discuss if your technology is suitable for immediate reimbursement and the next steps to demonstrating an effective case to support its adoption, or view our services.
Does your technology fit into the OPCS-4 tariff (or is it more expensive)?
The NHS is based on a payment by results system where hospitals are reimbursed for the services they provide through Health Resource Groups (HRG) codes. Each HRG is made up of an ICD-10 (diagnoses codes) and OPCS-4 (procedure codes). All costs of a procedure are included in the OPCS-4 code including medical devices.
Contact us to understand if your technology can be coded through an existing OPCS-4, or view our services for further information.
Does your technology have an existing OPCS-4 code?
The NHS system reimburses hospitals for the services they provide through Health Resource Groups (HRG) codes. Each HRG is made up of an ICD-10 (diagnoses codes) and OPCS-4 (procedure codes). All costs of a procedure are included in the OPCS-4 code including medical devices.
Contact us to understand if your technology can be coded through an existing OPCS-4 or if a new code is required, or view our services for further information.
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Find out how Device Access UK can support your technologies adoption across Europe.
