Registration
Morning Seminar Implications of the New Dutch DRG System (DOT) on the Dutch Medical Device Industry and Reimbursement
Jan 30, 2012
From DBCs to DOT. Rotterdam, The Netherlands
Welcome to this unique opportunity to hear from the main stakeholders involved in the Dutch Reimbursement system about the most important changes in the new Dutch DRG system:
The DOT System.
During 2012, the Dutch health care system will experience a substantial change in its DRG system.
The aim of this new DRG system (the DOT system) implies the following major changes:
- The number of DBCs (diagnostic treatment combinations) will be reduced from more than 40.000 to 4.400.
- The percentage of negotiable DBCs, DBCs belonging to segment B, will increase from 30% to 70%.
- The role of tariff negotiation between hospital finance departments and health insurance companies will play an important role in the Dutch reimbursement process.
- Hospital selection based on quality will have a strong prevalence: insurance companies are no longer obliged to contract with all centers. This will lead to a scenario in which innovative procedures will only be concentrated and reimbursed in Key reference centers.
- Dedicated Innovation Funding from the biggest Health Insurances is cancelled as per Jan 1, 2012: How is Innovation going to be funded without this discretionary budget?
- In summary, less government intervention as the goal is to achieve a full market driven health care system.
The objective of this seminar is to first explain the formal changes in the new Dutch DRG system to be introduced in 2012 in the Dutch Health Care Market and how these changes will influence the implementation of a new DBC (Dutch DGRs) when a new medical device is to be introduced in the Dutch Medical Device industry i.e. if a new DBC is required for a specific therapy using an innovative technique.
Besides the formal reimbursement framework, this seminar will also consist of two practical sessions and a business case for the Dutch Medical Device market.
During 2012, the Dutch Health Care Market will experience a transition year where a switch from a DBC to a DOT based reimbursement system will be taking place.
The number of DBCs will be reduced from almost 40.000 to 4.400 DBCs linked to 3.700 declaration codes with their corresponding reimbursement tariffs.
Seventy percent of these new DBCs (segment B) will be negotiable compared to the current thirty percent; this will involve a higher level of tariff flexibility in the Dutch Health Care Market implying more room for tariff negotiations between Health Insurance companies and Hospital Finance Departments.
The role of the selection for Care Quality and Key Reference Centers will be important from both the Health Insurance and Industry perspective as from 2012; Health Insurance Companies will no longer need to contract with all hospitals.
It is crucial for a Medical Device Manufacturer to understand what changes this new DRG system (the DOT) will bring and how they will influence the actual reimbursement tariff for targeted DBCs.
For new medical technology manufacturers, achieving CE mark and other country specific regulatory approvals may not be enough to have full market access.
There are three different situations that an innovator company may have to confront while entering the Dutch Medical Device Market and to achieve reimbursement:
1. The existing DBC - Dutch DRG - tariff does not sufficiently compensate for the cost of your device and other direct and indirect hospital cost (including physicians Honoraria).
2. Your medical technology does not fit into any existing DBC or Care Activity Code (Zorgactiviteit codes) implying a problem for hospitals to implement your technology.
3. There is no interim funding available for your medical technology to be initially funded: the lack of discretionary funding.
In this seminar, we have brought together the most important stakeholders involved in the Dutch Reimbursement System in an intensive morning session at Erasmus University Rotterdam.
On the one hand, the CVZ and the DBC-Onderhoud representatives will explain the most important issues while implementing a new DBC and Care activity code:
Prior to the reimbursement application:
• How long does it take for a medical device company to achieve both payers and clinical endorsement in the Dutch market?
• What is needed before approaching the DBC-Onderhoud?
• What are the Criteria for DBC application under the new DOT system?
Along the reimbursement process:
• What is the role of the NZa under the new DOT system?
• When does the CVZ intervene? What does the CVZ look at while assessing new technologies? Is a HTA a compulsory assessment in The Netherlands?
• What is the difference between a DBC and a Care Activity code? When is a DBC or a Care Activity Code implemented? Are they done at a national or at a hospital level?
• What is the different level of DBCs and Care Activity Codes reimbursement categorization under the new DOT system?
• How can my technology qualify for conditional reimbursement for a period of 3 years in this new system? Will the criteria be different for conditional reimbursement in the new system? A different pathway? Different stakeholders? Cost effectiveness?
Decision Making:
• On which criteria does the Ministry of Health base its final decision?
• What are the process timelines and the likelihood of acceptance?
Alternative Funding:
• Are there any other mechanisms to achieve funding until a DBC or care activity code is implemented?
On the other hand, the new DOT system increases the role of Health insurance companies when it comes to tariff negotiation for DBCs belonging to segment B. Thus, the health Care Insurance Board (representing all Health care insurance companies in the Netherlands) -Zorgverzekeraars Nederland ,ZN- will present its perspective in regards to the new DOT system and emphasize the role of tariff negotiation between hospitals and health insurances and the implications for a medical device manufacturer.
The last two sessions involve two practical and hands-on sessions where Mr Van Belleghem, the Hospital Accountant and DBC expert from Utrecht Medical Center -one of the biggest and most important hospitals in The Netherlands will explain how hospitals will deal with the new DOT system when recording indirect and direct costs, care activity codes, DBCs and declaration tariffs including how medical devices are introduced at a hospital level.
Mr Van Belleghem will also touch upon the following topics:
• Inside the DOT financing system : history, present and the future
• What are the main Cost Drivers in a hospital in general:
Product profiles
Price*Quantity
• How is innovation paid in the Dutch Health Care system
When is a new Care activity code/DBC needed?
Are there any other mechanisms of funding?
The business case:
Introduction of the Trancatheter Aortic Valve (TAVI) in the Dutch healthcare setting: Preliminary steps and recent challenges & opportunities
- TAVI: a real breakthrough innovation
- Early introduction of TAVI in Dutch hospitals: Global budget and local funding
solutions
- A new specific measure: Hospital authorization process
- The HTA with CVZ: past and present situation
- The DBC/DOT aspect: from anticipation to implementation
- 2012 = A transition year - Risks and new challenges
Agenda:
Introduction
8:00 – 8:30 Breakfast and Registration
8:30 – 8:45 Introduction to the Seminar by Richard Murrugarra - Centurion
First Part: Formal Reimbursement Pathway
8:45 - 9:20 "An introduction into the DOT system: incorporation of
innovation"
by Mrs Ingebort van Dijke, DBC-Onderhoud
10:20 – 10:05 Achieving conditional reimbursement in the new system
Future Implications and the Role of HTA.
by Mrs Paula Polman, CVZ
10:05 – 10:35 Dutch Reimbursement in a European Context: stakeholder
management and strategic decision making
By Mr Mattias Kyhlstedt, Synergus
Coffee Break ==> 10:35-11:00
Second Part: Hands-On Reimbursement and Business Case
11:00 – 12:00 Topic 1: The actual system with all its ingredients
(Dealing with hospital accounting)
Topic2: Incorporation of new technologies and alternative ways
for cost declarations: DBCs, Cost Drivers, Add-ons and Outliers.
by Mr Hans van Belleghem - Utrecht Medical Center
12:00 – 12:30 Industry Perspective - Business Case by Mr Michel Verhasselt
Senior Reimbursement Specialist
Third Part: Questions & Networking Activities
12:30 – 13:00 Questions and Answers
13:00 – 14.00 Optional Networking Lunch at the Erasmus Faculty Club with the Synergus Team
Registration fee
150 euros (The fee does not include the Optional Networking Lunch at 13:00)
The price for the Optional Lunch Buffet is 21,80 EUR + 6% VAT
For registration, please click on the button on the top right corner.
Mr Kyhlstedt and Richard Murrugarra will be available for individual meetings throughout the day.
Location:
Rotterdam, The Netherlands
Erasmus University Rotterdam
Faculty Club
Burgermeester Oudlaan 50,
3062 PA Rotterdam,
The Netherlands
Conference Room: Rivium Zaal, H17- 02
Cancellation Policy:
Cancellation to this event is only possible if the participant informs Synergus within 5 working days prior to the event. (Monday, JAN 23)
About Synergus:
Synergus is a global Medical Technology consultancy and solution provider with considerable experience and know-how of reimbursement and market access strategies in Europe, US and Asia, along with an unparalleled support in regulatory and quality control. This unique experience makes us a team of highly accomplished and dependable consultants and analysts to support Medical Device companies not only in building strategies but also in implementing and monitoring them.