Table 3.
Definitions and appraisal results of pre-coverage recommendations of the Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) and final decisions of the Federal Health Commission (n = 69, 2008–2017)
| Variable | Category | Definition | Assessment, n (%) |
|---|---|---|---|
| Recommendation | Yes | The inclusion in the catalogue of benefits is recommended | 0 (0.0) |
| Yes (with restrictions) | The inclusion in the catalogue of benefits is recommended with restrictions | 15 (21.7) | |
| No (preliminary) | The inclusion in the catalogue of benefits is currently not recommended | 50 (72.5) | |
| No | The inclusion in the catalogue of benefits is not recommended | 4 (5.8) | |
| Decision | Yes | The coverage is accepted and the technology is included in the MEL list | 5 (7.2) |
| Yes (with restrictions) | The intervention is included in the hospital benefit catalogue via special coding “XN code” (with restrictions), thus, the procedure has to be reassessed within a defined time frame | 20 (29.0) | |
| No | The intervention is not included in the MEL list | 44 (63.8) |