Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
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<strong>KCE</strong> Reports 74 Hyperbaric Oxygenation Therapy 79<br />
As for these rare diseases a high level of evidence cannot be expected, the CVZ applies<br />
an adjusted evaluation procedure. For these diseases, the CVZ has based its evaluation<br />
on the state of research and practice within the international professional group. The<br />
CVZ has not evaluated the necessity and effectiveness of the treatment. This needs to<br />
be evaluated case by case by the insurer. It concerns the following indications for which<br />
the effectiveness of the therapy needs to be evaluated at individual level by the insurer:<br />
• Relapse neuroblastoma grade IV<br />
• Osteoradionecrosis at other places than the mandible<br />
• Radionecrosis soft tissue other than head/neck/pelvic<br />
• Surgery and implants of irradiated tissues other than the head/neck<br />
area<br />
• Pneumatosis intestinalis.<br />
6.1.3 Non-covered indications<br />
HBOT is not part of the insured care for the following indications, as there is neither<br />
sufficient scientific proof nor a broad acceptation within the professional group:<br />
• Acute deafness<br />
• Tinnitus<br />
• Non-diabetic ulcers, such as decubitus, arteriosclerotic and venous<br />
ulcers<br />
• Cerebral hypoxia, traumatic or after a stroke<br />
• Burns<br />
• Ischemic ocular disorders/abnormalities<br />
• Radionecrosis of the central nervous system<br />
• Multiple sclerosis (based on Cochrane review 2004)<br />
• Acute coronary syndrome (based on Cochrane review 2005)<br />
• Malign otitis externa (based on Cochrane review 2005)<br />
• Acute traumatic brain damage (based on Cochrane review 2004)<br />
• Anoxic encephalopathy<br />
6.1.4 Reimbursement level<br />
The NZA (Nederlandse Zorg Authoriteit) published the following reimbursement price<br />
for treatment with hyperbaric oxygen (declaration code 39995) per session per patient<br />
(independent from whether alone or in group) f:<br />
• Hospital costs: €160.00<br />
• Fee for specialists: €0.00<br />
For hospitals, this amount is fixed and compulsory. For ZBCs (Zelfstandige<br />
Behandelcentra), clinics and independent specialists this is a maximum amount and in<br />
practice many insurers only pay about 75% of this maximum (based on expert<br />
communication).<br />
6.2 FRANCE<br />
6.2.1 Hyperbaric centres<br />
France had a population of 60.87 million people in 2005 on an area of 549 000 km 2 . g<br />
There are 23 civil and 4 military centres offering HBOT (Table 28).<br />
f Source: http://ctg.bit-ic.nl/Nzatarieven/top.do<br />
g Source : OECD demographic data 2007