Market Access & Reimbursement Strategy

8 weeks

Delivered a comprehensive market access roadmap defining all feasible reimbursement routes for the SCS therapy. The report outlined code applicability, procedural classification scenarios, and engagement steps with payers and authorities. The insights guided the client’s strategic decision to position its SCS system as a clinically equivalent but technologically superior option within Poland’s neuromodulation funding framework.

The client required expert support to assess reimbursement and coding opportunities for its advanced spinal cord stimulation (SCS) device in Poland. The assignment focused on identifying feasible pathways under the National Health Fund (NFZ) framework, benchmarking against existing SCS devices, and clarifying whether the product could be introduced under existing benefit codes or through new pilot or tariff creation.

• Conducted an in-depth review of the Polish reimbursement system for implantable neuromodulation technologies, including the roles of the Ministry of Health, AOTMiT, and NFZ.
• Analyzed current procedural codes (JGP/NFZ) and their applicability to rechargeable and adaptive SCS systems.
• Benchmarked competing SCS devices (open-loop systems) already covered under pilot or national programs to determine alignment and differentiation potential.
• Evaluated policy and funding mechanisms under Art. 48e (Pilot Programmes Fund) and STI (Innovation Fund) pathways.
• Developed strategic recommendations for market entry, value communication, and evidence generation aligned with AOTMiT evaluation criteria.