According to §135 of the Social Code Book V, the Joint Federal Committee (G-BA) takes decisions about which outpatient services are part of the social health insurance (SHI) in Germany. Synchronous balneo phototherapy in atopic dermatitis was evaluated by the G-BA over 12 years ago for the first time. However, the assessment of the method was paused in 2008 due to a lack of sufficient evidence to make a reimbursement decision. Since then, synchronous balneo phototherapy had been included in Annex III of the outpatient benefit directive, which lists methods that are excluded from reimbursement until their assessment can be completed.
In the previous evaluation, evidence suggested that patients with psoriasis vulgaris profit from bath and UV light therapy (balneo-phototherapy) to a higher degree than from UVB light therapy alone. In patients with atopic dermatitis, indications of an additional benefit exist. However, this only applies to so-called synchronous balneo phototherapy, where the patient is exposed to UV radiation during a bath. In its last report from December 2006, IQWiG concluded that the different types of lights used make a comparison and a summarising evaluation of balneo-phototherapy difficult. Although 11 trials were identified that fulfilled the inclusion and exclusion criteria, these trials included 11 different treatment comparisons.
On February 15th 2018, the G-BA decided to resume its evaluations. To support the final decision, the Institute for Quality and Efficiency in Health Care (IQWiG) will perform a health technology assessment (HTA). According to the project time plan, the HTA report is expected to be completed in October 2019 and the final decision by G-BA is planned in February 2020. The result will determine the reimbursement of synchronous balneo phototherapy in atopic dermatitis in outpatient settings.
The decision document and project time plan are available here.
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