RESULTS OF A DELPHI PANEL SURVEY AMONG GERMAN SPECIALISTS IN PAIN MANAGEMENT ON THE USE OF HIGH-CONCENTRATION CAPSAICIN PATCH (HCCP)
Author(s)
Tino Schubert, PhD1, Markus Nass, MHBA2, Eva Bartmann, MD3, Kai-Uwe Kern, MD4.
1LinkCare GmbH, Ludwigsburg, Germany, 2Grünenthal GmbH, Stolberg, Germany, 3Pain Center, Neu-Ulm, Germany, 4Institute of Pain Medicine, Wiesbaden, Germany.
1LinkCare GmbH, Ludwigsburg, Germany, 2Grünenthal GmbH, Stolberg, Germany, 3Pain Center, Neu-Ulm, Germany, 4Institute of Pain Medicine, Wiesbaden, Germany.
OBJECTIVES: Peripheral neuropathic pain (PNP) is a chronic disorder requiring long-term treatment. In Germany, outpatient consultation fees vary by specialty with predefined time budgets that do not always reflect actual time spent. Reimbursement for HCCP application is part of a general consultation code with predefined time budgets. Data on time required to apply HCCP in Germany are limited.This survey gathered information on the time required for HCCP application in Germany and evaluated discrepancies between actual procedural time and reimbursed time across specialties who manage PNP.
METHODS: A structured, online Delphi survey of three rounds was conducted with 29 physicians specialized in neurology (n=8), diabetology (n=10), and pain medicine (n=11). Participants had on average 16 years of experience in pain management.Ten procedural steps were defined based on the HCCP Summary of Product Characteristics and validated by a clinical expert.In round 1, participants provided open-ended numeric estimates of time required for each step; these results informed time estimates for subsequent rounds, which participants rated on a 5-point Likert-scale.Consensus was defined as ≥21/29 panelists (72.41%) somewhat/strongly agreeing with the estimates.
RESULTS: Response rate was 100%. Consensus was reached on the time required for 7 of the 10 HCCP application steps.Across all specialties surveyed, the estimates for these 7-steps exceeded reimbursed time budgets: neurologists concluded they would require 48 minutes versus 12 minutes reimbursed via the predefined consultation fee (4-fold difference; reimbursement gap: EUR 70), diabetologists 46 versus 16 minutes (3-fold; EUR 51), and pain specialists 48 versus 22 minutes (2-fold; EUR 59).
CONCLUSIONS: These results suggest a potential reimbursement gap that may represent a disincentive for HCCP use in routine outpatient care.The discussion on specific reimbursement codes for HCCP in private insurance suggests this gap is recognized and should be addressed to facilitate reimbursement.
METHODS: A structured, online Delphi survey of three rounds was conducted with 29 physicians specialized in neurology (n=8), diabetology (n=10), and pain medicine (n=11). Participants had on average 16 years of experience in pain management.Ten procedural steps were defined based on the HCCP Summary of Product Characteristics and validated by a clinical expert.In round 1, participants provided open-ended numeric estimates of time required for each step; these results informed time estimates for subsequent rounds, which participants rated on a 5-point Likert-scale.Consensus was defined as ≥21/29 panelists (72.41%) somewhat/strongly agreeing with the estimates.
RESULTS: Response rate was 100%. Consensus was reached on the time required for 7 of the 10 HCCP application steps.Across all specialties surveyed, the estimates for these 7-steps exceeded reimbursed time budgets: neurologists concluded they would require 48 minutes versus 12 minutes reimbursed via the predefined consultation fee (4-fold difference; reimbursement gap: EUR 70), diabetologists 46 versus 16 minutes (3-fold; EUR 51), and pain specialists 48 versus 22 minutes (2-fold; EUR 59).
CONCLUSIONS: These results suggest a potential reimbursement gap that may represent a disincentive for HCCP use in routine outpatient care.The discussion on specific reimbursement codes for HCCP in private insurance suggests this gap is recognized and should be addressed to facilitate reimbursement.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD19
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Study Approaches
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)