OBJECTIVES: e-Health technologies which optimise traditional devices and drugs (e-Connected) cross different regulatory frameworks. This study aimed to provide an overview of the funding pathways for e-Health technologies in Europe.

METHODS: A literature review was conducted from government and health authority websites, PubMed, and grey literature to identify funding regulations, processes, and practices in EU-5.

RESULTS: In Europe, there is no standard reimbursement pathway specific to e-Health in place. EU directives are in development and the overall framework is to be established by 2020. Differences in reimbursement approach reflect differences in healthcare system structures leading to differences on what will be funded (scope), who pays (payer), and on what basis will payment be made (payment method). UK and Germany offer possibilities to have integrated contracts where all technology components may be funded together. However, there are no guarantees that all technology components will be funded. It depends on specific agreements with the CCGs (UK) and health insurances (DE). In other situations, each technology component is identified as one reimbursement area and goes through different reimbursement paths. Currently, most do not have a standard funding path such as remote monitoring fee, electronic health records (EHR) integration and maintenance. UK is a frontrunner in the use of EHRs as a national infrastructure is already in place unlike the other countries. However, interoperability of e-Health solutions with EHRs must be assured by the manufacturer for each type of EHR.

CONCLUSIONS: E-health programs remain small scale pilots without any perennial funding. A major obstacle preventing e-Health solutions to reach the mainstream of healthcare provision is related to the lack of innovative and adequate reimbursement models. EU regulatory frameworks are still catching up with the technology. The lag in the regulatory pathways may explain the lack in clear funding pathways in the EU.