The NUB reimbursement pathway has been effective in bringing high-cost innovative medical technologies to the German market, but there are challenges. The CRA Life Sciences practice assesses the funding of medtech through NUBs and outlines the strengths and weaknesses of the NUB pathway. By Eva Marchese, Lorenzo D’Angelo, Anthony Barron, Oriol Viader-Llargués, and Lukas Ziegler, CRA.
The diagnostic and treatment methods reimbursement pathway called Neue Untersuchungs- und Behandlungsmethoden, or NUBs, was introduced 15 years ago to help manufacturers bring innovation more quickly to the largest medtech market in Europe, Germany. Over this timeframe, we have seen that NUBs uses a well-defined and understood process that is effective in supporting earlier access and can lead to wider adoption of new and innovative medical technologies, but challenges exist. To overcome these challenges, the Life Sciences Practice team at CRA recommends engaging early with multiple hospitals experienced in the NUB application process and that report directly to the Institute for the Hospital Remuneration System (Institut für das Entgeltsystem im Krankenhaus, or InEK). For manufacturers, it is crucial to understand the unmet needs of these hospitals and how those needs can be addressed by the product being brought to the market, and to support these hospitals in their NUB applications.