The Supply of Medical Isotopes

Annex D. Current unbundled Tc-99m payments in Germany and Japan

Germany

Table A D.1. Unbundled Tc-99m billing codes and prices for office-based specialists paid FFS according to the German national uniform value scale (EBM)

EBM Version 3rd quarter 2018

EBM Billing Code	Description	Price (EUR)
40500	Material costs related to the provision of services in accordance with EBM billing codes 17310 or 17320 when using 99mTc pertechnetate (thyroid)	1.50
40502	Material costs related to the provision of services in accordance with EBM billing codes 17310 or 17311 when using 99mTc phosphonates (bone / skeleton)	19.00
40504	Material costs related to the provision of the service according to the EBM billing code 17310 using 99mTc macroaggregates (lung)	29.00
40506	Material costs related to the provision of the service according to EBM billing code 17310 using 99mTc aerosol (lung)	133.00
40508	Material costs related to the provision of the service according to the EBM billing code 17310 using 99mTc-HMPAO, 99mTc-ECD (brain)	205.00
40510	Material costs related to the provision of services according to the EBM billing codes 17310 or 17340 when using 99mTc-DMSA, 99mTc-DTPA (kidney)	40.00
40512	Material costs related to the provision of the service according to according to the EBM billing code 17310 using 99mTc-DTPA (brain)	40.00
40514	Material costs related to the provision of the service according to the EBM billing code 17340 when using 99mTc-MAG3 (kidney)	92.00
40516	Material costs related to the provision of services according EBM billing codes 17310 or 17351 using 99mTc colloid (liver)	42.00
40518	Material costs related to the provision of the service according to EBM billing code 17351 using 99mTc IDA compounds (bile)	42.00
40520	Material costs related the provision of services according to EBM billing codes 17330, 17331 and 17310 using 99mTc-labeled perfusion markers (heart, thyroid)	76.00
40522	Material costs related to the provision of services according to EBM billing codes 17332, 17333 and 17350 using of 99mTc-labeled auto-erythrocytes (heart, liver, abdominal bleed search)	60.00
40524	Material costs related to the provision of services according to EBM billing codes 17310 or 17311 when using 99mTc-labeled ligands (tumor localization)	375.00
40526	Material costs related to the provision of services according to EBM billing codes 17310, 17311 or 17350 using 99mTc-labeled antibodies (bone marrow, inflammation localization)	382.00
40528	Material costs related to the provision of services according to EBM billing codes 17310 or 17311 using 99mTc-labeled micro- / nanocolloids (lymph node diagnostics)	70.00
40530	Material costs related to the provision of the service according EBM billing code 17351 using a 99mTc-labeled test meal (gastrointestinal motility)	40.00

Note: Prices reflect national reference values and may vary by federal state.

Source: Translated by the Authors from the German national uniform value scale (EBM) (KBV, 2018, pp. 220-21[1])

Japan

Table A D.2. Radiopharmaceutical products and reimbursement prices in the national fee schedule

Pharmaceutical name	Company name	Standard unit	2018 price (JPY)
Asialoscinti Injectable	Nihon Medi-Physics Co., Ltd	10MBq	826
Ultra-Techne Kow	FUJIFILM Toyama Chemical Co., Ltd.	10MBq	261
Cardiolite Daiichi	FUJIFILM Toyama Chemical Co., Ltd.	One dose	29 764
Cardiolite injection Daiichi	FUJIFILM Toyama Chemical Co., Ltd.	370MBq/syringe	25 333
		600MBq/syringe	48 683
		740MBq/syringe	50 115
Sodium Pertechnetate (99mTc) Injection		10MBq	280
Technescinti Injectable - 20M	Nihon Medi-Physics Co., Ltd	10MBq	280
Technesol	FUJIFILM Toyama Chemical Co., Ltd.	10MBq	280
Technescinti Injectable - 10M	Nihon Medi-Physics Co., Ltd	10MBq	284
Kidneyscinti Kit	Nihon Medi-Physics Co., Ltd	One dose	3 127
Kidneyscinti Tc-99m Injectable	Nihon Medi-Physics Co., Ltd	10MBq	660
Clearbone Kit	Nihon Medi-Physics Co., Ltd	One dose	3 304
Clearbone Injectable	Nihon Medi-Physics Co., Ltd	10MBq	397
Tin Colloid Tc-99m Injectable	Nihon Medi-Physics Co., Ltd	10MBq	N/A
Tin Colloid Tc-99m Kit	Nihon Medi-Physics Co., Ltd	One dose	2 643
Cerebrotec Kit	Nihon Medi-Physics Co., Ltd	One dose	20 939
Techne Albumin Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	4 251
Techne MAA Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	4 237
Techne MAG3 Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	25 443
Techne MAG3 Injection	FUJIFILM Toyama Chemical Co., Ltd.	200MBq/syringe	23 564
		300MBq/syringe	34 652
		400MBq/syringe	45 674
Techne MDP Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	3 086
Techne MDP Injection	FUJIFILM Toyama Chemical Co., Ltd.	370MBq/syringe	21 566
		555MBq/syringe	21 566
		740MBq/syringe	28 495
		925MBq/syringe	36 762
Techne DMSA Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	3 116
Techne DTPA Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	3 110
Techne Pyrophosphate Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	3 110
Techne Phytate Kit	FUJIFILM Toyama Chemical Co., Ltd.	One dose	2 545
Neurolite Daiichi	FUJIFILM Toyama Chemical Co., Ltd.	One dose	18 389
Neurolite Injection Daiichi	FUJIFILM Toyama Chemical Co., Ltd.	400MBq/syringe	28 697
		600MBq/syringe	43 506
Poolscinti Injectable	Nihon Medi-Physics Co., Ltd	10MBq	570
Hepatimage Injectable	Nihon Medi-Physics Co., Ltd	10MBq	796
Myoview for Injection	Nihon Medi-Physics Co., Ltd	One dose	29 556
Myoview Injectable Syringe	Nihon Medi-Physics Co., Ltd	296MBq/syringe	23 795
		592MBq/syringe	43 401
		740MBq/syringe	48 247
MAGscinti Injectable	Nihon Medi-Physics Co., Ltd	222MBq/syringe	23 514
		333MBq/syringe	34 534
		555MBq/syringe	56 655
Meditec	Nihon Medi-Physics Co., Ltd	10MBq	272
Lungscinti Tc-99m Injectable	Nihon Medi-Physics Co., Ltd	10MBq	531

Note: Status per March 5, 2018 (Notification No. 46 of Ministry of Health, Labour and Welfare), Implementation April 1, 2018.

Source: OECD Health Division survey, translated by the Authors from Japanese. The national fee schedule is available at https://www.mhlw.go.jp/topics/2018/04/tp20180401-01.html

References

[2] (n.a.) (n.d.), X.

[1] KBV (2018), Einheitlicher Bewertungsmaßstab (EBM) Stand: 3. Quartal 2018 Arztgruppen-EBM: Nuklearmediziner, Kassenärztliche Bundesvereinigung, http://www.kbv.de/media/sp/EBM_Nuklearmediziner_20180701_V1.pdf.