{"id":"5e48f1cff0c6","type":"article","url":"https://hartvaat.nl/2026/02/03/aanbesteding-van-cardiale-implanteerbare-devices-in-europa-waarde-of-kosten/","title":"Aanbesteding van cardiale implanteerbare devices in Europa: waarde of kosten?","title_en":"Public procurement of cardiac implantable electronic devices across Europe: are we purchasing value or cost-effectiveness?","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["icd-implantatie"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euaf323","source_url":"https://doi.org/10.1093/europace/euaf323","authors":["Lucía Osoro","Elena Arbelo","Nikola Kozhuharov","Runa Landen","Martin Martinek","Christophe Leclerq","Laurent Fauchier","Jean-Claude De Haro","Serge Boveda","Philipp Sommer","Michiel Rienstra","Piotr Symanski","Michal Farkowski","Anastasia Egorova","Francisco Moscoso Costa","Diana Tint","Stefan Simovic","Krasimir Dzhinsov","Francisco Leyva","Giuseppe Boriani","Josep Figueras","Zenichi Ihara","Jose Luis Merino","Haran Burri","Helmut Pürerfellner","Rubén Casado-Arroyo"],"significance":5,"published":"2026-02-03","source_date":"2026-02-03","image":"","kennis":[],"congress":"","summary_en":"A survey across 22 European countries examined how procurement of cardiac implantable electronic devices is implemented, exploring clinical, economic, and structural factors that influence tendering processes under the shared EU legal framework.","created":"2026-07-03T10:25:12Z","updated":"2026-07-03T13:24:39Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De aanbesteding van cardiale implanteerbare elektronische devices (CIED's) in de EU wordt bepaald door diverse zorgstelsels en vergoedingsmechanismen. Ondanks een gedeeld juridisch kader zijn er weinig vergelijkende data beschikbaar over de implementatie en betrokkenheid van clinici.","abstract_original":"AIMS: Procurement of cardiac implantable electronic devices (CIEDs) across the European Union is shaped by diverse healthcare systems, reimbursement mechanisms and levels of clinician involvement. Despite a shared legal framework, limited comparative data are available on how procurement is implemented across countries. OBJECTIVE: The objectives of this study are to examine CIED procurement strategies in 22 European countries where public tendering is mandatory and to explore how clinical, economic and structural factors influence procurement processes. METHODS AND RESULTS: We conducted 23 structured interviews with cardiologists and one industry expert across 22 European countries. A thematic analysis was used to synthesize procurement models, clinical involvement and reimbursement structures. No formal outcome or cost-effectiveness analysis was performed. Procurement models varied widely, encompassing centralized, decentralized and hybrid systems. Clinician involvement ranged from leading device selection based on clinical criteria to being excluded from decision-making in systems driven primarily by price. Reimbursement pathways also differed, with procedure tariffs for single-chamber pacemakers ranging from €1059 to €14 889. A single region in Finland had implemented a pilot value-based procurement model linking payment to patient outcomes. CONCLUSION: Cardiac implantable electronic device procurement across Europe is heterogeneous and predominantly cost driven, with limited integration of clinical outcomes or value-based principles. While not designed to evaluate cost-effectiveness directly, this study identifies procurement structures that may support or hinder value-based decision-making. Further research is needed to assess how procurement impacts clinical outcomes, innovation adoption and system sustainability."}