Pricing in MedTech isn’t just a number — it’s your business model. In the EU, where public payers dominate and health systems are increasingly value-driven, getting paid requires clinical validation, health economic proof, and a clear story about long-term cost savings.
This post breaks down how to approach reimbursement and pricing for MedTech startups, with examples from DTx, devices, and AI diagnostics. We focus on the frameworks that matter and what early-stage founders must do to prepare.
1. Understand What Payers Actually Buy
Public and private payers (like insurers and national health services) don’t buy tech — they buy outcomes. Successful pricing strategies show how your product: – Improves health outcomes (efficacy) – Saves money (cost avoidance) – Improves workflow or capacity
Tip: Frame pricing in terms of cost per QALY (quality-adjusted life year) or ROI within 12–24 months.
2. Pricing Models That Work in MedTech
| Model | Best for | Notes |
| One-time sale | Capital equipment, implantables | Require large budget cycles |
| Subscription | DTx, RPM, AI tools | Common for digital health; easier for payers to adopt |
| Outcome-based | Digital diagnostics, chronic care | Reimbursed only if outcome achieved; harder to negotiate |
| Bundled with services | Monitoring devices + clinical services | Enables multi-stakeholder value delivery |
Example: Kaia Health offers MSK therapy via reimbursed app + coaching in Germany, priced as monthly license.
3. EU Reimbursement Pathways to Know
Germany: DiGA Pricing
- Startups can set their own price in the first year post-listing.
- After 12 months, price must be negotiated with the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds).
- Must show comparative evidence vs standard of care.
Caution: DiGA price averages dropped 30% post-negotiation in 2024 (IQVIA DiGA Report).
France: PECAN / LPPR
- PECAN pilot covers early-stage pricing with proof-of-concept.
- Long-term reimbursement requires HTA via HAS and inclusion on LPPR list.
- Prices often benchmarked to existing therapies.
UK: NICE HTA and Value-Based Pricing
- NICE uses cost-effectiveness models (e.g., ICER thresholds: ~£20k–£30k per QALY).
- Pilots with NHS can inform real-world pricing.
- Commercial frameworks like NHS England’s MIA allow negotiated price-volume deals.
4. Building Your Reimbursement Strategy Early
a. Collect Health Economics Evidence
- Use budget impact models (BIMs)
- Simulate payer scenarios: what happens if 1,000 patients adopt your solution?
b. Start Conversations With Payers
- Germany: GKV associations
- France: CNAM and HAS
- UK: NICE and NHS regional leads
c. Use External Tools
- Partner with health economics consultancies like Coreva Scientific
- Validate models with HTA reviewers and KOLs
5. Common Pricing Mistakes to Avoid
- Pricing too high without evidence → rejection by payers
- Free pilots without contract conversion → unsustainable
- Lack of cost comparator → HTA rejection
- Misunderstanding budget holder (hospital vs insurer)
Insight: In France, even successful pilots stalled due to unclear budget responsibility between national and regional health bodies.
Quick Reference Table: National Pricing Characteristics
| Country | Negotiation Body | Model | Notes |
| Germany | GKV | Post-listing price set | DiGA pricing volatile post-year one |
| France | HAS / CNAM | Case-by-case | PECAN pilots used for prep |
| UK | NICE / ICS | Value-based | Uses QALY model and ROI thresholds |
Final Takeaways for MedTech Startups
- Start pricing strategy early — not after CE mark
- Understand payer incentives and outcome expectations
- Prepare BIMs and value dossiers during pilot phase
Up next in the series: 📌 Commercial Channels That Actually Work in MedTech
This content has been enhanced with GenAI tools.
