The mechanisms for funding can be reimbursement or prior assessment, as said before. In addition, there are other ways for users to purchase medical equipment at a low cost. These ways are directed to the user and not the manufacturer.

The manufacturer has no way of including his device in these two types of payment. What the manufacturer knows, is that in concert with the lists of equipment inserted in these two types of payment, whether his equipment can be reimbursed or not.

Support Products for People with Disabilities or Impairments
Through Social Security (Segurança Social), people with disabilities or impairments can obtain funding to acquire support products ⁰.

Support product is defined as “any product (including devices, equipment, instruments, technology and software), specially produced or generally available, to prevent, compensate, monitor, alleviate or neutralize disabilities, limitations of activities and restrictions on participation” (ISO 9999: 2007) ⁰.

Financing and Prescription

The financing of support products is exclusively for people with disabilities (Order n.^o 6133/2012, 2nd series, of May 10) ⁰.

A person with a disability or impairment is a person who, because of a loss or anomaly, congenital or acquired, of bodily functions or structures, including psychological functions, presents specific difficulties that may, in combination with environmental factors, limit or to hinder activity and participation on an equal basis with other persons (Law n.^o 38/2004, of August 18, article 2 (1)) ⁰.

For more information, consult this link ⁰.

Professional Rehabilitation through Support Products

Professional rehabilitation through support products available by IEFP (Instituto de Emprego e Formação Professional).  ⁰.

Financial support for persons with disabilities and impairment to purchase, adapt or repair specialized, or commercially available products, devices, equipment or technical systems that are indispensable to prevent, compensate, mitigate or counteract activity limitations and participation restrictions which hamper, hinder or render impossible the access and frequency of vocational training or the attainment and maintenance of employment and career advancement ⁰.

Recipients

Persons with disabilities and impairment who are proven to be barred or impeded access or frequency of vocational training actions and/ or access, maintenance or progression in employment, due to lack of support products ⁰.

Support

Contribution of the IEFP to the cost of acquiring, adapting or repairing the support products corresponding to ⁰:

• 100% of the cost when it is not reimbursed by the health system or subsystem or insurance company of which the person is a beneficiary;
• Difference between the cost of the acquisition, repair or adjustment and the amount of reimbursement to which he is entitled, through the health system or subsystem of which the person is the beneficiary or the respective insurance company.

For more information, consult this link ⁰.

The increasing availability and use of medical devices in Portugal have increased the need to create a database, where it is possible for caregivers and health institutions to consult all the particularities of medical devices registered and marketed at the national market level. In addition, it was necessary to evaluate and compare the price for which a single medical device was obtained in different health institutions through different public tenders. The existence of such a database could allow better monitoring of the medical devices market.

The need to create a Portuguese Coding System for the medical devices was growing, and in 2012, Portuguese Order n.o 15371/20122 (revoked in April 2019, by Order n.o 2945/2019), was published, which established the provisions regarding the acquisition of medical devices coded by INFARMED, I.P. by the NHS services and establishments. With the publication of this order, the NHS services and establishments have to acquire the medical device whose respective groups had already been codified and published by INFARMED, I.P. and were part of the database ⁰.

The codification of the medical devices consists of the attribution of unique device identification and the consequent assignment of a code when registering the medical device ⁰. The codification of the medical devices available in the Portuguese market promotes the consolidation of an information repository that allows health care providers and health institutions a greater knowledge about these health technologies ⁰.

The medical devices purchased for NHS must be inserted into a database and contain the respective CDM. Therefore, INFARMED, has developed the coding of medical devices to be purchased and used in the NHS, promoting the consolidation of an information repository that enables carers and healthcare institutions to access relevant information for the correct and safe use of these technologies ⁰.

Through this link can find the groups of medical devices already with a codification.

As previously mentioned, the existing support for MedTech technologies in Portugal in relation to reimbursement is limited.

The reimbursement, through the decree-law, is only attributed to the equipment in which the regulator verifies that there is an extreme necessity of that equipment by the patients, is often prescribed.

The reimbursement through IEFP is dedicated persons with disabilities and impairment who are proven to be barred or impeded access or frequency of vocational training actions and/ or access, maintenance or progression in employment, due to lack of support products. The support products covered by this reimbursement are in this dispatch ⁰.