SwissHTA

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SwissHTA is a project for the further development of Health Technology Assessment (HTA) in Switzerland. The project was initiated by santésuisse, the association of health insurers, and Interpharma , the association of research-based pharmaceutical companies, with scientific support from the Institute for Innovation and Evaluation in Health Care (InnoVal). The FMH , the Association of Swiss Doctors, and the SAMS , the Swiss Academies of Medical Sciences, also participate in the sponsorship . The Federal Office of Public Health (FOPH) and, since 2012, the Swiss Conference of Cantonal Health Directors (GDK) are also involved in the project with observer status.

SwissHTA was initiated in summer 2010 and began with an inventory of international experiences with HTA with special consideration of health economic evaluations at a seminar event with top-class scientists.

background

In a report from August 2008, the Parliamentary Administrative Control (PVK) identified deficiencies in the system of determining and reviewing medical services in the basic insurance. Accordingly, there is a considerable need for optimization for a systematic, early and priority-based evaluation of even complex services. Among other things, the PVK recommends defining the operationalization of the WZW criteria and clearly separating the assessment and the appraisal from an institutional point of view. In Switzerland, the compulsory health insurance covers sickness, accident and maternity benefits, but according to the Health Insurance Act only those benefits that are effective, appropriate and economical (WZW criteria). The Swiss Federal Council has tackled improvements to the current system and announced them in its goals for 2012. The Federal Council wants to integrate any new HTA agency into the planned National Quality Institute. The quality institute is part of the specification of the “Quality Strategy in the Swiss Healthcare System”, which the Federal Council adopted on October 28, 2009. Health Technology Assessment (HTA) should be pursued further in connection with the approval process of effective, appropriate and economic services as well as the regular review of existing health services and the associated discussions with regard to the HTA Institute.

Project goals

The project sponsors of SwissHTA supported the health policy priorities of the federal government in the health sector. Accordingly, the goal is to further increase the quality, but also the transparency, as well as to increase the efficiency and thus also to reduce costs. According to their own statements, the project sponsors wanted to work out a consensus on the use and design of health technology assessment in Switzerland, which would reflect the current state of scientific development and the experiences made in other countries with the use of HTAs. To this end, they have drawn up guidelines on how HTA could in future support the management of the entire catalog of services of the compulsory health insurance (OKP) in a targeted manner.

Recommendations from SwissHTA

The members of SwissHTA recommend that the following benchmarks be observed in the further development of Health Technology Assessment in Switzerland:

  • Separation of assessments (synthesis of the available evidence), appraisals (recommendation based on the assessments) and decisions (about reimbursement or price decisions);
  • Transparency about processes, criteria and decisions for new as well as for existing health technologies;
  • Specification and systematisation of the criteria of effectiveness, appropriateness and cost-effectiveness (WZW criteria) of the Swiss Health Insurance Act (KVG);
  • Practice-oriented application of the principles of evidence-based medicine , taking into account the relevance and the size of clinical-therapeutic effects, the degree of confidence in the available data based on the available level of evidence in relation to the context-dependent best expected level of evidence and the quality of the available studies;
  • Orientation towards the expectations (“social preferences”) of the insured within the limits of normative requirements in the sense of Swiss legal tradition;
  • Economic feasibility assessment based on the cost consequences and then the efficiency (“ cost effectiveness ”), however without normatively problematic reductionist simplifications such as context-independent threshold values ​​for still acceptable cost effectiveness (e.g. maximum costs per “ QALY ”);
  • Setting boundaries on several levels (added benefit, expediency, economic viability) taking into account the rapid access of all patients to innovations;
  • Forward-looking consideration of future development opportunities.

literature

  • Felix Straumann in the Tages-Anzeiger on January 27, 2012.
  • Swiss Medical Journal, 2011; 92: 48, editorial by Daniel Herren. Member of the central board of the FMH, “Is newer better? Not always ".
  • Schweizerische Ärztezeitung, 2012; 93: 3, article by Thomas B. Cueni , Interpharma , “Health Technology Assessment in Switzerland Pragmatic Solutions for the Management of the Service Catalog”.
  • Schweizerische Ärztezeitung, 2012; 93: 3, article by Christian Affolter, santésuisse, “National consensus as a prerequisite for the use of health technology assessments”.

Web links

Individual evidence

  1. ↑ Press release , November 24, 2010, accessed on June 20, 2012.
  2. ↑ Felix Straumann in the Tages-Anzeiger on January 27, 2012. “Testing institute for therapies planned”.
  3. ↑ [1] (PDF; 858 kB), Report of the Parliamentary Administrative Control for the attention of the Business Audit Commission of the National Council Determination and Review of Medical Services in Compulsory Health Insurance, Report of August 21, 2008, accessed on June 6, 2012.
  4. ↑ [2] , KVG Art. 32 Paragraph 2, accessed on June 20, 2012.
  5. ↑ [ Archived copy ( memento of the original dated May 23, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ], Annual goals of the Federal Council, resolution of November 9, 2011, accessed on June 6, 2012. @1@ 2Template: Webachiv / IABot / www.admin.ch
  6. ↑ [3] , page no longer available ] , search in web archives: [6] , media release from the Federal Office of Public Health of May 25, 2011, accessed on June 20, 2012.[4] , @ 1][5] , @ 2]Template: Dead Link / www.bag.admin.ch
  7. ↑ [7] , page no longer available ] , search in web archives: [10] , Federal Health Policy Priorities, continuously updated, accessed on June 20, 2012.[8] , @ 1][9] , @ 2]Template: Dead Link / www.bag.admin.ch
  8. ↑ [11] , consensus from SwissHTA, accessed on June 6, 2012
  9. ↑ [12] , Swiss Medical Journal, 2011; 92: 48, editorial by Daniel Herren. Member of the central board of the FMH, “Is newer better? Not always ”, accessed June 20, 2012.
  10. ↑ [13] , Schweizerische Ärztezeitung, 2012; 93: 3, article by Thomas B. Cueni , Interpharma . “Health Technology Assessment in Switzerland Pragmatic Solutions for the Management of the Service Catalog”, accessed on June 20, 2012.
  11. ↑ [14] , Schweizerische Ärztezeitung, 2012; 93: 3, article by Christian Affolter, santésuisse, “National consensus as a prerequisite for the use of health technology assessments”, accessed on June 20, 2012.