MTU-SFOPH – Medical Technology Unit – Swiss Federal Office of Public Health
"It is far better to rationalize than to rationize medical technology."
– Dr. Maya Züllig, Director, MTU-SFOPH
History and Structure
In 1960, SFOSS created a unit called Medical Advisors Service, as an advisory body for its different divisions (Disability Insurance, Accident Insurance and Sickness Insurance) linked directly to the SFOSS director. Since the early 1980s, this unit's main task has been to assess technology for the SFOSS Sickness Insurance Division. A reorganization in 1992 upgraded the unit from a service into a section and attached it to the Sickness Insurance Division.
The Sickness Insurance Law considers routine medical procedures in physicians' practices and in hospitals to be appropriate, effective, and cost-effective (the so-called confidentially assumption). The MTS reviews only procedures which have been "contested or are controversial" as to their effectiveness, appropriateness, and/or cost-effectiveness. The MTS is responsible for the assessment of these technologies for the Swiss Federal Coverage Committee.
How SFOPH-MTU Works
The basis for the work of MTU is the "Manual for the Standardization of Clinical and Economic Evaluation". The procedure is as follows:
- An application is sent to MTS from the requestor
- MTS sends a standard letter to the Swiss Insurers Body (SIB) and the Swiss Medical Association (SMA) asking whether the technology in question is controversial (appropriate, effective, cost-effective)
- If the technology is considered controversial by SIB or SMA or both, a complete TA must be undertaken
- MTS then prepares comprehensive documentation ; staff members of MTS visit and discuss the technology with the applicant and check whether it conforms with the requirements stated in the Manual
- The recommendation of MTS and the applicant's documentation are both presented to the Swiss Federal Coverage Committee
- This Committee advises the Swiss Federal Department of Interior about coverage
- The technology may eventually be included in the official procedures list.
A principle diffusion activity of MTS involves distributing the SFOSS "Manual for the Standardization of Clinical and Economic Evaluation of Medical Technologies" (in German, French, and English).
- Gamma knife for brain metastasis
- MRI, addition of new indications
- PET, addition of new indications
- PET-Center in Basel (without own cyclotron)
- Laser-disc decompression (PLDD)
- DEXA, addition of new indications
Shockwave therapy in orthopedics.
Description of population served: National
Population served (mil):
Current HTA budget (mil USD): NR
Permanent staff: 6
Ongoing TA projects: 20+
Director: Dr. Maya Züllig
Contact person: Mr. Christoph Künzli
Medical Technology Unit – Swiss Federal Office of Public Health
CH-3003 Bern Switzerland