“Wise persons proportions their beliefs to the evidence” on the basis of David Hume
History and Structure
The socalled Medical Technology Unit at the Swiss Federal of Social Security was one of the HTA-pioneers in the 1980ies. As such this unit was invited to collaborate in EU-HTA- projects up to EUnetHTA Joint Action 3.
In parallel, the unit was a Founding Members of INAHTA and Euroscan International Network and became a EUnetHTA Founding Partner in 2009.
Internally, through all these years, there have been several organisational changes like the transfer from the Federal Office of Social Security to the one of Swiss Federal Office of Public Health (SFOPH).
Nowadays, HTA is dealt with within the 3 Departments HTA, Medical Services and Pharmaceuticals of the Division Health Care Services.
Therefore we have adopted our INAHTA-Membership to the Division Health Care Services in autumn 2017.
SFOPH and its Division Health Care Services are – among many other tasks – responsible for the implementation and surveillance of a proper HTA-process in order to give the best possible advice to the political decision makers at the Office of the Health Minister and thus bring the biggest possible benefit of all kind of Medical Technologies to the Swiss population
How HTA Works
As a basis for our HTA-process, the Federal Law on Health Insurance assumes that medical technologies (pharmaceuticals, medical devices, laboratory analyses, procedures, services of health professionals, health programmes etc.) are appropriate, effective, and cost-effective (EAE-criteria). Principles of HTA are used in:
- the definition of the “Health Benefit Basket” in the compulsory health insurance.
- applications for the admission of new technologies for reimbursement by the compulsory health insurance.
Furthermore with the implementation of the agenda “Health 2020” the SFOPH increased its activities in the re-evaluation of Effectiveness, Appropriateness and Economic Efficiency (EAE) of medical technologies and pharmaceuticals reimbursed by the compulsory health insurance. In 2017 a new Department Health Technology Assessment (HTA) was installed to manage the production of HTA reports to support these activities.
In the re-evaluation program medical technologies or pharmaceuticals are reviewed, that are considered "contested or controversial" (disinvestment) as to their effectiveness, appropriateness, and economic efficiency. The HTA Department is responsible for the production of HTA reports to support the re-evaluation process on behalf of the Federal Medical Services Commission.
The following process is installed:
- Topic selection: a public submission procedure invites stakeholders and individuals to submit topics for re-evaluation. Also the HTA Department established a systematic topic search procedure. All submitted topics are admitted to a selection procedure using prioritization criteria.
- Subsequently, external HTA agencies are commissioned to produce a scoping and full HTA report, based on a brief pre-scoping report produced within the HTA Department.
- A dedicated review group is formed to follow the writing process and additional time is reserved for stakeholder feedback.
- The HTA report, extended with specific relevant information for the decision-makers, is presented to the Federal Commissions.
- The Federal Department of Home Affairs, advised by the Federal Commissions, is the final decisive body regarding national coverage for the re-evaluated technology, except pharmaceutical, where the decision is made by the SFOPH.
Scoping and HTA reports, as well as stakeholder consultation reports, are publically accessible (www.bag.admin.ch/HTA).
Annually selected re-evaluation topics are presented on the website of HTA Department of the SFOPH (www.bag.admin.ch/HTA).
- Increase the number and speed up production of HTA-reports for the re-evaluation program of reimbursement in order to increase the quality of care and reduce costs.
- Install a program for horizon scanning and early dialogues.
- Speed up the decision process in cases of technologies reimbursed under the CED-principle (Coverage with Evidence Development).
Description of population served: National
Population served (mil): 8.5
Current HTA budget (mil USD): NR
Permanent staff: HTA, Medical Services and Pharmaceuticals 6-12 persons
Ongoing TA projects: 6+
Director of SFOP: Pascal Strupler
Director Division Health Care Services: Sandra Schneider
Contact person: Dr. Klazien Matter-Walstra
Swiss Federal Office of Public Health
Division of Health Care Services