The Swiss Medical Association (FMH), Interpharma, the Swiss Academy of Medical Sciences (SAMS) and santésuisse set forth a framework, with the involvement of the Federal Office of Public Health, showing how Health Technology Assessments (HTAs) can in future support the management of all services provided under compulsory health insurance (OKP) in keeping with objectives.

The scope of HTAs therefore covers both new and already established (existing) technologies; for the selection of products and procedures to be evaluated in the context of HTAs, a transparent process is presented with clear selection criteria.

Implementation is in principle not dependent on a particular type of organization, if and as long as there are guarantees in place to ensure that there is uniform process leadership for HTAs at federal level, the people responsible for implementation are independent and sufficient funds are provided. Just one of several conceivable options is the formation of a Swiss Institute for Technology Evaluation and Quality in the Health Service (“SITEQ”), which could allow a meaningful link-up with the quality strategy of the federal authorities.

Essential features of the consensus on the new Swiss HTA process include in particular:

  1. Clear separation of assessment, appraisal and decision-making;
  2. Transparency of process, criteria and decisions, including their underlying reasons, with defined timelines and broad stakeholder involvement, for new and existing technologies;
  3. Operationalization and consistent systematization of the criteria of the Swiss health insurance act (KVG) for efficacy, suitability and cost-effectiveness;
  4. Practice-oriented application of the principles of evidence-based medicine taking into account the relevance and scale of clinical therapeutic effects, the degree of trust in the existing data based on the available level of evidence in relation to the best level of evidence to be expected in the given context and the quality of the existing studies;
  5. Focus on the expectations (“social preferences”) of insured people within the limits of normative standards in the sense of Swiss legal tradition;
  6. Assessment of cost-effectiveness without normatively problematic reductionist simplifications, such as threshold values for acceptable cost-effectiveness regardless of context;
  7. Setting of limits at several levels (added benefit, suitability, cost-effectiveness) without being detrimental to innovation;
  8. Consideration of further development opportunities in the future.
  9. The likely cost of the new HTA processes at around CHF 15 million p.a. – which should be borne equally by technology providers/users, insurers and the public purse – contrasts with a substantially greater potential for increasing efficiency.