Sweden

In Sweden, the Priority Council of Skåne Region prepares and presents suggestions for new methods, routines, and treatments, to be included in the healthcare system. In August 2019, the HTA report for endoscopic procedures in dysphagia was released. The analysis showed that fiberoptic endoscopic evaluation of swallowing and videofluoroscopy are clinically well-established procedures that have good and equal coherence between different assessors and in repeated assessments.

The HTA center of Swedish Västra Götaland region has published a report for the effectiveness of laminar versus turbulent airflow in operating theaters, with regard to risk for postoperative surgical infections. It was concluded that vertical laminar airflow, compared with any other type of ventilation system in operating rooms, is probably associated with a further reduction of CFU concentration in air sampled near the operation table.

The HTA center of Swedish Västra Götaland region has published a report for effectiveness and safety of microsurgical testicular sperm extraction (TESE) in infertile men with non-obstructive azoospermia (NOA) and concluded that it is uncertain whether there is any difference in complication rates for micro-TESE compared with testicular sperm aspiration (TESA). There is a need for extensive high-quality studies comparing results of micro-TESE with TESA

The HTA center of Swedish Västra Götaland region has published a report for gene expression profiles to guide adjuvant chemotherapy in luminal, HER2-negative breast cancer. It was concluded that withholding adjuvant chemotherapy in breast cancer patients with intermediate clinical risk of recurrence and low/intermediate risk according to a gene expression assay, compared with providing chemotherapy, probably results in little or no difference in overall survival within nine years and can probably not exclude a small increased risk of recurrence.

The test for severe combined immunodeficiencies (SCID) is part of neonatal screening since July 1, 2019, in Germany. At the beginning of July 2019, the Swedish National Board of Health and Welfare (Socialstyrelsen) has stated that health care should offer screening for the severe combined immunodeficiency (SCID) as approximately two or three children per each year can be diagnosed and treated for the fatal disease with the test available.

The HTA center of Swedish Västra Götaland region has published a report for the impact of postmastectomy radiotherapy (PMRT) on complications and results of immediate breast reconstruction (IBR). PMRT compared with no radiotherapy (RT) results in a clinically significant increase of implant or tissue expander loss in patients undergoing IBR with moderate certainty of evidence. Other findings (decrease in patient satisfaction, an increase of re-operations or capsular contracture rate increase) gained low certainty of evidence.

In June 2019, the Dental and Pharmaceutical Benefits Agency (TLV) has published a completed health economic evaluation regarding the cost-effectiveness of the comprehensive genomic profiling test for all solid tumors FoundationOne CDx. TLV believes that in most cases, the use of FoundationOne CDx is more expensive in comparison to current treatment methods. However, it has greater sensitivity and accuracy in the diagnostics.

In Sweden, Skåne Region develops knowledge base and prepares questions for decisions on the introduction of evidence-based health and medical care throughout Region Skåne. In May of 2019, there are two ongoing projects for fast track for rapid diagnostic for giant cell arteritis and the impact of daily rhythm lighting on patients in psychiatric full-time care. The final reports are going to be published at the web-site of Skåne Region.

In Sweden, the Priority Council of Skåne Region prepares and presents suggestions for new methods, routines, and treatments, to be included in the healthcare system. In April 2019, the HTA report for thrombectomy 6 to 24 hours after stroke was released. The health economic analysis showed that the use of thrombectomy during extended time frames is expected to be cost-saving in a socio-economic perspective and increases patient benefit measured in terms of won quality-adjusted life years.

The HTA center of Swedish Västra Götaland region has published a report, which aimed to evaluate the effectiveness of EEG-based neurofeedback as a treatment for post-traumatic stress disorder (PTSD). It is uncertain whether the procedure compared with no or standard treatment reduces PTSD symptoms in adult patients. It is also uncertain whether the treatment results in any difference in suicidal thoughts, level of functioning, or medication use.

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in healthcare region Uppsala-Örebro. Currently, CAMTÖ is working on several assessments related to the medical devices and technologies such as equipment for 3D Printing, robot Intuitive daVinci Xi etc. After the completion of assessment procedure, the reports will be published at the web-site of Örebro County Council.

More than 50 new DRGs were introduced in the Swedish system in 2019, while two have been deleted. The changes affected nursing care, psychiatry, hospital and day case services of different major disease categories. Important changes relate to cardiac ablation, placement of neurostimulator.