Switzerland

On February 12, 2020, it was announced that the Swiss Federal Council is planning to modify the Health Insurance Ordinance (OAMal / KVV) with the goal of enhancing hospital planning, and unification of the inpatient tariffs throughout the country.

On January 31, 2020, the non-statutory HTA body, Swiss Medical Board, published the results of the report in which they compared the surgical and non-surgical treatment of rotator cuff tears. Though the surgery is more effective, the traditional treatment demonstrated better cost-benefit results. Thus, the Swiss Medical Board recommends the rotator cuff surgery with limitations.

At the end of January 2020, the entity managing the DRG system in Switzerland, SwissDRG, has published the data collection forms for SwissDRG 2020 (2019 data). Furthermore, an explanation about the coding of “Aortic stent graft (stent prosthesis)” has been released.

We have released the interview on the Market Access Insider channel on Youtube. The interview covered key stakeholders, procedure coding, functioning of the DRG system, reimbursement processes for medical technologies in Switzerland. Michel discussed the biggest mistakes made by the Med Tech companies on the market and advised on the best strategy on how to approach the market.

The Swiss Services Ordinance (KLV/OPre) is the document that defines the health care services which are covered by the compulsory health insurance in Switzerland. It is updated annually (with more frequent updates possible); thus, the 2020 version is released. Changes concern autologous transplantation of chondrocytes, extracorporeal photopheresis, transcatheter aortic valve implantation, ultrasound therapy focused on the pallidum, thalamus and subthalamus, CAR-T cell therapies, tomography with positron emission (PET/CT), stereotactic radiation therapy (photons) of wet age-related macular degeneration.

In mid-December 2019, the Swiss Federal Department for Home Affairs (FDHA) has decided that two new autologous cell therapies (CAR-T therapies) for the treatment of leukemia and lymphoma will be reimbursed by compulsory health care insurance.

In December 2019, the Swiss Medical Tariff Commission (MTK/CTM) has published their recommendations regarding the knee Autologous Chondrocyte Implantation (ACI). The CTM recommends covering the costs of the implant for knee ACI until the end of 2024.

At the end of November 2019, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the tariff versions (2020/2020) of the DRG and the add-on reimbursement catalog.

Within the framework of the Federal HTA program, the benefits currently paid under the compulsory health insurance are being reevaluated. On the 4th of September, 2019, the health technology assessment of arthroscopy of the knee, developed by the Swiss Medical Board on behalf of the Federal Ofice for Public Health, has been published.

On July 31, 2019, the Swiss Federal Statistics Office (UFS) has published the list of CHOP procedure codes, version 2020, which are used for procedure coding and in the DRG system for reimbursement of hospistal services.

Technical overviews include details of application processes for procedure codes and payments (e.g. DRG), inclusion into health benefit catalogs. Overviews are available as presentations in Acrobat PDF.

Explanation about the coding of selective intravascular radiotherapy (SIRT) with microspheres labeled with holmium-166, and of creation of intracardiac septal defect with implantation of an interauricular implant (percutaneous transluminal) in Switzerland was released by SwissDRG on July 26, and July 31, 2019, respectively.