Switzerland

On June 6, 2019, the Swiss Federal Department of Home Affairs (FDHA) has changed the Services Ordinance (OPre/KLV), which determines coverage of health care services in Switzerland. The changes regard mostly the reimbursement rules for various services. Furthermore, there are updates regarding the Health Insurance Law (LAMal/KVG), List of Analyses, List of Medical Aids and Equipment, and clinical coding.

On 17th June 2019, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the catalog version of SwissDRG 9.0/2020 (2017/2020). Eleven days later, the planning version of SwissDRG (2018/2020) has been published as well.

Between the 3rd of June and the 15th of July, SwissDRG will be receiving the requests/suggestions regarding the DRG system in the country.

The report includes all published reimbursement decisions for IVD tests in 2018 in European countries with established frameworks for out-patient reimbursement laboratory tests (Belgium, France, Germany, Netherlands, Switzerland).

The report includes an overview of funding framework and all (as of May 2019) decisions from ultimate payers and decisions makers in England (NHS England, one CCG), Germany (G-BA), Netherlands (Zorginstituut Nederland), Norway (“New Methods” framework) and Switzerland (Federal Office of Public Health). More than 1000 decisions are included.

The Swiss innovation agency, InnoSuisse, reminds that the deadline for the application for financing of truly innovative projects is May 20, 2019. The Swiss Federal Council has ensured additional funding of CHF 24 million for 2019 and 2020 for the “Impulse digitalization programme.”

On March 15, 2019, the Swiss Medical Board published two appraisal reports: “Robot-assisted laparoscopic surgery versus open surgery for radical prostatectomy” and “Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery for simple or radical hysterectomy.”

In February 2019, the entity that is in charge of the DRG system in Switzerland, SwissDRG, announced the publication dates of the SwissDRG 9.0/2020 catalog, but also information that concerns the suggestions regarding SwissDRG.

In mid-February 2019, the Swiss conference of cantonal healthcare directors (GDK/CDS) has published information about allocation of hospitals for highly complex visceral surgery in the fields of oesophageal, pancreatic and hepatic resections.

On February 5, 2019, the Federal Department of Home Affairs (FDHA) decided that in case of suspected infection or fever of unknown origin, positron emission tomography (TEP) will be considered mandatory services. Also, percutaneous electrical stimulation of the posterior tibial nerve (PTNS) was approved for incontinence indication. Furthermore, the reimbursement amounts relating to incontinence and ostomy materials will be reduced. List of Analyses was also updated.

Curafutura, an association of health insurance companies in Switzerland, started the initiative to change the current outpatient pricing structure (TARMED) in 2016. In late 2018, they let the public know that the new tariff structure for ambulatory medical benefits is almost ready to be submitted to the Federal Council.

The Federal Statistics Office has published, in late December 2018, the changes regarding procedure coding that would come into force in January 2019. The changes concern CAR-T cell therapy and intervertebral arthrodesis devices, among other treatment methods. Besides the changes implemented, the list of all requested changes in 2018 was published.