Switzerland

Between 28th of May and 9th of July 2018, SwissDRG will be accepting the requests/suggestions regarding the DRG system in the country.

On 5th of April, 2018, the Board of Directors of SwissDRG SA has given the director the mandate to establish, where appropriate, codifications by analogy in agreement with the Federal Statistics Office (FSO). The regulation from April of 2018 covers CytoSorb for removal of cytokines.

In February 2018, the DFI (the Federal Department of Home Affairs) has decided to make a change in the activity order (Ordinanza sulle prestazioni, OPre) concerning “out-patient before in-patient.” The modification is coming into force starting January 1st, 2019. Six procedures will be reimbursed only in out-patient settings.

The Department of Home Affairs (EDI) in Switzerland decided upon the coverage with evidence development (CED) of two types of positron emission tomography as well as stereotactic radiotherapy (photons) of exudative age-related macular degeneration. The status is given to contested medical services for a specific period which is extended until evidence is complete.

The further-developed tariff structure SwissDRG was approved by the Federal Council in Switzerland. The new tariff version for inpatient services will be effective from January 1st in 2018. The tariff structure SwissDRG defines how inpatient services in the acute care area of the hospitals and birthplaces are reimbursed within the framework of compulsory health care insurance in Switzerland.

An international advisor group of 14 medical and health economic experts proposed 38 measures of how control the increase of healthcare costs in Switzerland. One third of the actions including the strengthening of HTA are already considered. The Swiss Federal Council now wants to develop concrete plans for the implementation of the new measures suggested in the report by the expert group, including global budgets for the outpatient sector, the introduction of medical boards, the encouragement of parallel imports of medical technology and implants and annual review of prices.

SwissDRG has released overview of planned update of DRG system (version 7.0) in 2018, including list of preliminary approved add-on reimbursement categories. Add-on will be established for endobronchial valves, proton therapy, autologous matrix-induced chondrocyte implantation at knee joint and intermitted hemodialysis for removal of proteins with molecular mass up to 60,000 Da.

SwissDRG has released the application form for suggestions for DRG change in 2017. Applications will be collected between 29th of May and 10th of July 2017. Approved changes will be implemented in 2019.