Here we offer insights into selected scientific projects at the Institute.
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SwissHTA: A Multi-Stakeholder Consensus
on Health Technology Assessment (HTA) in Switzerland
In the past, Health Technology Assessment (HTA) initiatives in Switzerland had been fragmented and impaired by blurred boundaries between assessments and appraisals as well as limited by a number of methodological issues. Therefore, a transparent and inclusive process (“SwissHTA”) was initiated by santésuisse (the national association of sick funds) and Interpharma (federal association of the Swiss research-based pharmaceutical industry) to develop a multi-stakeholder consensus on the future implementation of official HTAs in Switzerland.
InnoValHC provided scientific guidance and input throughout the project. Santésuisse and Interpharma invited national stakeholders to participate in SwissHTA. The process was led by a project steering committee, with membership from santésuisse, Interpharma, the Swiss federal government (Bundesamt für Gesundheit, BAG, as an observer), the Swiss Medical Association (FMH), the Swiss Academy of Medical Sciences (SAMW), the Swiss Conference of Cantonal Health Directors (Schweizerische Konferenz der kantonalen Gesundheitsdirektorinnen und -direktoren, GDK, as an observer), and InnoValHC.
The project began with a kick-off meeting at the Ittingen Charterhouse (Kartause Ittingen) in November 2010, which set the stage for the consensus process by discussing the international Health Technology Assessment (HTA) experience with high-level experts who presented their respective perspectives. After seven retreats of the project team and three public workshops, which were supported by a scientific steering committee, the team reached a Consensus that was officially endorsed by the participating organizations on October 19, 2011.
In a second phase of the project, the Consensus documents were subsequently supplemented by six “implementation papers”, recommending a broad technology focus (covering both new and existing ones by specific processes following a common set of core principles) and defined opportunities for stakeholder involvement. Primary evaluation criteria should be driven by the social preferences of the Swiss population, constrained by a prior normative commitment in line with the rights-based legal tradition of Switzerland. The full range of health-related benefits should be evaluated. Assessment of clinical evidence should take into account the level of evidence that can reasonably be expected in a given context, rating the degree of confidence in outcomes in relation to the relevance and the magnitude of the effects observed. Economic viability should be evaluated based on budgetary impact and social cost-benefit ratios. Notably, SwissHTA firmly rejected the idea of incremental cost per quality-adjusted life year (QALY) gained benchmarks as a measure of “value for money”.
SwissHTA illustrates the possibility of a broad-based stakeholder consensus on HTA and offers well-defined evolutionary options. By 2014, the project has moved into an implementation phase aiming at the integration (“convergence”) of the various Swiss HTA initiatives into one consistent framework. InnoValHC will continue to support this process, which ideally should take place under the lead of the Swiss federal government, according to the Consensus of October 19, 2011.
Consensus Document (1.1 MiB)
Consensus Document – Appendix (888.1 KiB)
SwissHTA: Guiding Principles (570.6 KiB)