Viewed\ninternationally, Switzerland has a high-quality healthcare system. However,\nmany reform projects are driven purely by cost considerations. Against this\nbackground, it is hardly surprising that the discussion of reform is currently\nfocused mainly on funding, and more specifically on the health insurance\nproviders, rather than on the benefits provided by the healthcare system. It is\nvital for more quality-related discussions to take place in the Swiss\nhealthcare system, instead of allowing this aspect to be drowned out by a focus\non costs. <\/p>\n\n\n\n
Health\ntechnology assessments (HTA) help to put cost-related discussions on an\nobjective footing. They are intended to create a basis for greater quality and\ncost-effectiveness in the healthcare system. A current example is the review of\nthe value of cannabis in medicine. Following a mandate from the Federal\nCouncil, the Federal Office of Public Health (FOPH) is planning to commission a\nhealth technology assessment of the scientific evidence available for cannabis\nin various indications, e.g. treatment of chronic pain or spasms associated\nwith multiple sclerosis. The objective is to elucidate the cost-effectiveness,\nand with it the appropriate form of funding, of cannabis-based medicinal\nproducts. Experience and the current discussion surrounding excessive\nconsumption of opioids have led to the suggestion that the public health aspect\nshould also be included in the HTA.<\/p>\n\n\n\n
The\nfederal government’s current HTA activities are focused heavily on examining\nthe efficacy of medicinal products. Yet these are the only benefits provided by\nthe healthcare system that are already institutionalised, and are reviewed\nevery three years for efficacy and cost-effectiveness. Interpharma is therefore\ncalling for a wider and more balanced focus to enable HTAs to contribute\ngenerally to increased quality in the Swiss healthcare system.<\/p>\n\n\n\n
Rationing means that the provision of medically justifiable benefits is artificially restricted. It would mean, for example, that a patient might be refused a hip operation because she has reached a certain age and surgery is no longer thought to be worthwhile as a result.<\/p>\n\n\n\n
In 2016, after years of legal dispute, the Swiss Federal Supreme Court confirmed a judgement handed down by the St. Gallen Cantonal Insurance Court that marked a legal milestone for patients with rare diseases. In the judgement, the health insurer KPT was required to pay for vital treatment needed by a patient with the rare neuromuscular condition Pompe disease. The necessary medicinal product is on the List of pharmaceutical specialities, but the insurance provider had criticised the criteria for inclusion of the product in the List (specifically effectiveness and cost-effectiveness). It therefore declined to pay for the cost of treating the patient. The Federal Supreme Court decided in its judgement that the patient fulfilled the conditions for reimbursement of the costs in accordance with the List and that the health insurance provider was not entitled to object to the inclusion of the medicine in the List or to its price. This is a very important judgement for all patients with rare diseases because it can help to prevent gaps in treatment due to time-consuming legal proceedings and to achieve more treatment equality in Switzerland. <\/p>\n\n\n\n
The\nblessing of ever-greater life expectancy poses enormous challenges for research\nand for society as a whole. The issue also raises ethical and moral questions\nthat will feature heavily in future public health policy. The question\noccupying health economists trying to make sense of rising costs is the\nfollowing: how much can an additional year of life be allowed to cost? There\nare various models for calculating this value, but the conclusion they reach\nalways means rationing medical care. The pharmaceutical industry rejects an\napproach of this kind because it will inevitably lead to two-tier healthcare.<\/p>\n\n\n\n
The\nmain issue here is therefore not financially motivated decisions but social\nand, to an even greater extent, moral and ethical decisions. Discussion of this\nissue has begun in Switzerland but is not yet taking place on a broad enough\nbasis. The same applies to palliative medicine. The federal government has\ninitiated a trial regimen and there is growing acceptance of palliative care,\nbut there is still a great need for discussion in society of the distinction\nbetween palliative and curative therapy.<\/p>\n","protected":false},"excerpt":{"rendered":"
Viewed internationally, Switzerland has a high-quality healthcare system. However, many reform projects are driven purely by cost considerations. Against this background, it is hardly surprising that the discussion of reform is currently focused mainly on funding, and more specifically on the health insurance providers, rather than on the benefits provided by the healthcare system. It […]<\/p>\n","protected":false},"author":1,"featured_media":14800,"parent":4196,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/unterthema.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-4148","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"\n