In view of the ageing population, one of the biggest challenges facing the healthcare system in Switzerland is the need to improve the treatment of diseases that occur more commonly in advanced years and are often accompanied by additional medical conditions (comorbidity). These include various forms of cancer, cardiovascular diseases and dementia.
This is a challenge that needs to be addressed initially through research and development, so that innovative therapies can not only extend life but also improve the quality of life. The Swiss population appreciates the high quality of the medical care it receives. It would be as unwilling to give it up as it would the wide range of benefits provided by basic and supplementary health insurance. Yet high expectations of the healthcare service and ever more and better benefits come at a price. These costs are the most intensively discussed aspect of the healthcare system. There is a limit to the willingness, and also the ability, of the individual to help pay for increasingly elaborate healthcare provision.
Health expenditure versus the cost of illness
If a way is to be found out of this apparently insoluble dilemma, the way we view our healthcare system must first change by comparing expenditure on health with the cost of illness. The decisive issue is not how much it costs to regain health but what it costs to be ill. This aspect is often ignored in the emotionally charged discussion of rising healthcare expenditures, as is the contribution that medicinal products make to medical progress by shortening the duration of a disease or alleviating its subsequent impact. Yet this contribution brings with it substantial economic advantages. Innovative therapies help to lower costs by shortening the length of stay in hospital or, in some cases, making surgery unnecessary.
Ultimately, spending on health can reduce the cost of illness. A disease generates not only the costs associated with treating the patient but also indirect costs, such as loss of productivity due to absence from the workplace and the effort required from family members to care for the patient at home.
HTA shows the way
Assessment of the benefits offered by medical products and services is an important tool in promoting this perspective. Health technology assessments (HTA), as they are known, can help to leverage the great potential for rationalisation that is without a doubt inherent in our healthcare system. They allow individual items to be weighed against each other, with the focus always on the benefit to the patient. HTA therefore simply reveal the ways in which the benefit can be maximised while focusing on the patient and on quality. It must not be a vehicle for lowering costs in Switzerland.