HTA projects

All HTA projects in progress or completed are listed below. Published here in the course of each project are the protocol and the HTA report, together with the feedback received from stakeholders. The reports are written in English (with summaries in French, German and Italian).

24.06.2022

Tumor treating fields (TTFields) for patients with newly diagnosed glioblastoma

This topic is currently in development. As soon as reports on this topic are available, they will be published here.

06.05.2022

Bone-targeting agents in patients with bone metastases

Cancer sufferers with bone metastases receive drugs on a monthly basis to reduce the risk of fractures and the release of excess calcium into the bloodstream. The latest studies indicate that administering the drugs only every three months rather than every month is similarly effective but is associated with a lower risk of side effects.

06.05.2022

Denosumab (Prolia®) for the treatment of osteoporosis

Denosumab (Prolia®) is used to treat bone loss, particularly among women after the menopause and people who are at a higher risk of breaking bones or who are undergoing certain cancer treatments. In 2017 there were reports that stopping therapy with denosumab could lead to excessive counter-reactions such as loss of bone density and a greater risk of broken bones in the area of the spine.

29.04.2022

Oral anticoagulants for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation

Direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) are currently prescribed in Switzerland for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). Based on evidence from an observational study, an external applicant requested the FOPH to re-evaluate the use of DOACs for NVAF in Switzerland. The aim of this HTA is to evaluate the efficacy, effectiveness, safety, cost-effectiveness and budgetary impact of DOACs compared to VKAs for the prevention of stroke and other thromboembolic events in patients diagnosed with NVAF.

09.02.2022

Sedative-Hypnotic Drugs for the Treatment of Primary Chronic Insomnia Disorder

Sedative-hypnotic drugs are used to reduce tension and anxiety and to induce calm (sedative effect) or sleep (hypnotic effect). Following clinical guidelines and product information, these drugs should not be prescribed for longer than four weeks for primary chronic insomnia disorder. The current total costs of these drugs have a large impact on the national healthcare budget. Despite the high costs, potential harms and clear discouraging guideline recommendations for long-term sedative-hypnotic drug treatment, the rates of sedative-hypnotic drugs use have not changed meaningfully over time.

07.12.2021

Multigene-expression tests for breast cancer

This topic is currently in development. As soon as reports on this topic are available, they will be published here.

05.11.2021

Medicines for Dementia due to Alzheimer's Disease and Parkinson's Disease

Donepezil, rivastigmine and galantamine are reimbursed for the treatment of mild to moderate dementia due to Alzheimer's Disease (AD). Rivastigmine is also reimbursed for the treatment of mild to moderate dementia due to Parkinson's Disease (PD). For the treatment of moderate to severe dementia due to AD, memantine is reimbursed.
The clinical benefit of these drugs is unclear. This HTA aims to evaluate the available clinical and economic evidence associated with these treatments in patients with dementia due to AD or PD in Switzerland.

02.11.2021

Effectiveness and safety of vitamin B12 tests

In the last five years, the use of vitamin B12 tests has increased significantly in Switzerland, especially with regard to tests for vitamin B12, transcobalamin II and III, holotranscobalamin (holo-TC) and methylmalonic acid (MMS). The question of whether vitamin B12 testing is necessary in patients at risk of vitamin B12 deficiency and in patients with clinical suspicion of vitamin B12 deficiency before starting vitamin B12 supplementation was explored. The aim of this Health Technology Assessment (HTA) short report was to highlight the advantages and disadvantages associated with vitamin B12 testing in patients with clinically suspected or at high risk of vitamin min B12 deficiency.

30.09.2021

Thyroid function tests for the diagnosis of suspected primary or secondary thyroid dysfunction

Thyroid function tests are used for the diagnosis and monitoring of patients with thyroid disorders. Most guidelines recommend a two-step testing approach: TSH should be measured first, only followed by a measurement of (free[f]) T4/(f)T3, if TSH is out of the reference range or if there is clinical suspicion of abnormal TSH secretion. However, it is observed that TSH and (f)T4/(f)T3 are often measured together in a one-step test approach.

16.09.2021

Magnesium supplements

This topic is currently in development. As soon as reports on this topic are available, they will be published here.

01.09.2021

Palbociclib (Ibrance®), ribociclib (Kisqali®) and abemaciclib (Verzenios®) as a treatment for advanced breast cancer

CDK4/6 inhibitors, such as palbociclib, ribociclib and abemaciclib, are a new class of drugs that are used in combination with endocrine therapy to treat advanced hormone receptor-positive, HER2 receptor-negative breast cancer. Results from clinical trials suggest that some of these new compounds may cause severe side effects. There is also evidence that not all CDK4/6 inhibitors contribute equally to prolonging the survival of burst cancer patients and improving their quality of life. The aim of the health technology assessment (HTA) is therefore to evaluate the efficacy, safety, cost-effectiveness and budgetary impact of treatment with CDK4/6 inhibitors in comparison with each other and with standard therapy.

20.08.2021

Levothyroxine as a treatment for subclinical hypothyroidism

Subclinical hypothyroidism (SCH) is a hormonal disorder in which the serum thyroid-stimulating hormone levels (TSH) are elevated, while the thyroid hormone levels are within the normal reference range. SCH can be treated with hormone replacement therapy using levothyroxine. However, the need for treatment of this subclinical disorder is still under debate. The evidence from the literature regarding the benefits of levothyroxine treatment for SCH is controversial. The aim of the HTA is to evaluate the clinical effectiveness and economic implications of levothyroxine treatment in patients diagnosed with SCH.

17.08.2021

Infliximab reference product versus biosimilar for the treatment of rheumatoid arthritis

The biopharmaceutical infliximab is a monoclonal antibody (mAb) used to treat a number of inflammatory autoimmune diseases including rheumatoid arthritis (RA). In 2019, infliximab generated costs of around CHF 132 million, rendering it the second most cost-incurring drug reimbursed by the mandatory health insurance in Switzerland.
Some European countries adopted policies recommending the substitution of infliximab reference products with biosimilars like initiating treatment with infliximab biosimilars as well as switching patients from infliximab reference product to biosimilars. In Switzerland, the legal framework does not facilitate implementing similar policies.
The aim of the HTA is to evaluate the efficacy, safety, cost-effectiveness and budgetary impact of initiating treatment with infliximab biosimilars as well as of switching patients from infliximab reference product to biosimilars in rheumatoid arthritis patients.

11.06.2021

Subacromial decompression as a primary/isolated intervention to treat subacromial pain

The aim of the Health Technology Assessment (HTA) is to evaluate the efficacy, safety, cost-effectiveness and budgetary impact of subacromial decompression in patients with subacromial pain.

04.06.2021

Statins in the primary prevention of cardiovascular events and mortality in Switzerland

The Health Technology Assessment (HTA) report on statins for the primary prevention of cardiovascular events and mortality in Switzerland. This is done on the basis of the identified number and quality of the primary literature. Based on the scoping report, the HTA report examines the efficacy, safety, cost-effectiveness and budgetary impact of statin therapy in adults without established cardiovascular disease at low, moderate or (very) high cardiovascular risk compared to no treatment and/or lifestyle adjustment.

04.06.2021

The treatment of hypercholesterolaemia and mixed/combined hyperlipidaemia with ezetimibe-containing medicines

The aim of the Health Technology Assessment (HTA) is to evaluate the efficacy, safety, cost-effectiveness and budgetary impact of ezetimibe-containing medicines compared to statins or fenofibrate in patients with hypercholesterolaemia or mixed/combined hyperlipidaemia.

21.05.2021

Long-term physiotherapy in patients after stroke, with multiple sclerosis, or with Parkinson’s disease

Some patients after stroke, with multiple sclerosis (MS), or with Parkinson’s disease currently receive physiotherapy over a lengthy period of time (more than 36 physiotherapy sessions per year). The question arises as to whether long-term physiotherapy for these patients has additional benefits compared with those receiving short-term physiotherapy. The aim of the HTA is to assess the efficacy, safety, cost-effectiveness and budgetary impact of long-term physiotherapy for patients after stroke, with MS or Parkinson’s disease. The scoping report showed that no data are currently available for this patient group to conduct an HTA on the efficacy, safety and cost-effectiveness of long-term physiotherapy compared to short-term physiotherapy.

18.05.2021

Vertebroplasty or kyphoplasty in patients with symptomatic osteoporotic vertebral compression fractures

The objective of this HTA is to evaluate the efficacy, safety, cost-effectiveness and budgetary impact of percutaneous vertebroplasty and percutaneous balloon kyphoplasty in patients with symptomatic osteoporotic vertebral compression fractures unresponsive to non-surgical treatment.

30.04.2021

Medical cannabis for treating various symptoms in Switzerland

Health Technology Assessment (HTA) is designed to assess the efficacy, safety, cost-effectiveness and budgetary impact of therapy with cannabis as compared with placebo, no therapy or standard of care in patients with various symptoms (pain, spasticity, vomiting and nausea in cancer patients, unintended weight loss).

30.04.2021

Corneal collagen crosslinking for the treatment of progressive keratoconus

The aim of this HTA short report is to evaluate the efficacy, safety, cost-effectiveness and budget impact of corneal collagen crosslinking (CXL) compared to sham or no treatment in patients with progressive keratoconus.

07.04.2021

Chondroitin sulfate in osteoarthritis

The objective of the HTA is to compare the safety and efficacy of chondroitin sulfate with placebo, on-demand analgesics and anti-inflammatory treatments in patients with osteoarthritis of the hands, knees and hips. In addition, the cost-effectiveness and budgetary impact of chondroitin sulfate are to be investigated.

13.11.2020

Dual Antiplatelet Therapy following Percutaneous Coronary Intervention

This report presents a summary of a health technology assessment (HTA) report published by the Canadian Agency for Drugs and Technologies in Health that evaluated the evidence pertaining to the comparative clinical efficacy and safety of six to 12 months dual antiplatelet therapy (DAPT) versus extended DAPT (>12 months), following percutaneous coronary intervention with stent insertion in coronary artery disease patients and various subpopulations.

02.10.2020

Vitamin D Testing

The Health Technology Assessment (HTA) intends to review the efficacy, safety, cost-effectiveness and budgetary impact of the use of vitamin D testing in risk groups as defined by the Swiss Federal Nutrition Commission (people with bone disease, older adults, obese individuals, pregnant women, people with dark skin and athletes). It will also analyse evidence regarding the clinical effects of vitamin D supplementation in these risk groups. The feasibility of a full HTA has been determined on the basis of the scoping report. A full HTA is not justified at this stage, as no clinical studies are available that would enable evaluation of vitamin D tests. This issue could be revisited once such studies are available.

15.09.2020

Point-of-care diagnostic tests

This topic is currently in development. As soon as reports on this topic are available, they will be published here.

Examples for search terms:
osteoarthritis or osteo* or *arthritis 

Last modification 21.06.2022

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Federal Office of Public Health FOPH
Health insurance benefits Division
Health Technology Assessment Section
Schwarzenburgstrasse 157
3003 Bern
Switzerland
Tel. +41 58 469 17 33
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