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).

11.11.2022

Hormone tests in suspected thyroid dysfunction

Where thyroid dysfunction is suspected, testing for thyroid hormones may provide useful insights. Two test approaches exist: the one-step test measures thyroid-stimulating hormone (TSH) and other thyroid hormones in a single step, while the two-step approach measures just the TSH to begin with. The report concludes that, from a clinical perspective, using the two-step testing approach carries only a low risk of missing cases of thyroid dysfunction. In terms of costs, the two-step approach represented a cost saving compared with the one-step approach.

28.10.2022

Use of the hormone Levothyroxine to treat a slightly underactive thyroid gland

One sign of a slightly underactive thyroid gland is a raised level of the hormone which stimulates the thyroid – known as thyroid-stimulating hormone, or TSH. The hormone levels in the thyroid are still within the normal range at this stage and symptoms are only minimal. To treat this condition in Switzerland, a manufactured form of the body’s own thyroid hormone is used – the hormone Levothyroxine. The report concludes that treatment with Levothyroxine successfully reduces the level of the TSH hormone, but does not reduce the associated complaints or side effects.

21.10.2022

Medications against dementia in Alzheimer’s and Parkinson's disease

This HTA report investigates the efficacy of various anti-dementia medications for the treatment of dementia symptoms in Alzheimer’s and Parkinson's disease. Literature searches found that in mild to moderate and in some cases also in advanced dementia in Alzheimer’s and Parkinson's disease, the anti-dementia medications used had a certain positive effect, for example on cognitive abilities, compared to placebo. Considered over a longer period, the cost/benefit ratio for most of the anti-dementia medications was positive.

23.09.2022

Tumor treating fields (TTFields) for patients with glioblastoma

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

05.08.2022

Revascularisation versus optimal medical therapy for the treatment of chronic coronary syndrome

Patients with chronic coronary syndrome (CCS) may be treated with conservative methods, including optimal medical therapy (OMT) and risk factor modifications, with or without invasive interventions. Revascularisation is an invasive intervention in which patients undergo percutaneous coronary intervention (PCI) – also known as percutaneous transluminal coronary angioplasty – or coronary artery bypass grafting (CABG). The aim of the HTA is to evaluate the evidence regarding efficacy, effectiveness, and safety of PCI with OMT and CABG with OMT compared to OMT alone.

05.08.2022

Calcitonin gene-related peptide antagonists for the prevention of migraine

Calcitonin gene-related peptide (CGRP) antagonists are a class of medicines for the management of episodic and/or chronic migraine. The aim of the HTA is to evaluate the effectiveness, safety, costs, cost-effectiveness and budget impact of CGRP antagonists compared to standard of care medications in patients who suffer from episodic and/or chronic migraine.

01.08.2022

CAR-T-cell therapy

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

06.05.2022

Comparison of dosing schedules for drugs to treat 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. Comparing trimonthly to monthly dosing, the analyses only showed minimal differences in terms of potential side effects while the efficacy was the same. If doctors treated patients on a trimonthly dosing interval from the outset, this would result in potential savings of over CHF 53 million in the next five years.

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. The report concludes that among most of the patient groups treated, denosumab achieved similar effects to other therapies and displayed a similar degree of safety.

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 and sleep-promoting medicines for the treatment of chronic sleep disorders

The group of sedative and sleep-promoting medicines is used in sleep disorders in order to alleviate persistent episodes of tension and anxiety. According to the product information they should not be prescribed for longer than four weeks. According to the report, the evidence indicated that the drugs remain effective to a certain extent and are safe even during long-term use, but that they are not necessarily cost efficient. The use of sedative and sleep-promoting medicines leads to dependency and increasing doses.

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.

02.11.2021

Vitamin B12 tests

The use of vitamin B12 tests in Switzerland has risen sharply in recent years. The aim of the report was to identify the advantages and disadvantages of various vitamin B12 tests and establish whether tests are needed at all before dispensing vitamin B12. The report concludes that the existing findings do not indicate whether a vitamin B12 test or test combination should be used, and if so which ones, or whether the tests have any influence on the treatment.

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.

16.09.2021

Betahistine dihydrochloride and drugs containing cinnarizine in the treatment of Menière's disease and menière-like syndromes such as dizziness, ringing in the ears, tinnitus and impaired hearing

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

01.09.2021

CDK4/6 inhibitors as a treatment for advanced breast cancer

CDK4/6 inhibitors are a relatively new class of drugs often used for advanced metastatic breast cancer in combination with anti-hormonal therapy to complement standard treatment. New studies indicate that not all CDK4/6 inhibitors contribute equally to prolonging survival of breast cancer patients or to improving their quality of life. The report concludes that the combination therapies consisting of CDK4/6 inhibitors and standard therapy can increase efficacy but will increase the need for medical care and produce more side effects. Further studies are ongoing and might produce more detailed results in future.

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.

09.08.2021

Antidepressants and cognitive behavioural therapy in major depressive disorders beyond the acute treatment phase

The topic was proposed concurrently by both the FOPH and the Swiss Medical Board (SMB) as an HTA topic for evaluation. As the SMB report covers the same research questions as were planned by the FOPH, the FOPH has decided that the SMB will take on the report.

11.06.2021

Surgical widening of the subacromial space for the treatment of lower shoulder pain

A suspected cause of pain below the shoulder blade is insufficient space between the shoulder blade and the shoulder joint. One possible treatment is surgical widening of the subacromial space. The report concludes that surgical widening of the subacromial space offers no significant advantages over the conservative approach. However, the alternative treatment with physiotherapy may result in cost savings.

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 after a stroke, in multiple sclerosis or Parkinson's disease

In Switzerland, the compulsory health insurance system pays for up to 36 physiotherapy sessions. However, many patients require longer-term physiotherapy, for example after a stroke or if they suffer from multiple sclerosis (MS) or Parkinson's disease. A report was designed to show whether long-term physiotherapy with more than 36 sessions offers any therapeutic advantage over short-term physiotherapy. The preliminary report showed that, for the aforementioned groups of patients, the data currently available are insufficient for producing a comprehensive report comparing long-term physiotherapy with short-term physiotherapy after a stroke, in multiple sclerosis or Parkinson's disease.

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

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.

30.04.2021

Medical cannabis for the treatment of various symptoms

Medical cannabis is used for a range of symptoms such as chronic pain, muscle spasms and unintentional weight loss. The report concludes that the efficacy of medical cannabis for chronic pain and muscle spasms is unclear. However, there is evidence that its use is associated with higher costs. Moreover, a number of legal, social, ethical and organisational questions remain unresolved.

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

Last modification 02.09.2022

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