Health technology assessment of three screening methods in Switzerland.
OBJECTIVE
To describe the level of health technology assessments for three screening methods in Switzerland.


METHODS
Analysis of documents and expert opinions on mammography screening, ultrasound examinations during normal pregnancy, and screening for prostate-specific antigen (PSA) with a focus on services provided, recommendations, formal regulations, national papers, projects, and formal assessments.


RESULTS
Preventive services are explicitly recommended by the Swiss federal law on health insurance. Two routine ultrasound examinations during normal pregnancy as well as PSA analysis for men over 40 years of age on medical indication are covered by basic health insurance. Mammography screening every 2 years has been covered since 1997 for women over 50 years. A systematic screening program for mammography exists in the western part of Switzerland, and a nationwide program is planned. However, a national program may not come into being until a quality assurance program for evaluation is established, and a nationwide fee for reimbursement-to include all costs of such a program-is accepted by providers and insurers.


CONCLUSIONS
According to the Swiss health insurance law, the effectiveness of mammography screening and ultrasound examinations during normal pregnancy have to be proven. Systematic evaluation of these screening methods is in preparation. PSA is not part of current evaluation. It can be concluded that health technology assessment in Switzerland is now required by law for several medical services. However, limited financial and personnel resources as well as the lack of disease registers may hamper progress in the near future.
Faisst
K
K
University of Zurich.
Schilling
J
J
Koch
P
P
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D013557:Switzerland; D013673:Technology Assessment, Biomedical; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*
D017430:Prostate-Specific Antigen