HTA System in Switzerland: Current State, Gaps, and Prospects for Improvement

Abstract Health technology assessment (HTA) is critical for funding decisions in solidarity-based healthcare systems. Switzerland's intricate healthcare system merges regulated competition and corporatism within a decentralized structure, inspired by direct democracy. This study aims to analyze the national HTA system, identify challenges, and propose insights to strengthen HTA, contributing to future research and supporting Universal Health Coverage efforts. A cross-sectional mixed-methods approach was employed, combining nine institutional surveys and eight in-depth interviews with participants from various health system levels in Switzerland. The study examined HTA practices in nine Swiss institutions, comprising 67% academic, 22% public, and 11% non-governmental sectors. Findings revealed structured processes (67%) with the Federal Office of Public Health as a central agency (67%). While 56% reported substantial funding, challenges included a lack of government financing. Primary HTA use was for reimbursement decisions (56%) and clinical guidance support (44%). Impediments included awareness gaps, political support deficiencies, and institutional capacity issues. The research highlights the importance of HTA in healthcare decision-making and resource allocation in Switzerland, revealing an effective grasp of HTA, but also identifying policy gaps. Enhancing awareness and institutional strengthening were identified as crucial for advancing HTA in the country. The study suggests that Switzerland could benefit from establishing a national HTA agency. Key messages • Establishing a unified and integrated national HTA agency in Switzerland is priority. • HTA system in Switzerland experianced a signaficit transformation with an urgent need to address the existing gasp such as integration, standardization, and resources and capacities.