Currently, in Switzerland, two CAR-T cell therapies are approved, both for the treatment of certain types of lymphoma. One of them is also approved for the treatment of certain forms of leukemia. The Swiss Federal Department for Home Affairs (FDHA) has decided to regulate their reimbursement of these treatments in the Services Ordinance (KLV/OPre) in more detail in January 2020. The reimbursement under the compulsory health care insurance applies only under certain conditions and is currently limited until the end of 2022. Until then, the efficacy, appropriateness and cost-effectiveness (EAE criteria) of the two therapies must be ascertained by the data.
The services can be delivered in centers that already carry out bone marrow transplants and have the corresponding accreditation.
Since these treatments are inpatient benefits, they will be reimbursed within the framework of Swiss DRG. The amount of the reimbursement can be found in the SwissDRG 9.0 (2020/2020) tariff version
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In addition to these changes, a number of other adjustments have been made to the OPre/KLV and its annexes. All changes to OPre/KLV will enter into force on January 1, 2020. Subscribe
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