Soll die Suva eine Handtransplantation bezahlen? Die Medizinaltarif-Kommission UVG, welche sich mit grundsätzlichen Fragen in der Unfallversicherung befasst, hat diese Frage nun zu beantworten. Als Grundlage für deren Entscheidung hat sie beim WIG ein Health Technology Assessment (HTA) in Auftrag gegeben. Darin sollen medizinische und ökonomische Fragen aber auch ethische, rechtliche und organisatorische Aspekte fundiert und umfassend beleuchtet werden. Finanziert wird das Projekt von allen Unfallversicherern.Das Projekt hat zu foglender Publikation geführt:

The health technology assessment of the compulsory accident insurance scheme of hand transplantation in Switzerland

U. Brügger, R. Plessow, S. Hess, A. Caballero, K. Eichler, V. Meyer, U. von Wartburg (2014), Journal of Hand Surgery (European Volume), Vol 40, Issue 9, pp. 914 - 923

doi.org/10.1177/1753193414559463

Abstract

Recently the decision-making committee of the compulsory Swiss accident insurance scheme needed to make a basic decision as to whether to fund hand transplantation under that scheme or not. A Health Technology Assessment was commissioned to inform decision-making and gain experience with applicability of the method. The following were main findings from various domains. Compared with prosthesis fitting, the outcome of hand transplantation is satisfactory for function and sensibility. Complications due to immunosuppression are frequent, sometimes severe and potentially life-shortening. The direct medical costs over the entire life span calculated for a 35-year-old unilaterally amputated base case patient were CHF 528,600 (EUR 438,500) higher than for a prosthesis. There are challenging ethical, legal and organizational issues. The committee decided not to reimburse hand transplantation for ethical reasons. The Health Technology Assessment has been shown to be a useful tool for decision-making in the context of Swiss accident insurance.