HTA Hand Transplantation
At a glance
- Project leader : Prof. Dr. Urs Brügger
- Project team : Prof. Dr. Klaus Eichler, Rafael Plessow, Prof. Dr. Simon Wieser
- Project budget : CHF 90'000
- Project status : completed
- Funding partner : Third party
- Project partner : Medizinaltarife-Kommission
- Contact person : Klaus Eichler
Description
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.