SWISSspine: An outcome and quality registry of orthopaedic implants as a condition for reimbursement by basic health insurance

Abstract

Abstract In the Swiss healthcare system, procedures yet to completely fulfil the criteria for basic health insurance reimbursement can be covered if they are considered promising and if healthcare providers participate in evaluation activities. Such has been the case with spinal disc arthroplasty, where, for evaluation purposes, the federal bodies linked reimbursement to the documentation of cases in a nationwide spine registry. Stakeholders from industry, medicine and science formed a working group and implemented SWISSspine, the first orthopaedic outcome registry for post-market surveillance of medical implants in which cases must be documented in order to receive basic health insurance reimbursement. Within the prescribed three-year timeframe, primary and follow-up data from over 550 cervical and 400 lumbar disc replacements were available for evaluation. Based on the treatment outcomes, the federal bodies granted continued reimbursement subject to a further year of mandatory documentation of the interventions. SWISSspine provides a model of successful cooperation between industry and the medical profession, and an example of a national outcome registry which generated sufficient evidence to complete a health technology assessment report and achieve the continued reimbursement of the surveyed products.