There are some strange things in this world, but this is very unusual. In a sensitive area such as health care, health insurers develop cost-effectiveness criteria that have never met scientific standards, without official supervision, in private, so to speak. Despite this, hundreds of medical practices are prosecuted every year for inefficiency. This is a huge scandal involving the reports, the FMH, the health insurers and the joint commissions. The analysis of the problem can be found here in 76 slides.
Medizin, Ethik und Mathematik