Pharmaceutical Pricing and Reimbursement Policies in Switzerland
In Switzerland, pharmaceutical spending has not been growing faster than health expenditure as a whole, as has been the case in many other OECD countries. Swiss pharmaceutical spending per capita and as a share of GDP is modest by OECD standards. This in part reflects relatively low levels of pharmaceutical consumption, given that public prices are among the highest in Europe and the Swiss tend to be early adopters of new pharmaceutical products. Although Switzerland is a small market, new medicines are generally available on the market promptly. Manufacturers choose Switzerland as a country for first or early world launch in part because of the leeway they are granted in establishing an initial market entry price when comparators are lacking. Switzerland’s regulation of prices for reimbursed drugs bases on referencing across countries and within the therapeutic class for products with comparators. Generic penetration of the market is increasing but falls short of what has been achieved elsewhere and the prices of generic products are higher than what is found in other countries. Relatively high mark-ups over ex-factory prices suggest that the distribution chain is a source of further potential efficiencies, although high costs (e.g. labour costs) could also reflect characteristics of the Swiss economy. Although the Swiss health system is characterised by a high share of out-of-pocket spending, the contrary is true in pharmaceuticals, as Switzerland ranks among OECD countries with the highest share of public financing. While there are limits on patients’ annual cost-sharing expenditures, low-income persons are not exempted, raising the potential for problems with accessibility and affordability, although although no evidence of this has been found.
