Medication tops list of cost factors for the first time

Helsana has been analysing the pharmaceutical market in Switzerland for eleven years. Despite the regular price reviews conducted by the Swiss Federal Office of Public Health (FOPH), the cost of medication under basic insurance increased considerably in 2023, passing the CHF 9 billion mark, which represents an increase of 5.9% on the previous year. This means pharmaceutical expenses now make up the biggest cost block in basic insurance. The price level continues to rise as new high-priced medications enter the market, and the use of generic medications and biosimilars remains rare.

Considerable unused savings potential

Once a drug’s patent protection has expired, other manufacturers are free to launch generic medications and biosimilars, which are just as effective and safe as the original medications. Yet there is still a lot of room for improvement in this area: products with no copycat versions continue to account for two thirds of outpatient medication costs, while the price of original medications has doubled in recent years to around CHF 1,500, and the cost of new active ingredients was almost CHF 6,000 in 2023. In order to reduce the share of original products, there needs to be more of an incentive to launch copycat products in Switzerland. It will then be possible to exploit previously unused savings potential to keep costs down in future.

Targeted cancer therapies

Another chapter examines the developments in targeted treatments and immunotherapies for lung cancer. Their introduction has seen changes made to numerous treatment regimens and led to a sharp rise in costs – from CHF 63 million in 2013 to CHF 146 million in 2023, an increase of 169%. This rise in costs is largely due to the increased use and approval of immunotherapies, which harness the power of the body’s own immune system to target cancer cells. These therapies are increasingly being used as first-line treatments, resulting in higher treatment costs and total costs. Volume discounts for medication are needed to ensure financing remains available for innovations like these. 

Safety warnings for new rheumatism medications

The report also shines a light on Janus kinase (JAK) inhibitors, a highly effective but expensive class of medication for chronic inflammatory and autoimmune disorders. In the field of rheumatology, JAK inhibitors cost around CHF 16,000 a year per patient, which is roughly 60% higher than for other patients. Safety concerns have a negative impact on the cost-to-benefit ratio of JAK inhibitors, especially in the case of elderly people with cardiovascular risk factors. At the same time, the costs associated with monitoring patients and treating any side effects limit how cost-effective the medication actually is. This is why a price reduction for JAK inhibitors and a thorough risk assessment before starting therapy are essential to enable medical professionals to make safe, effective decisions regarding treatment.

Read more at: www.helsana.ch/drugreport2024