In 2020, medication costs in Switzerland totalled approximately CHF 7.7 billion. The front runners were immunosuppressants and cancer medication. The year was strongly affected by the global COVID-19 pandemic. Due to high levels of psychological stress and uncertainty, increasing quantities of psychoanaleptics and sleep remedies were purchased during the lockdown. As a relatively small market, Switzerland is often one of the first to suffer from supply shortages. Almost a third proved to be highly critical, as only one preparation is available on the Swiss market at a time.
The latest Helsana Drug Report shows that medication costs borne by basic insurance amounted to CHF 7.7 billion in 2020. Although slightly fewer medications were purchased compared with 2019 (-2.2%), the total costs continued to rise (+1.2%). As in the previous year, the immunosuppressant group generated the highest medication costs. In second place among the cost drivers were cancer drugs at CHF 898 million, a cost increase of +10.5% compared with the previous year. This increase in costs is due to several indication expansions. However, the increase in volume was not reflected in a significant price reduction.
Savings potential of almost CHF 100 million – through generic preparations of biological pharmaceuticals, or biosimilars – remained unrealised. The market sales of all biologics for which biosimilars were available totalled CHF 474 million in 2020. Biosimilars represented only 14.8% of this. Thus, considerable savings potential is yet to be realised. This becomes particularly clear in comparison with the biosimilar market in Germany, where, for example, the biosimilar share of infliximab was an impressive 70.4% in 2020, whereas in Switzerland biosimilars represented only 27.9% of infliximab purchases.
“Today, service providers earn more when they dispense a more expensive medication. This is why cheap generics and biosimilars are much less popular in Switzerland. Consequently, an enormous savings potential of several hundred million is going unused every year. Eliminating this false incentive requires price-independent margins. This would mean service providers would always be compensated to the same extent, whether they dispense original medication or a generic.” Roman Sonderegger, Helsana CEO
Last year was strongly affected by the global COVID-19 pandemic. Due to high levels of psychological stress and uncertainty, more psychoanaleptics and sleep remedies were purchased during the lockdown. Furthermore, purchases of vitamin D3 preparations increased sharply following reports that vitamin D provided protection against COVID-19. Although later studies contradicted this, reference figures remained at an almost constant level above previous years. Even during lockdown, cancer patients started on essential therapies such as cytostatic and immunotherapies, with only brief delays.
In Switzerland, the number of supply shortages has been steadily increasing for several years now. The cause of the problem is a worldwide decline in manufacturers and the resulting concentration of a few productions sites. As a small market, Switzerland is often one of the first to suffer from supply shortages. In 2019, a year not yet affected by the COVID-19 pandemic, there were already supply shortages for a total of 673 products with 371 active substances from the specialities list. Fortunately, the supply shortages were largely non-critical, as other pack sizes and dosage strengths were still available to compensate. However, almost a third proved to be highly critical, as only one preparation is available on the Swiss market at a time. Supply shortages lead to bottlenecks and problems that must be prevented. This calls for innovative solutions to improve and secure the supply situation.
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