Record-breaking medication costs

In 2024, almost 7 million people – around three quarters of the Swiss population – obtained at least one medication through basic insurance. The number of recipients increased by 2.3% and the number of packs dispensed by a full 2.9%. Every person obtaining medication from OKP now receives an average of 20 packs per year. At the same time, new medications are becoming increasingly expensive: the prices of newly approved medications have almost doubled in the last ten years. This also applies to products that do not involve any innovation. Overall, a few medications are particularly costly: the three most expensive medications alone generated combined costs of more than CHF 465 million in 2024. Rapid and consistent implementation of the cost-follow-up model adopted by Parliament is essential.

Hidden prices are driving up costs

A major driver of rising costs is the increasing lack of transparency in the pricing process. Price negotiations between the Federal Office of Public Health (FOPH) and pharmaceutical manufacturers are often based on artificially inflated shop window prices that do not reflect the amounts actually paid. Such prices should no longer be used for pricing in Switzerland. In addition, medication prices are only reviewed every three years, delaying price reductions and perpetuating the high price level. An annual review would help to lower costs.

Reforms to promote generic medications and biosimilars are having an impact – but not enough

In 2024, the FOPH aimed to promote the sale of low-cost generic products by means of several legislative changes. These include increasing the differentiated excess, new price discounts for generic medications and biosimilars and a uniform sales share. These measures are having an impact: the generics rate rose to 70.2% in the first quarter of 2024 and rate for biosimilars rose to 32.5%. Nevertheless, a great deal of potential remains untapped – at around CHF 76 million, the savings target of CHF 250 million was clearly missed. In order to further reduce costs, consistent implementation of the reforms and additional incentives are needed, such as maintaining the differentiated excess above the upper limit.

Gender medicine: differences in care, but no structural under-provision

The report also examines gender-specific aspects of medication provision. Analyses show that men and women are treated slightly differently before and after a heart attack, but this does not indicate a structural under-provision for one gender. In the case of antidepressants, the prescription rate is significantly higher for women than for men, but the dosage hardly differs – even though there is scientific evidence that women and men absorb and process antidepressants differently. Further research is needed on this topic to enable gender-specific treatments in future.