Drug Report

The latest Helsana Drug Report shows that the medication costs borne by basic insurance exceeded CHF 8 billion for the first time in 2021. This development is down to isolated new medicinal therapies for treating various cancers and tumours – at very high price points. The prices of these medications are increasingly being kept confidential. 

The key findings are as follows:

• Since 2020, Switzerland has seen growing numbers of “pricing models” being used for setting medication prices. In many cases, this is because a manufacturer does not accept the prices determined using the conventional method, leading to delays in approval.
• Many of these pricing models include confidential agreements between the FOPH and pharmaceutical companies. The “actual” price is kept secret from the public.
• Pricing models are chiefly used for high-cost medications and accounted for 15% of the whole medication market in 2021. The approach is particularly prevalent for cancer and immunotherapy drugs.
• The proportion of new medications subject to pricing models is increasing year on year. Overall, 39% of the preparations added to the list between 2015 and 2021 were governed by a pricing model.
• Pricing models can help facilitate access to innovative treatments thanks to the additional flexibility they offer. However, they do not contribute to curbing the costs.

In addition, the report looks at three further topics: Are women being properly served in terms of medication with regard to possible pregnancy? What do the general public think about the issue of polypharmacy? And not least: new migraine prophylaxis is being put to the test.