The most recent measures implemented for the pharmaceutical
sector by the Swiss Federal Council and the Federal Department of
Home Affairs effective from 1 May 2012 mean further losses for the
pharmaceutical companies in Switzerland. Given global advances in
sales and the growth rates for the life sciences sector, at first
glance this hardly seems significant, but if we look at the
importance of local pharmaceutical, biotech and medtech companies
for the Swiss economy, these latest efforts to relieve the burden
on the mandatory social health insurance scheme should be seen in a
Additionally to the comparison of its price in other countries
the price-setting process of a pharmaceutical, when initially
admitted on the reimbursement list (SL), will
continue to include a comparison with state-of-the-art
pharmaceutical treatment. This Swiss specific therapeutic value
assessment will not be carried out anymore in the subsequent
three-yearly re-assessments (see new Art. 65d par. 1bis Health
With this decision, Switzerland is delegating the structuring of
its pharmaceutical prices even more strongly to foreign countries
than today. This increasing "implantation" of decisions
from other jurisdictions is weakening Switzerland's autonomy,
specifically in an area that falls outside the sphere of current
discussions on the (autonomous) implementation of European
provisions, as in this instance Switzerland is not adopting EU law
but is following decisions by individual states.
The future practice of the Federal Office of Public Health (BAG)
will show whether prices will still be determined with great care
and autonomy, when drugs are first admitted to the reimbursment
list, or whether even at this stage, the procedure will be
restricted to "copying" prices that already apply in
The latter would mean that Switzerland factually will not have a
legal or economic vote on the market prices of one of its most
important export products, not only during their life cycle, but
already upon their introduction to the market.
If not even Switzerland succeeds to determine pharmaceutical
prices according to an intellectually sound "equation"
that rigorously aims to reflect the complexity of this issue, the
life sciences industry runs the risk of finding ever less
recognition and financial support for its growing R&D
investments, both nationally and internationally.
The new policy will only have a small impact on individual
pharmaceutical companies what their scope for action is concerned:
In most cases it will be impossible to justify a higher price for a
pharmaceutical than in the reference countries at the three-yearly
review. There are cases, however, where a higher Swiss price could
or even ought to (e.g.) stimulate research, introduce market
fairness or boost a specifically effective therapeutic use. Every
once in a while it may therefore be necessary to check whether
narrow interpretation and general application of this new Art. 65d
par. 1bis of the Health Insurance Ordinance might not be
inappropriate or designed to promote unequal treatment of two
It is of utmost importance to individual companies whether an
appeal against a three-yearly price alteration decree will have
suspensive effect. The complexity of an individual case might
justify it, although (older) decisions by the Supreme Court in
similar matters suggest otherwise.
1 As a collection of individual decisions, the
Federal Office of Public Health's list of pharmaceutical
specialties determines which drugs must be reimbursed at what price
and under what conditions to insured persons with basic health
insurance cover, i.e. all Swiss residents.
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There have been specific rules governing the promotion of medicinal products in Turkey since the beginning of the 90’s.
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