Switzerland represents a healthcare system where health spending accounted for 11.8% of its GDP in 2020. This percentage surpasses the OECD average of 9.7% in 2022, reflecting Switzerland’s strong commitment to healthcare investment. This makes it an attractive focus for pharma, biotech and medtech firms looking for Market Access. Our agency Justin Stindt Consultants is specialized in Market Access in Switzerland and can help you navigate the Swiss Market Access.
DEVELOPING PRICING & REIMBURSEMENT STRATEGIES FOR MEDICINES, MEDICAL DEVICES AND E-HEALTH
To successfully provide sustainable access to a new medicine or medical device, it is essential to have a robust pricing & reimbursement strategy that maximizes profits and/or access. An understanding of the Pricing & Reimbursement opportunities, willingness to pay, international reference pricing implications, and value drivers for payers, key opinion leaders, and other decision-makers is crucial to inform the pricing strategy and launch sequence.
Decision-makers’ needs and expectations vary across markets, and tailored approaches by a proficient consulting agency are needed to provide solutions meeting their needs. At Justin Stindt Consultants, a renowned consulting firm, we have experience designing hundreds of successful pricing & reimbursement strategies for medicines and medical devices in different therapeutic areas, and we strongly believe our team of experts can also help you achieve the best possible results for your market access.
Market Access Switzerland – Essentials to access an attractive EU market for pharma, biotech and medtech
Switzerland is ranked among the top three countries within the OECD in terms of health spending as a percentage of GDP in 2020, making it an interesting market for pharma, biotech and medtech firms to explore and consider for their market access activities.
Switzerland offers various pathways for market access and reimbursement. The Swiss Agency for Therapeutic Products (Swissmedic) is responsible for evaluating and approving medicines for the Swiss market, ensuring safety, efficacy, and quality standards. Swissmedic collaborates with other regulatory agencies for example via the project Orbis which many companies engage in to leverage e.g. the FDA approval for regulatory approval in Switzerland.
The Swiss compulsory health insurance (OKP) warrants that everyone living in Switzerland has access to good medical care.
Federal HTA Program in 2015: Meeting Reimbursement Criteria under the Federal Health Insurance Act
The federal government launched in 2015 an HTA program based on Article 32 of the Federal Health Insurance Act (KVG). In order to be reimbursed by compulsory health insurance (OKP), medical services must meet the criteria of effectiveness, appropriateness, and economic efficiency / cost-effectiveness (WZW criteria). For the economic criterion both International Reference Pricing and therapeutic comparison with products targeting the same disease is taken into account. For more information visit our P&R strategy page.
Switzerland’s HTA Process and Reimbursement Lists: Navigating the Federal Office of Public Health’s Framework
The Federal Office of Public Health (FOPH) compiles both the list of pharmaceutical specialties and packaged medicinal products with prices (Spezialitätenliste, SL), the list of products for congenital anomalies (GG-SL), as well as the list of preparations, active and excipient substances used in compounding, with fees (ALT). The Birth Defect Medication List (GGML) contains the prices or fees that are reimbursed at most by mandatory health insurance (OKP) / disability insurance (IV). These lists indicate the maximum prices and tariffs for payment under OKP or IV.
The HTA process follows the next steps:
- Topic finding
- Pre-scoping
- HTA protocol
- Assessment and creation of HTA report + commentary procedure
- Appraisal by an extra-parliamentary commission, the Federal Medicines Commission (Eidgenössische Arzneimittelkommission, EAK)
- Decision by the Swiss Federal Office of Public Health (FOPH/BAG)
Re-examination of the specialty list is conducted every 3 years. For medicinal products that no longer meet the WZW criteria, the price is adjusted, their use restricted, or they are removed from the SL by the BAG.
In special situations, mandatory health insurance may reimburse the cost of a drug on an individual basis even if it is not included in the SL. Conditions are laid out in articles 71 a-d, please contact our agency if you would like further details.
Understanding Switzerland’s DRG System: Hospital-Only Drug Coverage and Market Access Opportunities
Hospital-only drugs must be covered within the framework of the Diagnosis-Related Group (DRG) system, which emphasizes price sensitivity in a hospital setting. Switzerland’s structured reimbursement system and commitment to quality care provide an environment conducive to market access and collaboration for pharmaceutical companies.
Justin Stindt Consultants is your agency to support you with Market Access in Switzerland
Justin Stindt Consultants is your consulting firm with experts who have extensive experience in Market Access in Switzerland.
As a service provider, our consultancy has helped many clients by developing pricing and reimbursement strategies and HTA dossiers. Our consultants also support price negotiations. For medical devices and digital health apps, our agency supports dossiers and negotiations.
Many of our consulting firm’s clients decided to enlist our agency as service provider of choice given our footprint and experience in the Swiss market.
Contact our experts today to learn how our agency can tailor our services to meet your unique needs to enable Market Access in Switzerland.
Market access services for pharmaceutical and biotech products in Switzerland
Case studies for Switzerland market
- Support entire Switzerland Market Access process
- ATU Feasibility Assessment
- HAS early dialogue meeting
