In a recent meeting, the Federal Council approved the revision of several acts covering access to medicines. These revisions will allow faster access to essential medicines and improve equal treatment of patients. The sale of generics and biosimilars is also promoted. The savings potential of these measures is estimated at around 250 million francs annually. The revised regulations come into force on January 1, 2024.
The changes will cover:
- Measures for individual case reimbursement: Currently individual case reimbursement is affected by the insurer leading to unequal assessment and complicated pricing negotiations. From next year there will be uniform rules for these types of assessment as insurers will have to use the same benefit assessment tool. The benefit category will then be used to set pricing and discounts.
- The promotion of generics and biosimilars: There will be increased saving benefits for the use of most generics and biosimilars to promote their use as well as requiring a proven need to use the more expensive preparation. Additionally, the out-of-pocket costs will be increased from 10-20% if the higher cost option is chosen.
- Process optimisation to speed up access: Manufacturers will be given the opportunity to have a preliminary investigation or early dialogue for treatments of rare diseases and complex applications. Enabling an initial assessment before submitting the main application, aiming to avoid long discussions and speed up inclusion in the speciality list. Early access will also be introduced allowing market approval and remuneration by inclusion onto the speciality list concurrently (reducing access time by ~3 months).
Sources:
- Der Bundesrat fördert Generika und Zugang zu lebenswichtigen Arzneimitteln. Federal Office of Public Health. https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/medienmitteilungen.msg-id-97800.html. 29th September 2023