Introduction to the cost containment packages

In August 2019, the Federal Council approved a first cost-containment programme for the attention of parliament. It requires all role players in the healthcare sector to ensure that costs only increase to the extent that can be medically justified. The discussion of this first package of measures was split into two sub-packages (sub-packages 1a and 1b). While our industry has primarily followed the debate on the experimentation article in package 1a, package 1b contains three proposals: measures to manage costs by the tariff partners, a reference price system for medicinal products and a right for health insurance companies to appeal cantonal hospital planning.

Cost containment package 1

Discussion of sub-package 1a was concluded by the chambers during the 2021 summer session. Industry noted with relief that - in contrast to the Federal Council - both chambers did not want to introduce any compulsory obligation in the context of the experimentation article. The new experimentation article has not yet been put into effect by the Federal Council. When it is applied, it will be important to ensure that it does not water down the principle of territoriality.

Following lengthy deliberations, the Swiss parliament adopted CCP 1b in the autumn session of 2022. This now provides for cost monitoring in the healthcare sector. However, the Confederation and the cantons should not be allowed to intervene if the collective bargaining partners are unable to reach an agreement. Fortunately, parliament already abolished the reference price system for generics in the first round of consultations, but the approval of parallel-imported drugs is now being simplified.

scienceindustries is relieved about the fact that the original decision of the National Council to bypass Swissmedic for imports of medicinal products  has been dropped, as this would have caused serious uncertainties regarding the supply of medicinal products in Switzerland. In addition, the two parliamentary chambers have agreed on a right of appeal for health insurance associations against hospital planning decisions in the cantons. The regulation on the right of substitution for pharmacists has also been amended.

Cost containment package 2
In August 2020, the consultation on a second package of measures to contain costs in the healthcare system (CCP 2) was opened. scienceindustries submitted its comments on 19 November 2020. On 7 September 2022, the Federal Council adopted the dispatch on CCP 2 (22.062) for consideration by Parliament. It proposes networks to promote coordinated healthcare and improve the quality of healthcare. The Federal Council also wants to ensure rapid and cost-effective access to innovative medicinal products and at the same time reorganise the review of the criteria for the obligation to provide benefits under basic insurance - efficacy, expediency and economic efficiency (EEE criteria).

In the autumn session of 2023, the National Council adopted CCP 2 largely in line with the majority of its pre-advisory committee (SGK-N) with regard to the key issues for the supply of medicinal products, which scienceindustries welcomed. However, it is not only the decision of the Council of States of 13 June 2024 in the summer session that gives cause for concern, but also the latest decisions of the SGK-N in the context of the resolution of differences. scienceindustries is surprised by the change of direction of the SGK-N and calls on the National Council to adhere to its original decisions and not follow the Council of States or its committee.

Health initiatives
Parallel to the discussion on the cost-containment packages, the introduction of targets in the healthcare system in the form of counter-proposals to the centrist Cost Brake Initiative and the Premium Relief Initiative of the Social Democratic Party (SP) were submitted for parliamentary deliberation. scienceindustries opposed both initiatives and was relieved to note the referendum decision of 9 June 2024. Neither initiative would have brought any viable solutions and would only have led to further problems.