New cost containment measures in health care in Switzerland
As of January 1, 2024, new cost containment measures in the health care sector in Switzerland will go into effect. These decisions were made by the Federal Council at its meeting on October 25, 2023. The main goal of these measures is to curb the rising costs of mandatory health care insurance (AOMS). The Federal Council adopted two cost containment packages based on an expert report.
The first cost containment package, known as "Package 1a," came into effect on January 1, 2023. This package was divided into two parts, 1a and 1b, adopted in 2021 and 2022, respectively. The second package, "Package 1b," contains four measures aimed at limiting the increase in healthcare costs in a medically justifiable way.
Among the measures taken is the introduction of cost monitoring. Benefit providers and insurers are now required to provide for strategic cost management measures if costs increase excessively. This may include reducing rates or reimbursements. These measures can be incorporated into existing cantonal or national tariff agreements or provided for in their own agreements valid throughout Switzerland.
In addition, the right of pharmacists to dispense more advantageous medicines has been expanded, ensuring "equal medical eligibility" for the insured and extending this possibility to biosimilars. This allows for assessment of the patient's individual health status and consideration of possible intolerances.
Another important new development is the introduction of the right of appeal by federations of insurers in the area of cantonal hospital planning. This will allow them to appeal cantonal decisions on hospital lists to the Federal Administrative Court.
Finally, the Therapeutic Agents Law will be amended to simplify the parallel import of medicines by simplifying product characterization and information.
The financial repercussions of these measures cannot be precisely quantified, as they depend on actual implementation and will manifest themselves in the medium term.
As always, we invite our readers to take advantage of the services that CMO CASSA MALATI ONLINE offers, for further information and support regarding these important changes in the Swiss health care system. Our mission is to get the best coverage for each of our clients and to ensure the best management of medical care and health insurance.
