New measures against rising health care costs take effect

New measures against rising health care costs take effect

الخميس, أكتوبر 26th 2023

New measures to curb the rise in healthcare costs will apply from 2024. Among them are cost monitoring for doctors and hospitals as well as health insurers and a right of appeal for health insurance associations in cantonal hospital planning.

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However, it is not possible to quantify what the measures will achieve.

On Wednesday, the Federal Council put measures passed by parliament in the fall of 2022 into effect as of Jan. 1, 2024. Among other things, service providers and insurers must now monitor costs and, if necessary, take countermeasures, for example by means of tariff reductions or reimbursements.

Having a say in hospital planning

However, the federal government and the cantons should not be able to intervene if the tariff partners cannot reach an agreement. This was the decision of parliament when it passed the bill.

In addition, health insurance organizations will now have a say in cantonal hospital planning. They can appeal against cantonal decisions to the Federal Administrative Court. However, this only applies to national and regional associations that have the protection of their members’ interests in their statutes.

The requirements for pharmacists to dispense a more favorable drug if several drugs with the same active ingredient composition are available for a treatment have also been clarified. In this case, patients only have to pay a ten percent deductible.

Dispensing cheaper drugs

It is now stipulated that a less expensive drug such as generics and biosimilars may be dispensed if it is “equally medically suitable” for the patient. This is to allow individual assessments, as the Federal Council writes.

If the more expensive original preparation is demonstrably necessary for medical reasons, it can be dispensed without an increased deductible. In addition, the labeling and drug information of parallel-imported drugs will be simplified.

According to the Federal Council, it is not possible to put a precise figure on the bottom line of the measures. On the one hand, the savings would depend on the concrete implementation of the players, and on the other hand, the measures could only curb costs in the medium term.

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