Evidence Review

We are working to find economically viable prices for new medicines in Switzerland through health economics and cost-effectiveness methods.

Factsheet

Lead school School of Health Professions
Institute(s) Institute of Health Economics and Health Policy
Funding organisation Others
Duration (planned) 01.01.2021 - 31.12.2024
Project management Niklaus Meier
Head of project Niklaus Meier
Project staff Prof. Dr. Katharina Blankart
Niklaus Meier
Partner CSS Versicherung
Helsana
Sanitas
SWICA Krankenversicherung AG

Situation

Switzerland faces significant challenges in the reimbursement of new medicines. The combination of rapid technological development in pharmaceuticals, lower approval barriers, and rising prices necessitates new approaches in the price negotiation of these medicines. These approaches must be capable of supporting the negotiation of economically viable prices for new medicines in a fair, consistent, and comprehensible manner based on the available evidence.

Course of action

We have developed, in collaboration with four health insurers (Helsana, Sanitas, CSS, SWICA), a value framework, the Swiss Drug Pricing Model (SDPM), for determining the prices of new medicines in Switzerland. We analyzed the methods of existing evaluation schemes based on a systematic literature review and adapted these methods for the SDPM to meet the needs of the Swiss healthcare system. We use the SDPM to determine justified prices of medicines based on their added value

Result

We have released a research report. In this report, we explain how the SDPM works, and illustrate this with an example. We have also summarised this report in a policy brief.

Looking ahead

Services in the Swiss health care system must be effective, efficient, and cost-effective. The SDPM can contribute to the cost-effectiveness of treatments and to the equal access of patients to care in Switzerland. We invite actors in the Swiss health care system to hold an informed discussion about the SDPM.