Health costs, new drugs in question

In the problem of increasing healthcare costs, the marketing of new drugs would have become one of the first bruise factors, even if strong growth is also notable in other fields. In addition, If the development of advanced treatments is of course precious for health. Consequently, the efficiency of the latter is not always proven and their price explodes. Meanwhile, In this context. However, for Philomena Colatrella, CEO of the CSS, it is imperative to be able to modernize the system for the marketing of drugs.

Among the most decisive factors in terms of rising health costs, you point to new drugs. Moreover, Explain that. – Health costs, new drugs question

Philomena Colatrella: It should indeed be known that new drugs contribute for a third party health costs in compulsory. Consequently, care insurance (AOS). Nevertheless, This is a phenomenon that the CSS Institute analyzed in a 2024 study. health costs, new drugs question Therefore, which has been confirmed for ten years already. Meanwhile, The new drugs, reimbursed by AOS between 2013 and 2022, thus led to an additional cost of nearly 200 francs per insured. Furthermore, At the same time. Furthermore, it should also be noted that spending on drugs already authorized on the market have dropped by around 60 francs, in particular thanks to the boom in generics. Moreover, Contrary to what we often think. Consequently, the aging of the population is therefore not in question in the problem of increasing health costs. Moreover, This factor actually only generates a seventh of the cost increase. In addition, I would also like to emphasize that the CSS is committed to access to innovative drugs. Nevertheless, These make it possible to treat up-to-incurable diseases and to considerably improve our quality of life. However, it is important that their price remains affordable so that basic health costs, new drugs question insurance can continue to finance long -term innovation.

New drugs contribute for a third party health costs in compulsory care insurance (AOS)

What should be changed. Consequently, to limit the increase in expenses due to medication?

It is necessary to act on the evaluation of the efficiency and the fixing of the price of the drugs. In other words, efficiency must be solidly proven and prices must remain reasonable. This is not easy. because if medical innovation is essential for our health, the race for innovation, which has intensified for fifteen years, makes the evaluation more complex. Consequently. long-term clinical studies are not always available, nor those that allow the added value of a novelty compared to pre-existing similar formulas. Personalized and very targeted therapies, which multiply, are struggling to provide large -scale clinical studies showing their effectiveness. As for the price. the OFSP is falling on a lack health costs, new drugs question of transparency of research and production costs, but also on comparisons with distorted foreigners since based on vitrin prices often different from the actually paid price. Not to mention certain principles. such as the one who would like for example that a country with a strong purchasing power, like Switzerland, must pay more. In short, the drug assessment criteria are no longer suitable and it is urgent to see them again.

With this in mind, what is the concept of determining the dynamic price?

It is the idea of reviving the price of medicines that generate a significant volume of expenditure. If it is just that the manufacturer can cover its costs. make profits to continue investing in research, it is also fair to limit costs for captive insured persons who must, whatever happens, finance these costs by their premiums and heal when they are sick. Concretely. this budgetary impact health costs, new drugs question model would allow the OFSP to lower the price when a drug achieves more than 20 to 25 million francs in annual turnover. This concerns around fifty products. The economy potential is 300 to 400 million francs. Of course, you must also ensure that you guarantee the right supply of the Swiss market. The CSS also argued this measure recently adopted by Parliament.

Is there still an economy potential thanks to generics?

There is still progress to be made. The generic prices are still too high. They are on average 45% cheaper abroad and some antibiotics are even half cheaper in France. Their use can also be extended more. Several measures taken into force last year, however, go in the right direction. The remuneration of pharmacists has been standardized: whether it is an original preparation. a credits, their share is now the same. The revision of pricing, there too according health costs, new drugs question to turnover, makes it possible to make generics even more advantageous. Their attractiveness is also reinforced by a 40% quota noted for original preparations. except when the use of the original is medically necessary. About 500 million francs are saved each year, and the additional potential is estimated at nearly 200 million.

How can the updating the list of drugs reimbursed by AOS play a role?

All reimbursed services must meet the criteria for efficiency. adequacy and economy (EAE), which is also specified in the Health Insurance Act (LAMAL). Medicines reimbursed according to the LAMAL must therefore also meet these criteria. It is also necessary to be able to accelerate the updating of LAMAL services according to the EAE criteria. with the OFSP to intervene when a drug does not respect them.

The cost of certain drugs such as Wegovy, a new obesity medication, obliges to review the principle of health costs, new drugs question Lamal solidarity?

Wegovy’s prescriptions have increased following the reimbursement of this medication by Lamal for a year. Our projections for 2025 also indicate additional costs of approximately 45 million francs. Wegovy is part of a new category of drugs which. associated with a hypocaloric diet and more physical activity, allow overweight people to lose 10 to 15% of their weight. You should know that. in medical terms, obesity is characterized as a disease of the adipose tissue which extends too much and impacts other organs. This treatment makes it possible to reduce the side effects provided you are taken over a long period. In Switzerland, up to 1.5 million people are affected, which could cost up to 3.5 billion francs at Lamal. This of course asks many questions about the health system. How to prevent this disease and encourage patients to change their lifestyle to optimize treatment? What are the health costs, new drugs question alternatives to overweight drugs to lose weight? So many essential questions that must be discussed. because Switzerland, in comparison with France or with Germany, is very generous in this care.