Medicines for which the patent has expired should not be subject to a reference price. The National refused Thursday, by 114 votes to 65, this flagship measure of the Federal Council’s plan to curb the rise in health costs.
These drugs are on average twice as expensive in Switzerland than in European countries. “Some differences are unjustifiable”, underlined the Minister of Health Alain Berset. The Federal Council would have liked to introduce a reference price system applicable to drugs for which the patent has expired.
At least three medicines containing the same active substance should coexist on the market. The price would have been fixed according to the price abroad and the volume of the market of the original preparation. Compulsory insurance would only have reimbursed this price. If a more expensive drug is dispensed, the insured should have paid the difference. This system should have made it possible to save 300 to 500 million francs per year.
The benchmark system, by putting pressure on prices, is the only way to achieve a reduction in prices, stressed Benjamin Roduit (PDC / VS). Without this, the price of generics will not be reduced, said Mattea Meyer (PS / ZH).
Despite their interventions, the deputies did not want it. The savings potential is controversial, argued Thomas de Courten (UDC / BL).
The People’s House also rejected by 114 votes to 65 a middle ground defended by Lorenz Hess (PBD / BE). The reference price would have been set on the basis of the price of the original preparation in Switzerland after the expiry of the patent, taking into account an appropriate price differential. But biosimilars would have been excluded from the system. This would have allowed a stronger transfer to generics, Berset said. In vain.
The deputies preferred to bring down health costs quickly through various measures. They tacitly adopted a motion to increase the relative share of generics. These drugs represent less than 20% of the Swiss market, compared to 80% in Germany, stressed Meyer.
The National also wants to eliminate the negative incentives that push pharmacists to sell the most expensive drug and therefore encourage the delivery of more advantageous drugs.
They will be allowed to give the most advantageous drug when several products have the same composition, provided that it is adequate. The left would have liked to force them to do so. In the event of a derogation, an explanation would have been required. The patient who requests a more expensive product should have paid the difference. This would facilitate the penetration of generics, argued Léonore Porchet (Verts / VD).
The services of pharmacists must also contribute to lowering costs. A clear recognition of their care benefits by compulsory insurance could represent real savings potential. The National supported almost unanimously a committee motion to this effect.
Parallel importation of these drugs will be allowed. Generics will not be subject to marketing authorization. This is already possible, Thomas de Courten said in vain.
The service providers must be able to agree at any time to discounts in relation to the prices fixed in the tariff agreements or by the authorities. Three quarters of the savings thus targeted must benefit the insured in the form of premium reduction in particular. The remaining quarter would be freely available to the insurance.
By 91 votes to 90 and 4 abstentions, MEPs refused to provide for cost management measures in this section. The right believed that this provision should be addressed in the second package of measures. “It is difficult to be against the fact that the partners get along”, retorted Alain Berset.
The National has also refused the principle of recourse against hospital planning in the cantons that the Federal Council wants to grant to insurers.
The government put a second package of measures for consultation in August. It constitutes an indirect counter-project to the initiative of the PDC “For lower premiums”, which requires the Confederation and the cantons to take restrictive incentive measures when the cost of care increases too sharply in relation to the evolution of wages. .
The file goes to the Council of States.