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SWITZERLAND To control pharmaceutical costs, coverage decisions on all new medicines are subject to evaluation of their effectiveness (by Swissmedic) and cost (by the FOPH). Efforts are being made to reassess more frequently the prices of older drugs. Depending on national market volume, generics must be sold for 20 to 50 percent less than the original brand. In addition to the aforementioned 20 percent coinsurance for brand-name drugs, pharmacists are paid flat amounts for prescriptions, so they have no financial incentive to dispense more expensive drugs. What major innovations and reforms have been introduced? As discussed throughout this profile, the Health2020 agenda outlines important national topics, objectives, and measures for improving quality of life, promoting equal opportunity and self-responsibility, ensuring and enhancing quality of care, and creating more transparency, better governance, and more coordination. In concrete terms, the SFC realized the following nine priorities in 2014 (SFC, 2015): • Adoption of the message (i.e., official explaining text of SFC) concerning the federal law of cancer registries (implementation date of law: not before 2018; • Submission for public consultation of the preliminary draft of a federal law concerning a national health quality institute in SHI (new proposal made by the Swiss Federal Council, with open date for implementation); • Submission for public consultation of a partial revision of the federal law on SHI concerning better control of the outpatient sector, more control of health care cost, and better assurance of health care quality (implementation date of law: mid-2016); • Submission for public consultation of the preliminary draft of a federal law concerning non-ionizing radiation and sound waves (implementation date of law: open); • Submission for public consultation of the preliminary draft of a federal law concerning tobacco products (implementation date of law: open); • Adoption of regulation on the adjustments of tariff structures in SHI (regulation introduced: October 2014); • Adoption of the results of a public consultation on the federal law concerning health professionals (implementation date of law: open); • Adoption of the results of a report on the current state of and need for action to support caring relatives; • Recognition of the results of the new constitutional article concerning primary health care and plans to enact it (implementation date: open). The Swiss Health Observatory (Obsan) is currently creating an indicator system to evaluate the effects of all measures proposed by the Health2020 agenda. The author would like to acknowledge David Squires as a contributing author to earlier versions of this profile. 168 The Commonwealth Fund
References SWITZERLAND Enthoven, A.C. (1993). “The History and Principles of Managed Competition.” Health Affairs, 12, no.suppl 1 (1993):24–48. DOI: 10.1377/hlthaff.12.suppl_1.24. Künzi, K., and S. Strub. (2012). “Einkommen der Ärzteschaft in freier Praxis: Auswertung der Medisuisse-Daten 2009.” Schweizerische Ärztezeitung, 93: 38:1371–75. Hostettler, S., and E. Kraf. (2015). FMH-Ärztestatistik 2014: “Frauen- und Ausländeranteil nehmen kontinuierlich zu.” Schweizerische Ärztezeitung 96(13):462–69. Organisation for Economic Co-operation and Development (2015). OECD.Stat. DOI: 10.1787/data-00285-en. Accessed July 2, 2015. Organisation for Economic Co-operation and Development. OECD (2011). Reviews of Health Systems: Switzerland. Paris: OECD. Swiss Conference of Cantonal Health Ministers (2015a). Online publication: http://www.gdk-cds.ch/fileadmin/docs/public/ gdk/themen/krankenversicherung/praemienverbilligung/ipv_2015_df_def.pdf. Swiss Conference of Cantonal Health Ministers (2015b). Online publication. http://www.gdk-cds.ch/index.php?id=942. Swiss Federal Council. SFC (2015). “Gesundheit2020: zehn prioritäten für 2015.” Pressemitteilung vom 25.03.2015, Bern. Swiss Federal Department of Home Affairs FDHA (2013). The Federal Council’s Health-Policy Priorities. Online publication: http://www.bag.admin.ch/gesundheit2020/index.html?lang=en. Swiss Federal Office of Public Health (FOPH) (2014). Statistik der obligatorischen Krankenversicherung 2013. Bern: BAG, Sektion Datenmanagement und Statistik. Swiss Federal Office of Statistics (SFOS) (2014). Schweizerische Gesundheitsbefragung 2012–Standardtabellen 2012. Swiss Federal Office of Statistics (SFOS) (2015a). Statistik der Kosten und Finanzierung des Gesundheitswesens 2013. Swiss Federal Office of Statistics (SFOS) (2015b). Krankenhausstatistik 2013–Standardtabellen 2013. Swiss Federal Office of Statistics (SFOS) (2015c). Statistik der sozialmedizinischen Institutionen 2013–Standardtabellen 2013. Swiss Federal Office of Statistics (SFOS) (2015d). Statistik der Hilfe und Pflege zu Hause 2013–Spitex-Statistik 2013. Swiss Health Observatory (Obsan) (2015). National Health Report 2015. Hogrefe Verlag, Bern. Vilpert, S. (2012). Médecins de premier recours—Situation en Suisse et comparaison internationale. Obsan Dossier 22, Schweizerisches Gesundheitsobservatorium, Neuchâtel. International Profiles of Health Care Systems, 2015 169
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JANUARY 2016 2015 International Pro
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Table 1. Health Care System Financi
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Table 3. Selected Health System Per
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AUSTRALIA low-income adults, childr
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What is being done to reduce dispar
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References AUSTRALIA Australian Bur
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CANADA What is covered? Services: T
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CANADA funding to 145 not-for-profi
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CANADA Organization of the Health S
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CANADA provides recommendations to
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CANADA Health Council of Canada (20
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CHINA Private health insurance: Com
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CHINA is not substantially more exp
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CHINA Organization of the Health Sy
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CHINA References Chen, X. (2014).
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DENMARK In addition, nearly 1.5 mil
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DENMARK Social psychiatry and care
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DENMARK Quality data for a number o
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DENMARK portion is small, it makes
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ENGLAND immunization, and vaccinati
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ENGLAND Hospitals: Publicly owned h
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ENGLAND Organization of the Health
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ENGLAND How are costs contained? Ra
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ENGLAND Organisation for Economic C
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FRANCE VHI finances 13.8 percent of
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FRANCE The average income of primar
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FRANCE What are the key entities fo
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FRANCE inequities in prevention rel
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FRANCE Nolte, E., C. Knai, and M. M
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GERMANY There were 42 substitutive
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GERMANY The 16 state governments de
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GERMANY management system, by the s
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GERMANY What major innovations and
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INDIA Private health insurance: The
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INDIA provide after-hour care, reim
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INDIA are provided by other ministr
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INDIA How are costs contained? Ther
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ISRAEL Together, these two types of
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ISRAEL Primary care physicians are
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ISRAEL Organization of the Health S
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ISRAEL • Using electronic health
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ITALY during hospitalization (Thoms
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ITALY Some regions are promoting ca
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ITALY Organization of the Health Sy
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ITALY although the degree of evolut
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ITALY The author would like to ackn
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JAPAN What is covered? Services: Al
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JAPAN incentives for providers to c
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JAPAN Organization of the Health Sy
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JAPAN The author would like to ackn
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THE NETHERLANDS receive faster acce
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