Swizzard Insight No. 2: The Swiss Federal Office of Public Health (FOPH)

The Swiss Federal Office of Public Health (FOPH) is responsible for national health policy and – together with the cantons – for promoting the health of the Swiss population. In addition, as a national authority, the FOPH represents Switzerland in health policy matters in international organizations and vis-à-vis other countries. This Swizzard Insight No. 2 offers a high-level summary of the Swiss FOPH’s organization, mission and duties as well as how drugs typically get included on the List of Pharmaceutical Specialties (source: www.bag.admin.ch).

Organization

Directed by Anne Lévy since October 2020, the FOPH is attached to the Federal Department of Home Affairs. In accordance with its tasks, the FOPH is divided into various departments such as Public Health, Health and Accident Insurance, and Law.

Mission

The main goals of the FOPH are to enable the people of Switzerland to deal competently and responsibly with their health. The office aims to maintain a healthcare system that provides high quality care and is affordable and accessible to all.

Duties

The main duties of the FOPH are providing competence in healthcare, promoting a healthy lifestyle, working for the general wellbeing of the public and being responsible for ensuring that the Swiss healthcare system remains efficient and affordable. The range of tasks is correspondingly broad and includes the ongoing development of the social health and accident insurance systems and the military insurance scheme. Additionally, the FOPH is responsible for more than twenty laws and numerous ordinances that are based on the standards of the Federal Constitution.

Reimbursement

The FOPH also draws up a positive list of special therapeutic agents (“Spezialitätenliste”, SL). The SL sets out the maximum prices for payment under mandatory basic health insurance and the reimbursement process is regulated by Art. 65 Health Insurance Ordinance (KVV). Successful listing depends on an agent having received a positive pre-decision by Swissmedic and the therapy being considered effective, appropriate and economically viable. Moreover, the FOPH may restrict SL listing to a certain patient population, pre-defined time period or impose sanctions in case certain sales thresholds are exceeded. The price-setting process is imposed by the FOPH according to a fixed formula which includes the average of a) the reference price of the drug from nine European reference countries (“Auslandspreisvergleich”, APV) and b) a basket of drugs within the same therapeutic area in Switzerland (“therapeutischer Quervergleich”, TQV). If a drug is considered innovative, a price premium of up to 20% may be granted.

For further insights, please contact us

Swizzard Pharma AG

Corporate Competence Center

Yves Heller

yves@swizzard-pharma.com