The amendments to the ordinance for a new pricing system have been in force since 1 March 2017. Since then, the international reference pricing (IRP) and the therapeutic reference pricing (TRP) have been weighted equally not only for the initial inclusion in the Specialties List (SL), but also in the price reviews every three years and upon patent expiry. Interpharma in principle welcomes the greater weighting given to therapeutic benefits but in practice the TRP has so far proved unpredictable and not transparent enough. Interpharma is in dialogue with the Federal Office of Health (FOPH) as to how the TPR can be made more predictable by adding further elements.
A further problematic issue is that delays are increasingly occurring especially when it comes to reimbursement for innovative, effective therapies, which increases the pressure on Art. 71. Interpharma advocates for adjustments in the processes (see also innovative price models and efficient procedures).
Triennial price review leads major price reductions
The FOPH resumed its regular triennial price reviews in 2017. The review of around one-third of all reimbursable medicines in 2017 and 2018 has so far led to savings of about CHF 325 million. This is massively more than the CHF 180 million forecast by the FOPH earlier for the three price review rounds in the period 2017 - 2019. The second round saw another third of all reimbursable medicines submitted to a price review in 2018. The 2018 price reduction round has not yet been completed, so the savings will increase further.
Considerable additional savings as a result of strict FOPH practices
In addition to the massive savings from the regular price review round, the FOPH ordered further savings amounting to CHF 105 million (retail prices) on the basis of extraordinary price reviews in 2016 and 2017 alone. This is revealed in calculations by Interpharma.