SWITZERLAND Trends and Developments Contributed by: Tobias Meili and André S. Berne, Wenger Plattner
(ATMPs) and their importance in medical practice, ATMPs are also to be regulated more specifically in the TPA. In the EU, ATMPs are regulated in a separate regulation (Regulation (EC) No 2007/1394) and include gene therapy medicinal products, somatic cell therapy medicinal products, bioengineered tissue products, and combinations of ATMPs and medical devices. Not being a member state of the EU, Switzerland nonethe- less seeks to mirror EU law as far as possible in the TPA to guarantee that Swiss patients have access to novel, high-quality treatments and products. The EU and Swiss markets should become more competitive and compatible as a result, and an equivalent level of safety should be established. The last area of revision is also due to developments in the EU aimed at avoiding trade barriers, prevent- ing the emergence of antibiotic resistance and guar- anteeing market access to cutting-edge veterinary medicine therapies. The EU has revised and modern- ised its regulation in the area of veterinary medicinal products (Regulation (EU) No 2019/6), which entered into force on 28 January 2022. Thus, amendments to Swiss law are required to preserve the safety of the country’s veterinary medicine supply as well as the ability to export animals and animal products to the EU. Amendments include modifications concerning antimicrobial active substances and – in this context – resistance-reducing measures, as well as modifying the duration of the authorisation for veterinary medici- nal products. In addition, market access to novel and innovative therapies in veterinary medicine is to be guaranteed. Uniform Financing of Inpatient and Outpatient Medical Services Another significant legislative recent revision is the uniform financing of inpatient and outpatient medi- cal services regulated by the Federal Health Insur- ance Act (HIA) that was approved by referendum on 24 November 2024. Thus, starting in 2028, outpatient and inpatient acute services will be uniformly financed, with care services to follow four years thereafter. To date, 55% of inpatient expenses have been jointly financed by the Cantons (ie, the taxpayers) and 45% by health insurance funds (ie, the premium payers); conversely, outpatient expenses have been entirely covered (ie, 100%) by health insurance funds, which
has led to misplaced incentives. An unnecessarily large number of inpatient treatments have been car- ried out, even though outpatient treatments would have been often medically more appropriate and less expensive. Hence, both methods of treatment will in future be financed according to a uniform distribution mechanism. Implementation of the Care Initiative As in other western countries, the population of elderly citizens in Switzerland is growing. The population of persons aged 100 and above has increased from 61 in 1970 to 2,198 in 2024 according to a survey recently published by the Swiss Federal Statistical Office. The demographic ageing of society exacerbates the need for qualified nursing personnel. In sync with the pop- ulation growth of elderly persons, the prevalence of diseases such as cancer, diabetes and cardiovascu- lar conditions, as well as increasing multimorbidity, is expected to increase in the forthcoming years. In November 2021, 61% of Swiss voters approved an initiative to improve working conditions for care staff (Care Initiative) and hence to mitigate the shortage of care staff. As a result of this initiative, since July 2024, legislative measures have been implemented to enhance the training of care staff at the tertiary level by supporting healthcare institutions with financial contri- butions aimed at increasing the range of qualified care degrees offered by higher technical colleges (HF) and universities of applied sciences (FH). Additionally, care staff will be authorised to directly bill specific medi- cal services to social insurance funds, thereby elimi- nating the need for a doctor’s prescription. The initial phase concentrated on the training of care personnel, whilst the subsequent phase, submitted to Parliament by the Federal Council in May 2025, emphasises the professional advancement of care professionals. The objective is to ameliorate working conditions in the care sector by limiting the maximum weekly working hours and increasing shift predictability. Nevertheless, deliberations in Parliament are still ongoing, and the result remains uncertain. In addition, a national monitoring programme for care staff has been introduced that aims to systematically assess the impact of measures implemented based on the Care Initiative over an extended duration. This
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