SWITZERLAND Law and Practice Contributed by: Oliver Brupbacher, Markus Schott, Markus Wang, Djamila Batache and Christine Schweikard, Bär & Karrer AG
products and markets (see 8.2 Price Levels of Pharmaceuticals or Medical Devices ). 8.5 Regulation of Prescriptions and Dispensing by Pharmacies Although the main purpose of the prescrib- ing and dispensing regulations is to safeguard patient welfare and safety in the dispensing and use of medicinal products by requiring that only HCPs with sufficient education, training and continuing education are involved (Articles 24–26 of the TPA), HCPs are required by their professional duties and corresponding provi- sions in their self-regulations to also observe the aspect of economic efficiency. Furthermore, the legal provisions on the advertising of medicinal products explicitly provide for the inadmissibil- ity of advertising (including to HCPs) that may encourage the excessive use of medicinal prod- ucts (cf Article 32 paragraph 1 lit b of the TPA). Lastly, the integrity provisions (cf the OIT and Article 55 of the TPA) prohibit the excessive pre- scribing of medicines.
In general, physicians may prescribe any author- ised medicinal product for a given indication without regard to its price and they are not obliged to propose a more affordable (generic) alternative. That said, if the SL contains differ- ent medicinal products containing the same API, the cost share that must be borne by the patient may vary. Physicians must inform their patients accordingly. Equally, for medicinal products that are not included in the SL or that are used off-label or off-limitation, HCPs must inform the patients that the costs might not be reim- bursed under the compulsory health insurance. According to Article 52a of the HIA, pharmacists are allowed – but not obliged – to substitute a prescribed original medicinal product listed on the SL with a generic unless there is an explicit request by the prescribing physician or chiro- practor to dispense the original.
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