Swiss audit finds most medication rebates withheld from insured people

A report by the Swiss Federal Audit Office has found that most discounts on medicines are not passed on to people covered by compulsory health insurance, prompting accusations of “organised theft” in Parliament, SRF reported.

The audit office estimates that pharmaceutical companies grant discounts worth 743 million Swiss francs each year. According to its report, only 12 per cent, or 88 million francs, is passed on to insurers and insured people.

Pharmacies, hospitals and medical practices retain part of the discounts they receive when purchasing medicines. The practice violates the law, which requires healthcare providers to pass such benefits on to insurers and insured people.

“At this scale, it can no longer be described as an administrative detail,” said Thomas Bläsi, a Geneva National Council member from the Swiss People’s Party and a trained pharmacist, in an interview with French-language broadcaster RTS. He criticised the Federal Office of Public Health, which is responsible for oversight, for being unable to determine the amounts involved or where the discounts flow within the medicine supply chain.

Baptiste Hurni, a Social Democratic member of the Council of States from Neuchâtel and vice-president of the Swiss Patients’ Organisation, described the practice as “nothing other than organised theft”. He said the law was clear that medicine rebates had to benefit insurers and insured people, but that this was not the case in the overwhelming majority of cases. He also criticised the use of elaborate accounting models resembling those found in criminal activity.

Bläsi said he hoped all parties would address the issue during Parliament’s next session in September. He called for full transparency and for insured people to be repaid money that had been taken from them unjustifiably.

Hurni said the Federal Office of Public Health’s responsibility should be put into perspective because of substantial staff cuts at the office and a general lack of transparency in the healthcare system. He nevertheless said the issue of medicine rebates had not been a priority for the office.

In the short term, Hurni called for stronger controls. In the long term, he said the rebate system should be abolished because it was unsuitable for compulsory insurance. He warned that people could not afford such a lack of transparency while struggling to pay rising health insurance premiums.

The audit office said the Federal Office of Public Health carries out too few checks and does not sufficiently base them on risk. It recommended collecting better data and extending oversight to pharmacies and wholesalers.