Helsana-Report: Drug Report 2025
Medication costs continue to rise

Medication is being dispensed in increasing quantities in Switzerland. In 2024, almost 7 million people – more than three quarters of the Swiss population – obtained at least one form of medication through compulsory health insurance. The number of recipients increased by 2.3%, and the number of packs dispensed by a full 2.9%. This means that more people are taking medication, and the average number of packs dispensed per person has also increased, with the average now 20 packs per person per year.
At the same time, new medications are becoming increasingly expensive. And cheaper older versions are often replaced by new, more expensive alternatives. These volume and price effects lead to a noticeable increase in costs.

At the end of 2024, 1,287 drugs were listed on the The specialities list itemises every medication covered by compulsory health insurancespecialities list. However, the cost of these medications varies greatly. The ten most cost-intensive medications generated costs of CHF 1.13 billion: more than 12% of the total cost for medications. Three medications alone – Keytruda for the treatment of cancer, Eylea for the treatment of wet macular degeneration and the blood thinner Xarelto – account for 5% of the total. Together, they generated costs of more than CHF 467 million. By way of comparison, spending on the three most cost-intensive medications amounted to CHF 396 million five years ago, and just CHF 288 million ten years ago. So it is essential that we see consistent implementation of planned cost follow-up models, which provide for sales-based refunds for the cost-intensive medications.

One of the main reasons for the constant rise in medication costs is the fact that newly approved products are coming onto the market at ever higher prices. While a newly approved medication cost an average of CHF 860 between 2010 and 2014, the average price rose to over CHF 1500 between 2020 and 2024.

This represents almost a doubling within ten years – even for products with no innovation potential. The 28 new medicines added to the list of specialties in 2024 already cost CHF 59 million, with half of these preparations having a package price of over CHF 2000. Although, only four of these drugs can be considered potential innovations.

The FOPH only reviews the price of a medication every three years, and reduces it if necessary. As a result, prices for cost-intensive medications are all too infrequently reduced to compensate for ever-increasing market entry prices.

In Switzerland, the Federal Office of Public Health (FOPH) negotiates with manufacturers to set medication prices. They compare with prices abroad (foreign price comparison) and prices for existing treatment alternatives (therapeutic cross-comparison) to determine the “economic price” which is covered by compulsory health insurance. Both values determined in this way are each included in the pricing process at a rate of 50%. Manufacturers may also apply for an innovation surcharge – if their medication has a significantly better effect, for instance.
In its comparison of international prices, the FOPH often uses so-called window prices as a benchmark. These are artificially inflated but publicly published prices for a medication. Window prices are used as a benchmark because the prices actually paid abroad are kept secret. This secrecy is advantageous for pharmaceutical companies, as it allows them to conduct price negotiations on the basis of the inflated window prices.

In order to counteract the rise in medication costs, it would be necessary for the FOPH to refrain from using foreign window prices and to conduct an annual price review of cost-intensive medications.

Imitation medications – generics and biosimilars – are usually therapeutically equivalent but significantly cheaper than original medications, yet Switzerland is not consistently exploiting this savings potential. This is relevant because there are generics available for almost a third of all active ingredients on the specialities list. The local market volume is around CHF 3 billion.

A number of legislative changes came into force in 2024, all of them aimed at promoting the sale of cheaper imitation products and counteracting rising costs for prescription medications. The most important changes were the revision of the sales share and the increase in the “differentiated excess”. You can find more details on the individual regulatory changes in the overview.

Differences between sexes and genders are apparent in many areas of medicine. Examples include the way symptoms of illness manifest, the frequency of different illnesses, and Pharmacokinetics is the study of how the body absorbs, distributes, metabolises and excretes different drugs.pharmakokinetik profiles. The research area of gender medicine, still in its infancy, systematically investigates these differences between men and women. In May 2024, the University of Zurich established Switzerland’s first chair in this field.
One area of gender medicine is healthcare research. This is an interdisciplinary field that analyses the structures, processes and outcomes of healthcare under everyday conditions. One example is the analysis of differing treatment patterns for women and men. Helsana statement data can be used to determine how often medications are prescribed and identify differences in treatment and potential gaps in care between women and men.

Medication supply for heart attacks

For example, we conducted analysis that showed that prior to heart attack, men were treated with cholesterol-lowering drugs (e.g. statins) and platelet aggregation inhibitors (e.g. acetylsalicylic acid) more often than women, but less often with ACE inhibitors, beta-blockers or other drugs that lower blood pressure.

After a heart attack, both women and men receive much more intensive medication treatment. On average, men received more comprehensive treatment than women. However, it would be premature to diagnose a discrepancy in treatment from this data, which lacks important clinical information that determines whether a medication is indicated. For example: the patient may have co-morbidities or intolerance which preclude use of the medication.
 
 

Antidepressants

Mental illnesses such as depression are much more common among women than men, and women seek professional treatment for them more often. Young women between the ages of 20 and 24 are more than twice as likely to purchase antidepressants as men of the same age, a trend that persists across all age groups.

From the literature we can already see potential differences in the way women and men metabolise antidepressants. Nevertheless, our data show that this is not reflected in drug dosages. In determining dosage, the chosen product appears to outweigh the sex or gender of the person for whom it is intended.

This result is not surprising. For one thing, treatment guidelines don’t (yet) provide for sex- or gender-specific dosing. However, the results could serve as an impetus for further research in gender medicine and truly targeted treatment for all patients in the future.

You can find more detailed information, including the methodology used, comprehensive figures and a large number of facts and charts relating to the above topics and specific sections in the “Helsana Report: Pharmaceuticals 2025».