External environment

Cost pressure and premium burden

In its annual forecast, the Swiss Economic Institute (KOF) at ETH Zurich predicted that healthcare expenditure in 2025 would be above the average of previous years and will continue to rise in the years to come. The main reasons are increased volumes and the rising costs of long-term care. Pharmacies make a minor contribution to growth.

According to the Helsana Report 2025, the costs of medicinal products are rising for three reasons. Firstly, there are new, high-priced special treatments, for example against cancer or for immunotherapies. Secondly, the growing and ageing population is leading to an increase in volumes and thirdly, the use of generics and biosimilars remains low.

The rising number of outpatients is also increasing the costs of premium-financed basic insurance. The introduction of standardised financing of outpatient and inpatient services from 2028 onwards will solve this problem. The EFAS key provides for standardised financing of outpatient and inpatient services. The cantons contribute at least 26.9% and the health insurers a maximum of 73.1% of the net costs. Care costs will be integrated into EFAS as of 2032.

Cost containment measures 2 strengthens the pharmacy sector

In spring 2025, the Federal Parliament approved cost containment package 2. This focuses on differentiated pricing for high-priced, high-selling medicinal products. Pricing models for medicinal products are now included in the Federal Act on Health Insurance (HIA). These allow for reimbursements, particularly for innovative therapies, which are expected to result in price reductions of 20% to 60% compared to the list price. The federal government can now set volume discounts for products with a large market volume. Once a certain sales threshold is reached, part of the sales flows back to the insurers. At the same time, a provisional fee from the date of Swissmedic approval allows faster access to medicinal products with high medical need.

Cost containment package 2 creates the legal basis for expanding services provided by pharmacists that are reimbursed by basic insurance. This concerns pharmaceutical consultations to optimise drug therapy and patient adherence. Preventive services such as vaccinations can now be covered by basic insurance.

Overall, savings of CHF 300 to 400 million per year are expected in the medium term. Exceptions for low-priced or cost-intensive drugs are intended to strengthen the security of supply. According to the Federal Office of Public Health (FOPH), the entry into force of the overall package is planned for early 2027, with individual elements being able to start before then.

Partial revision of the Therapeutic Products Act 3a

In autumn 2025, the Federal Council adopted the dispatch on the amendment to the Therapeutic Products Act (Revision 3a) and submitted it to Parliament. Prescriptions are planned to be issued and dispensed electronically in the future to reduce legibility problems, counterfeiting and multiple redemptions. The commitment to e-medication plans is intended to improve patient adherence and facilitate communication between healthcare professionals.

An electronic system for calculating drug doses for quality assurance purposes is also planned to be used in facilities providing paediatric inpatient care. Furthermore, the TPA provides clearer and more specific regulations for medicinal products for advanced therapies in order to improve access to innovative forms of treatment. The earliest possible date for entry into force is given as 2028.

Agenda for basic care

Federal Councillor Elisabeth Baume-Schneider launched the Basic Care Agenda in November 2024. The aim is for all people in Switzerland to continue to have access to high-quality basic medical care in the future. Over the course of a year of intensive collaboration, around 50 healthcare organisations have jointly compiled a technical report. This was submitted to the Head of the Federal Department of Home Affairs (FDHA) in December 2025. However, the final version is not supported by all the organisations involved. There is also criticism that essential elements of basic care, such as women’s health, are absent from the report.

Pharmacies are explicitly mentioned in the report as partners of GP practices and the intention is to include pharmacies as part of coordinated, continuous care. As part of “needs-based access” for people with acute symptoms or in need of advice, the plan is to use pharmacies to relieve the burden on GP practices, emergency call centres, emergency services and hospital emergency departments. A planned competency matrix is designed to clarify which professional group is allowed to provide which services in the event of simple complaints. Pharmacies are explicitly included in this process.

In 2026, the Minister of Health will prioritise measures that fall within the remit of the federal government. She will determine the next steps in consultation with the stakeholders concerned.

National digitalisation programme DigiSanté

With the start of the operational phase of DigiSanté in 2025, the digital transformation of healthcare will become a strategic focus of healthcare policy. The ten-year programme was developed on behalf of the FOPH in collaboration with the Federal Statistical Office (FSO). It aims to create a national health data space, promote the use of electronic prescriptions and e-medication plans, and measurably increase the quality, patient safety and efficiency of care. This results in new requirements for service providers and companies in terms of interoperability, data security and process standardisation as well as new opportunities for interconnected care offerings and data-based services.

Transparency and integrity

The FOPH is responsible for implementing the provisions on integrity and transparency in the Therapeutic Products Act (Art. 55 and 56 TPA). In early December 2025, it announced a clarification of practices with regard to payment in exchange for advertising campaigns by pharmaceutical companies in medical practices, pharmacies and other institutions, which is valid with immediate effect. In the opinion of the FOPH, advertising campaigns should not be paid for the market value of the advertising service, but only for the actual cost of the work performed. The FOPH understands this to mean, for example, the activation and display of an advertising screen, but not the equivalent value of the advertising shown. Many healthcare associations oppose this practical change, as there is neither a legal basis nor a need for it. It is to be expected that the legality of the practical change will have to be clarified in court.

In 2025, Parliament decided against tightening the rules by adopting a parliamentary initiative entitled “Pharmaceutical Industry and Medicine. More transparency”. This entailed tightening the TPA with regard to the disclosure of vested interests and the acceptance of “non-cash benefits”.

New compensation for services provided for the LOA V

After extensive consultation, the tariff partners Prio.Swiss and the Swiss pharmacy association pharmaSuisse submitted a revised version of the new LOA V (service-based remuneration) pharmacy tariff model to the Federal Council for final review on 1 June 2025. The Federal Council approved the LOA V (service-based remuneration) tariff model in October 2025.

The LOA V tariff model includes a more differentiated service structure, a bonus-malus system for savings, monitoring with volume brakes and new tariffs. The latter applies, for example, to substitution for generics or biosimilars, machine blister packaging and the distribution channel. It should be emphasised that blister packaging is now included in the collective bargaining agreement. Another new feature is that the mail-order business can benefit from the LOA V tariff model. As a result, the activities of pharmacies that were previously remunerated on a flat-rate basis will be broken down in a more granular way and linked more closely to the promotion of generics and biosimilars as well as cost control. The LOA V tariff model entered into force on 1 January 2026.

Weakening of the territoriality principle

As part of a consultation process, the Federal Council proposed an amendment to the HIA, whereby certain medicinal products and items can be purchased in the EEA on a physicians' prescription and paid for via basic insurance.

The consultation process ended in March 2025. While major political parties support the bill, relevant professional associations such as pharmaSuisse are opposed to it. It is unclear when the Federal Council will pass the bill over to Parliament.

In 2025, the Council of States voted against weakening the principle of territoriality on two occasions. It rejected a motion that provided for the reimbursement of medicines and medical aids purchased abroad. It was feared that domestic service providers such as pharmacies and pharmaceutical wholesalers would be disadvantaged if the motion was adopted. Security of supply would also be put at risk if purchases were systematically relocated abroad. There were also concerns that counterfeit medicines could be imported into Switzerland if purchased abroad. From a patient safety perspective, it is problematic that recalls of medicines purchased abroad are not possible on the patient’s side.

The Council of States also voted against a motion that provided for pilot projects to finance medical services in neighbouring countries via basic insurance.

By definitively rejecting both motions, Parliament has strengthened the principle of territoriality.

Completed consultations

Many consultations were held on health policy proposals in 2025, some of which are laid out below:

Direct counterproposal to the popular initiative “Yes to the security of medical supply”

There are wide-ranging problems with the supply of important medical goods. At the federal level, there is a lack of responsibility and thus a lack of action. With the direct counterproposal, the Federal Council is aiming to close this gap at the constitutional level, while simultaneously strengthening existing supply structures. The expansion of the federal government’s remit takes account of the popular initiative’s main concern, which is justified. The aim is to alleviate the causes of supply problems.

Numerous organisations took part in the consultation on the counterproposal to the popular initiative “Yes to the security of medical supply”, the majority of which supported the counterproposal. However, some organisations are calling for certain amendments. The Federal Council’s dispatch is expected to be adopted in the course of 2026.

New Ordinance on individual identification features and safety precautions on the packaging of medicinal products for human use

The draft ordinance stipulates that individual identification features and safety precautions are to be applied to the packaging of prescription-only medicinal products. These are intended to prevent counterfeiting and the illegal marketing of medicines in the legal supply chain. Many associations are critical of the imposition of this obligation.

Outlook for 2026

Cost trends in healthcare remain the central topic of healthcare policy. The focus is on solutions to strengthen the security of supply, which remains at risk due to the shortage of skilled workers and medicinal products. Measures to curb basic insurance premiums and the high losses being made by many hospitals are controversial.

General topics

Structural change, hospital crisis and outpatient treatment

The hospital landscape is facing profound structural change: many are suffering from financial deficits, investment backlogs and a shortage of skilled workers, while at the same time certain locations have an excess of capacity. Analyses are proceeding on the assumption that, without far-reaching transformation, the system could reach its limits due to rising demand and a shortage of staff. Policy to promote outpatient treatment is intended to help reduce staff-intensive inpatient treatment, but requires the targeted expansion of outpatient structures, tariffs and coordination models.

Shortage of skilled workers and demographic change

The shortage of skilled workers remains one of the biggest challenges in the healthcare sector and continued to intensify in 2025 – particularly in general practice, nursing and long-term care. Studies and care reports point to thousands of vacancies and an increasing lack of primary care providers and qualified nurses. At the same time, the need for services is increasing due to an ageing population and more chronic conditions. The focus is therefore shifting to efficiency improvements – for example through the implementation of the nursing initiative, more attractive healthcare professions, new interprofessional care models and easing strain through digitalisation and reassignment of tasks (e.g. expanded services in pharmacies).

Regulation of pharmaceuticals

The Federal Council is aiming to reduce the administrative burden on companies and review existing regulations to this end. As part of the Business Cost Relief Act, it has stipulated that, among other things, pharmaceutical regulations are to be reviewed for potential opportunities to ease strain on the system. A “sectoral study” commissioned by the FOPH is expected to be published in the second half of 2026.

Planned consultations

In 2026, the Federal Council announced two consultations that are relevant for the Galenica Group:

Partial revision of the Therapeutic Products Act 3b

The partial revision of the TPA 3b is intended to lower the hurdles faced by the mail-order business. A doctor’s prescription is currently required in advance for every order. It will now be possible to order non-prescription medicinal products without a doctor’s prescription. Mail-order companies will continue to ensure appropriate expert advice and the documentation of all relevant information.

Strict regulations imposed by cantonal pharmacists regarding home delivery of medications are to be eased. This will allow pharmacists to deliver non-prescription medicinal products to the homes of known customers.

The partial revision of the TPA 3b is not expected to enter into force until next decade at the earliest.

Federal Act on the Digital Health Data Space

The Federal Council is expected to open the consultation process on the “Federal Act on the Digital Data Space for Health” in the second half of 2026. This is designed to be a cross-sectional framework act and is intended to lay the foundation for the establishment of central services to support data flows without discontinuities between media types in the areas of treatment, billing, research and public health. It aims to define the framework for infrastructure, basic services and secondary use.

New legislative consultations

Electronic Health Records Act

In the fourth quarter of 2025, the Federal Council passed the dispatch on the Act on Electronic Health Records (E‑GD, elektronisches Gesundheitsdossier) over to Parliament. The E‑GD replaces the previously little-used electronic patient record and goes far beyond that in terms of structure, organisation and use. The plan is to give all residents a health record automatically unless they actively opt out. In addition, the intention is for all service providers to work with it in future. The E‑GD relies on a central technical infrastructure procured by the federal government, while the cantons ensure its operation and range of services. The federal government may also delete data in the E-GD that has been entered incorrectly.

It is to be assumed that a referendum will be held on the E-ID Act and that the population will vote on the bill. As the second vote on an electronic identity (E-ID) in September 2025 was close, with 50.39% of votes in favour, it seems to be a great challenge to win a majority of the population over to the bill. It is currently unclear whether and how Parliament will amend the bill in order to increase the chances of its adoption.