Guides
What is the Swiss Specialities List?
The Specialities List is the register kept by the Federal Office of Public Health of the medicines reimbursed by Swiss mandatory health insurance. It sets an ex-factory price and a public price for every pack, reproduces any reimbursement limitation verbatim and is updated monthly.
What the Specialities List is in law
The Specialities List is a federal positive list: only what appears on it is reimbursed by mandatory health insurance. The legal basis is Art. 52 para. 1 let. b of the Health Insurance Act, made concrete by Art. 64 to 75 of the Health Insurance Ordinance and Art. 30 to 37e of the Health Care Benefits Ordinance.
Exhaustive means there is no fallback rule for products that are absent. If a medicine is not listed, insurers owe nothing, even where Swissmedic has authorised it. Where treatment remains medically indispensable, only individual case reimbursement under Art. 71a to 71d of the Health Insurance Ordinance is available.
Positive list
A benefits catalogue that names each reimbursable product individually. Anything not named counts as not reimbursable. The opposite model is a negative list, which names only the exclusions.
Who maintains the list and how often it changes
The Federal Office of Public Health is responsible, known as BAG in German, OFSP in French and UFSP in Italian. It assesses admission requests, sets prices and publishes the list monthly, normally effective on the first day of a month. The Federal Drug Commission acts in an advisory role.
Every monthly edition carries new admissions, price cuts, revised limitations and removals. Anyone reusing prices must therefore always carry the as-of date; an SL price from last month may already be superseded.
What an SL entry contains
An entry describes a pack, not a medicine. It shows the preparation name, the authorisation holder, the active substance, the pack size, the ex-factory price, the public price, the IT group, any limitation text and flags for generics, biosimilars and the differentiated 40 per cent co-payment.
| Field | Meaning | Practical consequence |
|---|---|---|
| Ex-factory price FAP | The holder's price without distribution share and without VAT | Reference figure for the foreign price and therapeutic comparisons |
| Public price PP | FAP plus distribution share plus VAT | Maximum price a pharmacy or practice may charge |
| Limitation | Binding reimbursement condition, verbatim text | No reimbursement unless met, often needs cost approval |
| IT group | Indication therapy group of the list | Basis for the therapeutic cross comparison |
| Co-payment | 10 per cent, or 40 per cent for an expensive originator | Direct financial consequence for the insured person |
The public price is a maximum, not a fixed price. A lower dispensing price is permitted, a higher one is not.
Swissmedic authorisation is not reimbursement
Swissmedic assesses quality, safety and efficacy under the Therapeutic Products Act and grants the authorisation. The FOPH then assesses efficacy, appropriateness and cost effectiveness and decides on reimbursement. These are two separate procedures with their own dossiers, their own deadlines and their own appeal routes.
- Authorised and listed: reimbursed within the limitation.
- Authorised but not listed: private payment or individual case review under Art. 71a to 71d of the Health Insurance Ordinance.
- Listed but used outside the authorised indication: no reimbursement through the SL entry.
Market access
Do you need your product on the Specialities List?
Questions about SL listing, prices or limitations? Contact Swiss Reimbursement.
- Independent directory
- Official FOPH data
- Website in eight languages
The other federal reimbursement lists
The Specialities List is only one register among several. Alongside it sit the tariff list for magistral preparations and bulk substances, the list of medical aids and appliances for items patients use themselves, and the separate regime for congenital conditions funded through Swiss disability insurance.
- Tariff list ALT: Annex 4 of the Health Care Benefits Ordinance, substances for compounding in the pharmacy.
- MiGeL: Annex 2 of the same ordinance, for example glucose test strips, compression stockings or inhalers.
- Congenital conditions: reimbursement under disability insurance law, partly via a dedicated specialities list.
How to read an entry correctly
Always read from the pack, not from the brand. Check the pack size first, then the public price, then the limitation text, and finally compare daily treatment costs with the other preparations in the same IT group. That is how lower-priced alternatives become visible.
- Identify the preparation and strength, not just the trade name.
- Select the pack size actually dispensed.
- Note the public price as a maximum and the ex-factory price.
- Read the limitation text in full, including prior therapy and maximum duration.
- Compare cost per day or per treatment cycle within the IT group.
FAQ
Is every medicine authorised in Switzerland on the Specialities List?
No. Swissmedic authorisation and SL admission are two separate procedures. With no admission request, during a price negotiation or after a rejection, a preparation stays authorised but is not reimbursed. Many over-the-counter medicines in dispensing categories C, D and E never appear on the list at all.
What is the difference between the ex-factory price and the public price?
The ex-factory price is the authorisation holder's price, excluding the distribution share and VAT. The public price is built from it by adding the distribution share set by the FOPH plus VAT.
- Ex-factory price: basis of every FOPH price comparison.
- Public price: the maximum chargeable at the point of dispensing.
How often is the Specialities List updated?
Monthly. The FOPH publishes admissions, price changes, revised limitations and removals normally effective on the first day of a month. What binds is the FOPH publication and its date, not an older copy of the data set. Larger waves of cuts from the three-yearly review land together, usually on 1 December.
What does a 40 per cent co-payment flag next to a product mean?
A markedly cheaper product with the same active substance exists. Choosing the more expensive one triggers a co-payment of 40 instead of 10 per cent under Art. 38a of the Health Care Benefits Ordinance. Where the practice documents a medical reason in the individual case, the ordinary co-payment continues to apply.
More guides
Market access
Do you need your product on the Specialities List?
Questions about SL listing, prices or limitations? Contact Swiss Reimbursement.
- Independent directory
- Official FOPH data
- Website in eight languages