Specialities list and limitations in Switzerland: list of drugs and medicines

2. What drugs are covered by health insurance?

Basic insurance covers the cost of all medicines listed on the SL/LS, minus out-of-pocket expenses. In addition to the drugs on the list of pharmaceutical specialties, basic insurance also covers:

• Drugs that have not yet been approved in Switzerland or are not yet on the list of specialties for a certain treatment, if all other treatments have failed (Art. 71 of the Health Insurance Ordinance (KVV/OAMal))

• Drugs that are produced as an extemporaneous preparation (usually in a pharmacy) – the ingredients must, however, feature on the list of medicines with tariff (LMT)

For adults, basic insurance also covers the cost of drugs on the list of drugs for birth defects and congenital disorders (GGML/LMIC) (in German, French and Italian only). For patients under the age of 20, disability insurance (IV/AI) will pay for drugs used to treat birth defects.

Finally, you'll find the last category of drugs on the list of pharmaceutical products payable by the policyholder (LPPV/LPPA). As a rule, you'll have to pay for these drugs yourself. These products are approved by Swissmedic and are not used exclusively to treat medical conditions but rather to improve quality of life, for example.

3. Which drugs are on the list of pharmaceutical specialties?

Approximately 2,500 drugs are currently approved by Swissmedic in Switzerland and most of them have been added to the list of pharmaceutical specialties by the Federal Office of Public Health (FOPH). They include proprietary drugs, generic drugs, biologics and biosimilars as well as medicines from the following areas of complementary and alternative medicine: anthroposophical medicine, traditional Chinese medicine, classical homeopathy and phytotherapy.

Useful tip: you can order medicines online. But that has its drawbacks. Here you can find out more about ordering drugs from abroad.

4. List of pharmaceutical specialties with a limitation ("SL/LS limitation")

Some drugs on the list of pharmaceutical specialties have a limitation placed on them.These products are only partially reimbursed by health insurance. In the list, this limitation is indicated by the abbreviation "LIM".

Whether or not compulsory basic insurance will cover the costs is determined by factors such as application, quantity, length of treatment and the policyholder's age.

5. What information is included in the list of pharmaceutical specialties?

• Product

• Galenical form/dose

• Ex-factory price

• Recommended retail price

• SB/QP = drug with higher coinsurance (an X on a red background)

• Lim-Pkt / Lim-Pt = limitation points

• Lim = limitations

• Swissmedic code

• Marketing authorization holder

• Active ingredient

• FOPH file number

• Date of inclusion on the list

• Temporary inclusion or temporary limitation

• PM/MP = price model

• O/G = proprietary/generic

• IT code

• ATC code

6. Supplemental insurance for drugs and medicines not included in the list of pharmaceutical specialities

Drugs that are not licensed in Switzerland, are not on the list of specialties, or are on the list, but not for the indication in question, are only covered by basic insurance in exceptional cases.

Many other medicines – especially from the field of alternative medicine – are covered by health insurance through outpatient supplemental insurance.