Swiss healthcare costs accelerate as premiums weigh ever more heavily

Switzerland’s health spending is growing at a pace the population is struggling to sustain. In 2024 the country devoted around 12% of its gross domestic product to health, the fourth-highest figure among OECD members, with a total budget of roughly 100 billion francs a year. Between 2024 and 2027, costs are expected to rise by an average of 3.9% a year, compared with 3.1% over the previous decade.

The bill shows up in health insurance premiums. In 2024 an adult paid an average of 423 francs a month, equal to 7% of average disposable income; in 2004 the share was 4%. In a survey commissioned by comparis.ch in 2025, 59% of respondents said they paid their premiums without difficulty, but around a third receive state subsidies. A study by the University of Fribourg also indicates that one in five older people forgoes treatment for financial reasons.

In January, State Secretary for Economic Affairs Helene Budliger Artieda acknowledged that Switzerland is «di fronte a un trilemma» (facing a trilemma). For Stefan Felder, professor of health economics at the University of Basel, «il sistema svizzero è semplicemente troppo costoso» (the Swiss system is simply too expensive); the savings proposed so far strike him as «ridicolmente esigui» (ridiculously meagre).

Part of the problem lies in the volume of services. Switzerland implants around 350 hip prostheses per 100’000 inhabitants, almost double the OECD average of 191. Medicines absorb around 22% of the compulsory insurance budget, and the cost of reimbursed drugs has doubled over the past decade. According to Thierry Mauvernay, who heads Debiopharm, clinical tests that once cost 40’000 francs now cost 400’000.

Reform in small steps

The federal government has intervened repeatedly. A first package, in force since 2022, introduced among other things incentives for generics, raising the patient’s co-payment from 20% to 40% for branded drugs. In March 2025 parliament approved a second package of 16 measures, including a review of medicine prices. The round table convened by Federal Councillor Elisabeth Baume-Schneider aims for voluntary savings of 300 million francs a year from 2026: barely 0.25% of the health budget.

On the structural front, in November 2024 voters approved a reform standardising the split of costs between insurers and cantons, while a new tariff structure for medical services has been in force since January 2026. Under consideration are caps on spending growth for the 2028-2031 period and an increase in the minimum deductible from 300 to 400 francs, the first in twenty years.

The international context also weighs on prices: after the tariffs on medicines imposed by President Trump, the government set up a working group in January with the heads of Roche and Novartis. The pharmaceutical sector generates 40% of Swiss exports, but a domestic market of 9 million inhabitants limits Bern’s bargaining power: the Federal Office of Public Health removed Roche’s cancer drug Lunsumio from the list of reimbursed medicines after price negotiations failed.

Baume-Schneider told RTS that «il vero problema è chi paga cosa» (the real problem is who pays for what). The open question is whether measures worth only a tiny fraction of total spending will be enough to bring cost growth back within limits that policyholders and taxpayers can bear.