MFN clause: one new medicine in three is not submitted in Switzerland

American policy to bring down medicine prices is having effects in Switzerland. This is the argument of Interpharma, based on a survey of its member companies.

At the centre is the most-favoured-nation clause, known as MFN. The principle is that the price paid in the United States is aligned with the lowest charged in other reference countries. The practical consequence is that a price set in a small market can feed through to by far the most profitable one.

How many products stay out

According to the survey, in nearly a third of cases the industry is not applying to have new products added to the specialities list, the step required for a medicine to be reimbursed by basic insurance.

The numbers are concrete. Of twenty-two products launched between January 2025 and June 2026, seven were not submitted for listing. Three others did not even request authorisation from Swissmedic, the Swiss agency for therapeutic products.

Companies, the association reports, do not feel able under current conditions to launch new therapies in Switzerland promptly without jeopardising US prices. Interpharma also warns that the planned revision of the health insurance ordinance risks amplifying the trend.

The result falls on patients, who find it harder to access innovative treatments. A medicine not on the specialities list is not reimbursed, and an unauthorised medicine is not available at all.

Interpharma is asking Switzerland for a pricing system compatible with the MFN clause, one that takes account of the availability of innovation, quality and cost.

The request should be read for what it is: the position of an industry body with an interest in higher prices. It nonetheless remains true that the mechanism of international reference prices, designed to contain spending, produces a side effect nobody planned. A small, high-income market becomes a commercial risk, and a lever for cost control turns into a barrier to entry. It is an aspect the Swiss debate on healthcare costs, so far focused on premiums, has given little attention.