#20 - Switzerland
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This is one part of a 20 part series on the world’s top rated country health care systems, according to the World Health Organization (WHO). A summary of the twentith country on this ranking, Switzerland, is below. Thanks to Matt Rettig, PharmD, graduate of Butler University COPHS, for researching and compiling this information.
Switzerland
The System:
KVG, or Kranken-Versicherungs-Gesetz is the “Law on Medical Insurance”, or legislation enacted in 2006 for the Switzerland health care system.1 Citizens of the country can choose between ninety public and private insurance companies, but insurers must be not for profit agencies according to law.2 Regulations and financing is managed by twenty-six different cantons (which are similar to states).3 Premiums differ by canton, and each canton has a minister of health.6,10 Basic coverage is required, but approximately 40% of people in Switzerland buy supplemental insurance.6 Approximately 11.6% of total Swiss GDP is spent on healthcare, second highest in the world (first is the US at 16%).7,8 Two point two percent of total healthcare spend in Switzerland is on preventative care.11
The Pharmacy:
Drugs make up approximately 10% of the total healthcare cost pie in Switzerland (2002).12 Apotheke or pharmacies carry legend (RX) drugs, while Drogories carry only over-the-counters (OTCs). There is 1 pharmacy per 4,457 citizens in Switzerland.13 Physicians can dispense in Switzerland. Pharmacy curriculum is 5 years (for community practice, and an additional 3 years is required for hospital pharmacists), and pharmacy techs are required to study under a 3 year apprenticeship. Also, pharmacists may only be reimbursed from a pharmacy directly after 2 years of practice experience post 5-years of education. Swissmedic (the Swiss Food & Drug type administration) determines classification of medications - Classes A-E have varying degrees of prescription status as a requirement.12
Interestingly, compensation for drug distribution and cognitive services is different. Cognitive services have a fee schedule via a “point” system, and there are 6 different types of cognitive services, with varying point schedules. One point equaled 1.08 Swiss francs in 2005. Emergency work, night and weekend work had a sixteen point rating per patient visit or intervention. Only certain classes of drugs are covered by the basic insurance package. Both hospital and community practice pharmacies have a quality certification to reduce medication errors, increase generic utilization and increase medication adherence.
References:
1. Buhler M. The Swiss Healthcare System. http://www.swissnetwork.com/?page=ViewArticle&id=88 . Published August 31, 2007. Accessed August 12, 2008.
2. Interview: Pascal Couchepin. PBS website. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/interviews/couchepin.html . Published April 15, 2008. Accessed August 12, 2008.
3. Dougherty A. Switzerland: The Health Care System. Insure the Uninsured Project website. http://www.itup.org/Reports/Fresh%20Thinking/Switzerland.pdf . Published July 9, 2008. Accessed August 12, 2008.
4. Health insurance: Public and private health insurance in Switzerland. Just Landed website. http://www.justlanded.com/english/Switzerland/Tools/Just-Landed-Guide/Health/Health-insurance . Accessed August 12, 2008.
5. Health Care Systems in Transition: Switzerland. European Observatory on Health Care Systems Website. http://www.euro.who.int/document/e68670.pdf . Published 2000. Accessed August 12, 2008.
6. The Swiss Healthcare System. http://www.civitas.org.uk/pdf/Switzerland.pdf . Published 2002. Accessed August 12, 2008.
7. Five Capitalist Democracies & How They Do It. PBS website. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/ . Published April 15, 2008. Accessed August 12, 2008.
8. Landers J. In Switzerland, everyone is insured, and businesses don’t pay. http://www.dallasnews.com/s/dws/bus/stories/DN-swisshealth_07bus.ART0.State.Edition2.21730ee.html .Published February 7, 2006. Accessed August 12, 2008.
9. Switzerland. World Health Organization website. http://www.who.int/countries/che/en/ . Published 2008. Accessed August 13, 2008.
10. Aetna Global Benefits World Spotlight: Switzerland. Aetna website. http://www.aetnaglobalbenefits.com/content/news/0806B.pdf . Accessed August 12, 2008.
11. OECD and WHO survey of Switzerland’s health system. Organisation for Ecomomic Co-operation and Development website. http://www.oecd.org/document/47/0,2340,en_2649_201185_37562223_1_1_1_1,00.html . Published October 19, 2006. Accessed August 12, 2008.
12. Guignard E, Bugnon O. Pharmaceutical Care in Community Pharmacies: Practice and Research in Switzerland. Ann Pharmacotherapy. 2006; 40(3): 512-517.
13. Healthcare in Switzerland. http://www.europe-cities.com/en/633/switzerland/health/?page=1 . Accessed August 12, 2008.
14. Martinelli E. The GSASA- Professional Association of Swiss Public Health Administration and Hospital Pharmacists. http://www.eahponline.org/upload/ejhp/P52-53.pdf . Published April, 2003. Accessed August 16, 2008.
15. 2008 Top 20 Pharmaceutical Companies Report. http://www.contractpharma.com/articles/2008/07/2008-top-20-pharmaceutical-companies-report . Published August 2008. Accessed August 17, 2008.
16. Whelan J. Switzerland’s thriving pharmaceutical industry. http://www.newscientist.com/article/mg19025502.500-switzerlands-thriving-pharmaceutical-industry.html . Published May 6, 2006. Accessed August 17, 2008.
17. World-wide sales of the “top ten” Swiss chemical and pharmaceutical companies. http://www.sgci.ch/plugin/template/sgci/*/9826 . Published 2007. Accessed August 17, 2008.
18. Quality management standards in Switzerland. http://www.spitalpharmazie-basel.ch/lehre/pdf/Swiss%20HP.pdf . Published November/December 2005. Accessed August 17, 2008.
Posted on: Wednesday, August 19, 2009 at 4:47 pm 
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