Why Switzerland brand drugs are cheaper
It’s cheaper because Switzerland sets one price for the drug. Every hospital and pharmacy pays that (or a cap under it). In the US, each insurer and PBM bargains a rebate off a high list, and the sticker stays high.
Federal Office of Public Health list
How it works
Swissmedic licenses the drug. The Federal Office of Public Health then puts it on the specialty list at a negotiated price, using international reference pricing. Insurers pay that list. They do not each cut a secret US-style rebate deal on a $150k sticker.
Why it holds
A national list is a ceiling. Switzerland is rich and still about 29¢ on US brands (RAND: US 3.39× Switzerland). They get the oncology year. They do not pay US list so the manufacturer can ‘recoup R&D’ a second time.
The invoices
See RAND drugs. 30-day list prices: CMS 2023, Inflation Reduction Act round 1.
Twenty brands — US sticker vs Switzerland
Ranked by the US number. 30-day list is CMS 2023 (Inflation Reduction Act round 1). Infusion doses are our hospital commercial bill. Switzerland column is that US sticker × this country’s RAND brand index. Gross list, not rebates. Even after a US rebate haircut, RAND says brands stay more than 3×.