Insurance will skip the deductible if you choose a generic

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MedicationsInsurance will waive the deductible if you choose a generic

Groupe Mutuel wants to contribute to increasing the share of generics, because the price of drugs weighs more and more heavily in health costs.

On the political side, elected officials sometimes find it difficult to swallow measures aimed at lowering drug prices.

20min/Simon Glauser

To be reimbursed each time by your insurance for the drugs you buy even if you have not reached your deductible: this is what Groupe Mutuel will offer from 2023, which announced on Tuesday the launch of a new basic model for compulsory insurance, which will exempt the purchase of generic drugs from the deductible. “They are up to 70% cheaper than the original preparations, but their share of use is only 37% in Switzerland,” laments the insurer.

“Increasing their distribution, relieving policyholders of deductible costs for medicines and at the same time helping to reduce healthcare costs”: this is the objective of Groupe Mutuel. It must be said that drugs weigh heavily in the balance of health costs, which, year after year, drive up premiums. “The total costs for drugs covered by basic health insurance already represent more than 8 billion francs. The savings potential for generics alone is several hundred million per year,” notes Christophe Kaempf, spokesman for SantéSuisse.

Initiative hailed

Groupe Mutuel ensures that the premium for this new model will be, “in the vast majority of cantons, the most attractive insurance model offered by Groupe Mutuel, because the savings generated by replacing original drugs with their generics allow to compensate for the cost of not levying the deductible”, specifies the communication manager Loïc Mühlemann.

The proposal seems well received by the political world, which is often torn around the solutions to be taken to curb the rise in health costs. Asked by “24 hours”, several elected officials from the left and the right consider the proposal “interesting”, as does the French-speaking Consumer Federation.

Encouraging the use of generics would lower part of the total bill; it will nevertheless remain higher than it should be. Generics are still, on average, approximately twice as expensive in Switzerland as abroad. “We are therefore asking for a reduction in the prices of generic drugs to the level of those of neighboring countries, as well as a systematic substitution of originals by generics,” says Christophe Kaempf.

In 2020, Parliament had rejected a proposal from the Federal Council which aimed to set a reference price for generics, based on the price abroad. The insurers would have reimbursed only this price and, if the insured persons chose a more expensive drug, the difference would have been at their expense. Fears of supply difficulties and cases where chronic patients would have had to change medication for financial reasons had been the skin of the project, refused by the two Chambers.

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