In Switzerland, the price to the public of a reimbursable medicine (maximum price that is reimbursed by the social health insurance) is not determined on the free market, but is set by the state. It is made up of the sales and marketing portion of the overall cost, the ex-factory price, the sales tax and the value-added tax. The ex-factory price is established on the basis of a therapeutic reference pricing system and an international reference pricing system. In the case of the former, the cost of the product is compared with that of medicines already approved to treat the same disease. The international reference pricing system looks at the prices in countries with economically comparable structures in the pharmaceutical sector. In June 2015, Belgium, Finland and Sweden were added to the basket of countries used for this reference pricing since 2010 (Austria, Denmark, France, Germany, Great Britain and the Netherlands).
The Swiss Agency for Therapeutic Products (Swissmedic) levies a sales tax. This is payable for every pack sold and is dependent on the ex-factory price. It amounts to 5 Swiss francs per pack at most and accounts for more than 50% of the income of Swissmedic.
For every medicine, a sales and marketing surcharge is imposed by law. For prescription-only medicines up to an ex-factory price of 880 francs a surcharge of 12% is imposed, and for more expensive medicines the surcharge is 7%. In addition, a price-related surcharge is levied for every pack. For reimbursable OTC medicines a surcharge of 80% is imposed without a surcharge per pack. In the case of non-reimbursable medicines, pricing is determined by competition.