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CSS Insurance

im dialog

This health policy publication from CSS is aimed at decision-makers in the healthcare sector. It appears three times a year in German and French.

Ad hoc reimbursement for medicine

im dialog

Ad hoc reimbursement for medicine serves to ensure that innovations are available to the seriously ill at an early stage. The Federal Council pursued this objective by adding new articles to the ordinance in 2011. The foundation was laid by a Federal Supreme Court judgement concerning the rare Pompe disease. Today, health insurers receive thousands of applications every year for reimbursement of medicine that is not covered by the regular reimbursement obligation. “im dialog” provides answers to: How is ad hoc reimbursement regulated? Does this regulation still serve its original purpose? And does innovative medicine really bring the expected benefits?