The revision of the Health Insurance Ordinance (KVV/OAMal) and the Health Benefits Ordinance (KLV/OPAS), presented by the Federal Council in September, will further deteriorate access to treatment and quality of care for rare disease patients in Switzerland. The specific needs of patients with rare diseases are still not fully reflected in the KVV and KLV.
The RDAF supports the improvements made to the system for reimbursement in individual cases, including the involvement of therapeutic experts in the benefit assessment, the obligation for insurers to justify negative decisions and the possibility to conduct joint assessments. However, the RDAF is of the opinion that the tool to be used by all insurers as of January 2024, the OLUtool, is not adapted to the specific characteristics of rare diseases and orphan drugs. Additionally, mandatory price cuts could delay access to treatment for patients with rare diseases, who are often facing a lack of therapeutic alternatives.
Read the RDAF full statement here.