Dr René Buholzer, CEO of Interpharma, covers Switzerland's healthcare advancements, regulatory progress, and the challenges in drug access and digitalization over the past three years. Emphasising collaboration and innovation, Interpharma’s 'Pharma Strategy 2030' aims to solidify Switzerland’s leadership in R&D and healthcare sustainability.
What have been the key developments in Switzerland’s healthcare and pharmaceutical sectors?
Over the past three years, Switzerland has maintained a strong global position in healthcare, particularly when compared internationally. Our healthcare system has proven resilient, especially in the aftermath of the COVID-19 pandemic. For example, Switzerland continues to rank second in global life expectancy, a testament to how effectively we managed the crisis. From an economic standpoint, Switzerland’s GDP also remained stable throughout the pandemic, highlighting our overall economic strength. Initially, Switzerland was criticized for not having a major vaccine producer, but within a year and a half, we became the fifth largest global vaccine producer. This shift was due to the strength of our R&D and manufacturing platforms. Companies like Roche and Lonza played pivotal roles, with Roche leading in diagnostics and Lonza manufacturing the Moderna vaccine. This adaptability reflects the resilience and expertise of our industry, which allowed Switzerland to quickly become a key player in the global pandemic response.
In terms of regulatory progress, Swissmedic has worked towards becoming a first-wave agency, meaning it aims to approve medicines as quickly as larger regions like the European Medicines Agency (EMA). Last year, Swissmedic even surpassed EMA in terms of approval times. While there was a slight slowdown this year, our approval processes remain among the most efficient globally. This demonstrates that, despite being a small country, Switzerland competes at a high level internationally. Additionally, our healthcare system has shown strong capacity for recovery. What I sometimes refer to as the ‘repairing system’—the ability to address illness and ensure access to treatment—continues to perform well. However, challenges remain, particularly in the reimbursement processes for innovative drugs and securing consistent supply chains for pharmaceutical products.
On the topic of digitalization, we’ve made significant progress, particularly on the legal front. In 2021, we implemented several projects that set the stage for a more digital healthcare system. However, much of this progress remains theoretical, and we need to see these changes translate into real-world improvements. The groundwork is there, but it will take time before the full impact is felt across the healthcare and pharmaceutical industries.
How has Switzerland’s stance on intellectual property (IP) evolved?
Switzerland has been a staunch defender of intellectual property rights, particularly during the World Trade Organization (WTO) negotiations regarding pandemic waivers. Switzerland stood out as one of the few nations to uphold the importance of protecting IP, a cornerstone for the research-based pharmaceutical industry. During these negotiations, we saw the US, UK, and other traditionally strong players remain relatively quiet, but Switzerland took the lead in ensuring that IP remained protected. This was a significant moment for the country, and we invested considerable time and effort alongside the Swiss government to advocate for this critical issue.
Beyond intellectual property, Switzerland continues to be recognized for its pharmaceutical leadership. The country has made notable strides in maintaining a strong research and development (R&D) platform and ensuring that the pharmaceutical industry remains competitive globally. Nevertheless, we face some challenges in drug access and reimbursement, particularly with new medicines. Our research highlights that Switzerland has started to slip in terms of the full availability of medicines on the Swiss Special List (SL), and reforms to the SL process have not been as effective as we would hope.
How is Interpharma helping further support the Swiss pharmaceutical sector?
At Interpharma, we remain committed to our Pharma Strategy 2030, which we revised after the COVID-19 pandemic. This strategy is built on three fundamental pillars: putting patients at the centre, maintaining Switzerland’s leadership in research and development (R&D), and ensuring a strong economic framework to support our capital-intensive pharmaceutical industry. The strategy was designed to serve as a cornerstone for a broader life sciences agenda, with a clear vision for Switzerland to remain a European leader by 2030. We’ve identified ten key areas that require attention, from fostering innovation and protecting intellectual property to developing robust health data ecosystems and improving clinical research. Some of the more general challenges, such as maintaining open markets and addressing our ongoing relationship with the European Union, are also crucial for the industry’s continued success.
A recent concern has been Switzerland’s approach to the OECD tax reform, where we feel the country aligned too closely with the EU’s direction. More broadly, the Swiss government needs to recognize the strategic importance of having a strong pharmaceutical sector, not only from a healthcare perspective but also from an economic policy standpoint. Other countries, such as Germany, the UK, and Japan, have already implemented forward-looking strategies to bolster their pharmaceutical industries. In Switzerland, the urgency is less pronounced because we managed the COVID crisis well, but it’s essential that we don’t lose our competitive edge. Our goal is not just to maintain a strong pharmaceutical sector, but to create a cohesive life sciences agenda that keeps Switzerland at the forefront of global healthcare. We are working diligently at Interpharma to advance these priorities and ensure Switzerland continues to thrive in this critical industry.
What steps are being taken to improve Switzerland’s standing in clinical trials, given the country’s current performance in comparison to other European nations?
It’s true that despite Switzerland’s well-established reputation for excellence in research and development, particularly in clinical trials, we are currently underperforming compared to countries like Belgium, the UK, and Spain. With only 149 clinical trials conducted here out of the 1,874 across Europe, it’s clear that improvements are necessary. One of the main challenges we face is the lack of digital integration within the healthcare system. The decentralized nature of our hospitals and the absence of a cohesive digital infrastructure make organizing and conducting clinical trials more complex and costly. We’ve been working to address this by advocating for the decentralization of clinical trials, and while Swissmedic has given approval for this, until now the adoption rate has been slower than anticipated.
Switzerland’s high costs also present a hurdle, making us less competitive in attracting clinical trials compared to other nations. Additionally, patient recruitment is more challenging here due to the fragmented healthcare system. While our hospitals, particularly university hospitals, are of high quality, and our doctors are among the best, there is still a lack of dedicated resources for clinical research, especially in terms of staff and infrastructure.
To tackle these issues, we have initiated a project in collaboration with academia to strengthen Switzerland’s position as a leading research hub. The goal is to not only improve the current clinical trials landscape but also to foster closer partnerships between industry and academia. While the quality of our healthcare system provides a strong foundation, we must address the structural and digitalization challenges to enhance our performance in clinical trials. This effort requires a collective commitment from all stakeholders, including hospitals, universities, and government bodies.
What are the main challenges Switzerland faces in advancing healthcare digitalization, and how is the country working toward establishing a national health data ecosystem?
Switzerland has indeed faced challenges in advancing healthcare digitalization, and we recognize that we are somewhat behind in this area compared to other sectors. When we formulated our strategy, we understood that the foundation of any digital healthcare advancement would be a robust health data ecosystem. Before focusing on cutting-edge technologies like artificial intelligence, we prioritized creating a data infrastructure that could support innovation across the healthcare sector.
In 2021, we introduced a detailed roadmap aimed at building this ecosystem, which has since gained traction. However, we have encountered several obstacles, particularly in aligning national and cantonal laws, which often have differing frameworks. This lack of harmonization complicates the creation of a unified digital system. To address this, we’ve collaborated closely with academia and stakeholders to push for legislation supporting the secondary use of health data. This is critical not only for improving healthcare but also for advancing research.
Our involvement in the “DigiSanté” initiative, which aims to modernize Switzerland’s healthcare infrastructure, has been pivotal. However, resistance from various stakeholders, including concerns about data privacy and funding, has slowed progress. Many institutions understand the importance of digitalization but have hesitated due to the financial burden it imposes. There’s also been criticism of the digital patient dossier, which has been seen as ineffective. Without a fully integrated system to facilitate data sharing, these tools offer limited value.
While we’ve laid a solid foundation, we remain far behind countries like Denmark, which began building similar systems over a decade ago. That said, the necessary legal frameworks are now in place, and we’re optimistic that with stronger governmental leadership, we can accelerate progress. Creating a national health data ecosystem is essential for the future of healthcare in Switzerland, and we are committed to ensuring this system is fully realized.
How is Interpharma working to address delays in patient access to new medicines?
The delays in patient access to innovative medicines in Switzerland have become a significant concern. Despite the legal requirement to approve reimbursement within 60 days after Swissmedic grants approval, the current median wait time has extended to 301 days. This is a clear indication of a systematic issue that is directly impacting patient care. At Interpharma, we have been actively addressing this challenge through various initiatives.
One of our key proposals is the Rückvergüteter Innovationszugang (Reimbursed Access for Innovation). This approach would allow new medicines to be provisionally reimbursed with a temporary price immediately upon Swissmedic approval, ensuring that patients do not face unnecessary delays. The final price would then be negotiated over a longer period, up to two years, providing more flexibility in the pricing process. This model is inspired by a similar system in Germany but offers a more generous framework, as companies would be required to pay back the difference between the provisional and final price. This proposal has been included by the Swiss Parliament in the Kostendämpfungspaket 2 (Cost Containment Package 2), but its progress has been slowed by debates surrounding the specifics of how provisional pricing would be managed. We are hopeful that these issues will be resolved because, fundamentally, this proposal prioritizes patient access without forcing them to bear the burden of administrative delays.
What efforts are being made to modernize the pricing system for medicines in Switzerland, and how does Interpharma aim to balance access and cost control?
Alongside addressing procedural delays, Interpharma is advocating for a broader modernization of the pricing system for medicines in Switzerland. The current system, which bases prices on a combination of foreign market comparisons and therapeutic value, lacks transparency in how comparator products are chosen. This has led to inconsistencies in pricing decisions, and we believe this process should be guided by clinical expertise to ensure a fair and accurate evaluation of new treatments. We are also pushing for a more practical benefit-value assessment, which would take a holistic view of the treatment’s impact—both on patient outcomes and on the healthcare system as a whole. This approach would provide a more balanced perspective, moving beyond a narrow focus on cost containment to consider the true value of innovation.
In parallel, there has been discussion about introducing volume-price models to control costs. Given the current pricing challenges, introducing volume-based pricing could further discourage the launch of new medicines in Switzerland, which is already seeing fewer drugs introduced compared to other countries. The ultimate goal is to strike a balance between ensuring timely access to innovative therapies and maintaining cost control. Over the past few years, the focus has been too heavily on cutting costs, often at the expense of improving access. Switzerland has one of the highest life expectancies globally, which reflects the quality of our healthcare system. However, maintaining this level of care requires a balanced approach, one that does not sacrifice access to cutting-edge treatments in the name of cost savings in a silo alone.
How does Interpharma foster collaboration among key stakeholders in research and development, and what initiatives are driving innovation in Switzerland?
At Interpharma, collaboration is fundamental to driving research and development. We strongly support the cluster model, where industry, academia, and government work together to stimulate innovation. Switzerland benefits from world-class universities, research institutes, biotech startups, and multinational pharmaceutical companies, and our goal is to connect these entities to enhance R&D efforts. We actively engage in joint platforms that bring academia and industry together. For example, I serve on the board of Switzerland Innovation, a network of innovation parks aimed at fostering collaboration between startups, universities, and businesses. One other significant initiative we support is the Swiss 3R Competence Centre (3RCC), which focuses on reducing, replacing, and refining animal testing, an important aspect of preclinical research. We also maintain direct partnerships with institutions like ETH Zurich and the University of Basel, where we collaborate on projects aimed at advancing health economics and R&D. Additionally, I chair the board of the Swiss Institute for International Economics and Applied Research at the University of St. Gallen, which helps strengthen the bridge between academia and the pharmaceutical sector.
Beyond these direct collaborations, we participate in multi-stakeholder platforms, which connects academic researchers with industry players to advance cutting-edge research. Through Gensuisse or Forschung für Leben (Research for Life) initiative, we promote the importance of research in healthcare, emphasizing the value of data or responsible animal testing as part of scientific advancement. Another key initiative is SanteneXt, which focuses on digital innovation and value-based healthcare, aiming to advance the overall healthcare system.
We are also committed to shaping the future of healthcare through thought leadership. Our annual Salon Santé event brings together a diverse group of experts to discuss emerging trends. Recently, we explored the concept of “prevention as a service,” focusing on the role of predictive medicine and the potential of new treatments to prevent diseases like obesity and associated chronic conditions. Lastly, we are putting significant emphasis on Switzerland’s role as a leading hub for pharmaceutical production. The pharmaceutical industry accounts for almost 40% of Swiss exports, yet its contribution often goes unrecognized. We have launched initiatives to highlight the modern, technologically advanced nature of pharmaceutical manufacturing, which requires specialized skills and cutting-edge facilities. This broader view of the pharmaceutical industry, encompassing not just drug pricing but also production and innovation, is key to understanding its true impact on both the Swiss economy and global healthcare.
What is Interpharma’s strategic vision for the future, and how do your guiding principles influence Switzerland’s healthcare system?
Our strategic focus remains anchored in the *Pharma Strategy 2030*, which continues to be highly relevant for guiding our actions. While this strategy is centered on the pharmaceutical sector, it has the potential to evolve into a cornerstone of a more comprehensive life sciences strategy. However, we are cautious to avoid it being interpreted as mere industry policy. Instead, we aim to refine the framework conditions that support the healthcare and pharmaceutical sectors in Switzerland, particularly given the competitive landscape emerging from Asia, Europe, and the U.S.
A key aspect of our vision is adopting a holistic view of the healthcare system. Medicines are undoubtedly essential, but they must operate within a strong and sustainable healthcare structure. The COVID-19 pandemic has underscored the importance of a well-functioning system. It is not just about drug innovation; it is also about ensuring that the system as a whole remains robust and responsive. This requires a focus on patient outcomes and sustainability, both financial and operational, across the entire healthcare ecosystem. We have distilled our approach into seven core principles, one of which is moving beyond a purely cost-focused view of healthcare. Rather than looking at healthcare through the narrow lens of expenses, we emphasize the broader benefits that innovations can bring, such as reducing the need for hospital stays by providing better treatments. For instance, a study by Frank Lichtenberg from Columbia Business School highlighted how innovative medicines have saved millions of Swiss francs by reducing hospital stays, a direct benefit to both patients and the healthcare system. Another priority is enhancing digital infrastructure. For healthcare to evolve, we need reliable data to measure patient outcomes and improve the quality of care. Currently, Switzerland lags in this area, and we are advocating for the development of a robust digital healthcare ecosystem to support advancements in patient care.
Innovation is at the heart of our strategy. Switzerland must continue to lead in research and development (R&D), and we remain committed to ensuring that the conditions for innovation remain strong. Our members invest CHF billion annually in R&D in Switzerland alone, and this level of investment must be sustained by ensuring strong intellectual property protection, open markets, and a regulatory environment that fosters innovation. Equally important is ensuring that these innovations reach patients in a timely and equitable manner, preventing the development of a two-tier healthcare system. We are also placing greater emphasis on prevention and health literacy. There is considerable untapped potential in prevention, both in improving health outcomes and reducing long-term healthcare costs. Countries like Norway and Sweden, for example, outperform Switzerland in terms of healthy life years after retirement. This highlights the need for a more comprehensive national prevention strategy, something that Switzerland currently lacks. We believe that by investing in prevention, we can enhance the quality of life for our aging population and reduce healthcare burdens.
Finally, securing the supply of both new and established medicines remains important. Recent discussions in Switzerland and the EU have brought this issue to the forefront, and we are working closely with the government to ensure that policy measures are put in place to maintain the availability of essential medicines. This, along with our focus on prevention and innovation, forms the backbone of our strategic vision for the future of healthcare in Switzerland.
