Benefits for drugs | Sanitas Krankenversicherung

Drugs & medicines

What should I bear in mind when buying drugs?

Buying medicines can be expensive, particularly if you take one or more medicines over longer periods. Health insurance benefits for the cost of medically prescribed drugs are mainly governed by law and leave little room for manoeuvre. Find out what share of the costs we pay here. Our money-saving tips help cut the costs of buying medicines.

Which drugs are covered by basic health insurance?

All drugs available on the Swiss market must be registered with Swissmedic. Before they reach the market, Swissmedic checks the drugs for effectiveness, quality and safety and approves them for a specific application. Basic insurance covers drugs on the list of pharmaceutical specialties (SL/LS) that are prescribed by a doctor and used in accordance with the approved indication or applied within a limitation specified on this list.

Drugs that are produced in a pharmacy for a specific person or specific group of persons (extemporaneous preparation) are also covered if the active and auxiliary ingredients are on the list of medicines with tariff (LMT). These products must also be prescribed by a doctor.

Which drugs are covered by supplementary insurance?

Sanitas covers the cost of medically prescribed drugs provided that the drug is registered with Swissmedic (Swiss Agency for Therapeutic Products) for the applicable illness. The applicable insurance conditions apply. These can be found here.

Excluded from cover are drugs covered under basic insurance or those included on the list of pharmaceutical products for special application (LPPV). Sanitas also keeps a list of uninsured drugs. This list is not exhaustive and is continuously updated by Sanitas.

Information on drugs used in alternative medicine can be found here.

What is a generic?

Generics are copies of brand name drugs whose patents have expired. They contain identical active ingredients in the same dosage as the original drugs and are available in the same form (tablets, capsules, suppositories, etc.). As the development costs for generics are low, these products are available more cheaply than original drugs. With a few exceptions for medical reasons, generics can be substituted for original drugs.

Find out whether your medication is available in generic form using the Sanitas generics finder (in German).

How high is the copayment for original drugs and generics?

In general, the copayment for original drugs is 20% and for generics just 10%. However, there are a few exceptions where the higher copayment for original drugs does not apply:

  • When there is no generic.
  • When a generic can’t be substituted for an original drug on medical grounds, the higher copayment is not applied. This must be confirmed by the doctor prescribing the medicine.
  • When the difference in price between the original drug and generic is less than 20%.

Why do I have to pay the higher copayment of 20% for my generic?

The higher copayment of 20% can also apply to generics. On 1 July 2011, the Swiss Federal Council passed a law on increased copayment for specific medicinal products. The copayment for drugs (original drugs and generics) is 20% when the price is at least 20% higher than the average of the cheapest third of drugs containing the same active ingredient.

Use the generics finder to find out whether you’re paying a higher copayment for your drugs.

Generics finder
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