Access to Remicade in Switzerland

Family, Education, Health and Pets
1
Hi!

I have Crohn's Disease and have been taking Remicade to for some years now to have the illness under control.

Turns out I've been offered a job in a swiss company, but I cannot even consider the offer before having high confidence (or even sure) I'll be able to keep under Remicade when moving to Switzerland.

Does anyone knows whether a foreigner with the proper permit/visa can have access to Remicade through the swiss healthcare system? I've been told any swiss citizen has to pay a healthcare insurance plan and even the basic plan would provide access to basically any drug prescribed by a doctor. Is that correct?

Any help/clarifycation here is very much appreciated. Thanks!

2

Welcome to the forum and hopefully to Switzerland soon.

From what I can see with a bit of googling it is available here. Any resident in Switzerland, not just citizens, must have at least basic health insurance cover from a recognised Swiss health insurance company. Pre-existing conditions must be covered under the basic health insurance so yes, costs would be mostly covered.

I say mostly because the Swiss system works like this. When you choose your medical cover you choose a franchise. This can be from 300 to 2,500 francs. This franchise is what you have to pay out of your own pocket before the health insurance kicks in to pay medical costs. So in your case it would be best to choose a low franchise - 300 or 500. This means your premiums will be a bit higher than someone who chooses a 2,500 franchise.

Once your franchise is used up there is then another part of the equation - the part-quote it’s called in French. Basically it means you pay 10% of the next 7,000 francs of medical costs while the insurance company pays the remaining 90%. If/when you get past that point then the insurance company picks up the whole tab.

All of this resets at the start of a new year so you’d be back to paying the franchise, then the part-quote from January.

Obviously if someone is healthy the higher franchise for lower premiums is the way to go, but it’s not worth it in your case.

As an example we have a 500 franchise and my husband needs expensive medication that costs just under 4,000 francs for a 3 month supply. So effectively for a large part of the year he pays nothing since he’s used up both his franchise and his part-quote.

You can use this site to play around with figures and look at the various options for health insurance plans.

https://en.comparis.ch/krankenkassen/default

Supplemental insurance is things like a private room in a hospital if you need to go to one, dental cover, etc. If you need special treatments for your Crohn’s then you may need to see if it falls under supplemental because it may not be covered by the insurance companies here since they can refuse supplemental coverage, unlike the basic which they must give you.

If you do decide to accept the job offer then get a prescription for the medication from your doctor to bring with you and make sure it has their contact details just in case your new doctor here wants to contact them. Also bring any medical records you can get hold of.

3
That is partially correct. It is any Swiss resident (safe some exception) not citizen. And yes the basic mandatory plan gives you insurance covered (minus deducible and co-pay) access to a lot of drugs. Those drugs are listed on the so called Spezialitätenliste SL ( http://www.xn--spezialittenliste-yqb.ch/ ) The SL those not only list the drugs, but also its intended applications. Off-label use is normally not covered by the basic health insurance.

Now to the most important part: Remicade is on the SL, and M. Crohn is listed as a intended use case.

https://compendium.ch/product/81983-...ckensub-100-mg

As a 100mg bottle is CHF 830.90 it might make sense to sign up for the lowest franchise.

4
...and as an additional reassurance, Remicade (infliximab) is on the list of medications that 3rd year med students have to learn....which means it's relatively commonly used and not an "only in special cases" medication

5
To complement the excellent tutorial given on the Swiss health insurance system, if you have a chronic condition, you are almost certainly going to be best off with a 300 CHF franchise. In my case I have diabetes and the cost of my insulin pump, consumables and insulin alone comes to a little under 5000 CHF per year. Add to that doctor's visits, lab tests and other medication, it's quite a lot more.

Essentially with a 300 CHF franchise, you pay the first 300 CHF yourself, then 10% of the next 7000 CHF, so 700 CHF. That makes a total of 1000 CHF you pay yourself, the rest is all covered by the basic health insurance.

In general you have to pay the various bills yourself and then recover them from the health insurance, but some health providers will bill the insurance directly, which will bill you back if necessary.

It may sound that "basic health insurance" is, well, basic. However its coverage is very broad and many people don't have any supplemental insurance. The basic health insurance is very heavily regulated, whilst the supplemental insurance is not and is only covered in the same way as any other private insurance you might have (including the right of the company to accept you as a risk or not, for example).

6
To expand on this, with a CHF 300 deductible and depending on your age and canton of residence (the cost varies with age and canton) you will probably be paying CHF 400-500 per month for your health insurance. So at the top end, you will be paying CHF 6'000.- for the health insurance per year, CHF 300.- +10% for the deductible and co-pay cost, plus up to CHF 700.- for the rest of you medicine/doctor visits during the year. All that to say, your contribution to the "cost" will be over CHF 7'000.- per year.

7

Still if the cost of the medication is in the range my husband’s, i.e. 4,000 every 3 months then that’s 16,000 just for that without all the annual checks, MRI, blood control tests and follow ups with the doctor needed. I’ve no idea how long a 100mg bottle of Remicade might last the OP, but I’m suspecting not that long. If it lasts a month at 830.90 then that’s 9,970.80 without all the other stuff.

8
Correct but s/he has a top end cost of +/- 7'000.- (based on age and plan). S/he may consider that to be too much based on what they are paying today and salary that has been offered.

9
I've received Remicade for nearly 10 years for Ulcerative Colitis(it's typically administered every 7/8 weeks as an infusion over 2/3 hours in an hospital).

You should be ok if it's already prescribed. The best thing is to talk to one of the health insurance companies before you arrive (I'm with SWICA and have always

found them helpful... also if you're coming to join a big company they may already have a link set up with an insurance provider.)

It 'costs' around 4k chf per hospital visit which will be paid directly by your insurance company. But talk to them first about the best way to handle your premiums and deductibles.