Federal Supreme Court, Decision 9C_805/2019 of 2 June 2020

19 June 2020 – In a recent decision, the Federal Supreme Court held that the price of combination therapies that have already been authorised by Swissmedic but have not yet been listed on the SL and thus, in particular, have not yet been examined on the criterion of economic efficiency, cannot already be inferred on the basis of the maximum price applicable to the monotherapies of the drug in question. It is further explained that the cost-benefit ratio of a combination therapy is not comparable to the sum of the prices set for the monotherapies. The Federal Supreme Court refers the matter back to the health insurance company concerned, which will have to set a price with the marketing authorisation holders concerned on the basis of article 71 para. 2 Health Insurance Ordinance (KVV). For the full decision, see here.