Federal Supreme Court, Decision 9C_401/2020 of 5 March 2021
9 April 2021 – In this decision, the Federal Supreme Court had to assess whether the lower court violated federal law by confirming the therapeutic cross-comparison (TQV) carried out by the Federal Office of Public Health (FOPH). Thus, as part of the triennial review of the conditions for inclusion of the preparations listed in the specialities list, the FOPH had reduced the price of one of the appellant's preparations on the basis of the public price determined. The package size and dosage strength of the preparation used for the TQV were in dispute. Pursuant to art. 65d para. 3 of the Ordinance on Health Insurance (KVV), the TQV must be carried out on the basis of the smallest package and dosage. In contrast, the appellant denied valid comparability within the meaning of art. 65d para. 3 KVV and demanded that larger doses be used for the TQV.
However, the Federal Supreme Court was not persuaded by the appellant's argumentation and dismissed the appeal.
For the full decision, see here.