Refusal to reimburse medicinal products in individual cases under Article 71a et seq. KVV
A marketing authorization holder contacted us due to a dispute with a health insurance company in connection with the reimbursement of medicinal products in individual cases based on Article 71a et seq. of the Health Insurance Ordinance (KVV).
A marketing authorization holder contacted us due to a dispute with a health insurance company in connection with the reimbursement of medicinal products in individual cases based on Article 71a et seq. of the Health Insurance Ordinance (KVV).
The health insurance company in question refused to reimburse a medicinal product that was used outside the indication listed in the specialities list (so-called off-label use) and demanded that the marketing authorization holder contribute to the outstanding costs.
In this context, the question also arose as to whether medicinal products that are used off-label can also be reimbursed in the outpatient sector on the basis of Article 71a et seq. KVV.
After various correspondence, we were able to reach an agreement with the health insurance company.
Experimental therapy
Swiss doctors have enquired with an international pharmaceutical company about the availability of a drug not approved in Switzerland for the treatment of a fatal disease as part of an experimental trial.
Swiss physicians contacted an international pharmaceutical company regarding the availability of a medicinal product not authorised in Switzerland for the treatment of a fatal disease. The product was intended for the treatment of a small number of patients for whom the available standard therapy was unsuitable or for whom all therapeutic options had been exhausted. We advised the company in order to enable the availability of the medicinal product in these cases.