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COVID-19

What to know about changes to free Covid testing in Switzerland

From January 2023, people in Switzerland will generally have to pay for Covid-19 tests. Here's a look at the changes.

People queue at a Covid test center installed in a street of Swiss capital Bern on September 17, 2021.
People queue at a Covid test center installed in a street of Swiss capital Bern on September 17, 2021. (Photo by Fabrice COFFRINI / AFP)

What’s happening?

The Swiss Parliament says that from January 1st 2023, the costs of Covid-19 tests will no longer be paid for by the government. 

It means that anyone who wants a Covid test will have to pay for it themselves. 

However, Covid-19 tests ordered by a doctor will be met by health insurance costs “provided the test is required to determine any further medical action,” the Federal Office of Public Health (FOPH) said in a statement.

“Such costs will also, however, be subject to the insurance’s deductible and copayment provisions,” said the FOPH. The test result has no influence on the reimbursement.

Why are the rules changing?

Since the early days of the pandemic, the Swiss government has been covering the cost of Covid tests – at least most of the time.

But testing is expensive – the government spent 2.1 billion francs on tests in 2021, and 1.6 billion this year up to the start of December.

“The continuation of reimbursement for tests that benefit public health would have cost around CHF 100 million in the 1st quarter of 2023, according to estimates by the FOPH, based on a 20 to 30 percent higher test volume than in the past weeks,” the FOPH says.

However, keeping tests free of charge could also lead to additional costs in other areas – such as a potentially greater burden on doctors’ practices and hospitals, the FOPH said.

What’s the reaction?

For infection specialist Jan Fehr, the end of free testing is happening at a bad time.

At the moment, it is difficult to keep track of which respiratory tract infections are having a significant burden on the health system with respiratory syncytial virus (RSV), influenza and Covid all circulating at the same time, he told Swiss broadcaster SRF.

“Charging for corona tests from January will lead to even fewer people getting tested and is currently incomprehensible from an epidemiological point of view,” said Fehr.

Santésuisse, the industry association of Swiss health insurers, urged the state to take over the costs of tests again if the Covid situation worsens in future. 

What else should I know?

According to the FOPH, Covid tests are possible in the same facilities as before, such as doctors’ surgeries, pharmacies, hospitals, retirement and nursing homes, as well as in test centres.

Despite tests not being free of charge unless a doctor has ordered them, vaccinations against Covid-19 will continue to be free for people in Switzerland in 2023.

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HEALTH

Switzerland tries slow-mo cannabis revolution

Switzerland, which pioneered prescription heroin and safe injection sites decades ago, is now experimenting with decriminalising recreational cannabis, with the drug now available in some Basel pharmacies.

Switzerland tries slow-mo cannabis revolution

“This is 1,000 times better,” said Paul, a 42-year-old resident of the northern Swiss city, as he picked up a package of cannabis from his local pharmacy.

After buying his drug of choice on the street from “weird people or criminals” for the past 25 years, Paul, who asked that his last name not be published, is taking part in a pilot programme allowing him to acquire it over the counter.

“People are happy, since they for the first time can buy it legally,” pharmacist Lucas Meister told AFP, showing off a stash of colourful packages containing various dried cannabis flowers and hashish-based products.

His is one of nine pharmacies that have been chosen to take part in the two-year pilot for the legal sale of recreational cannabis.

Thousands of people applied to take part in the trial, but Paul, who mainly uses the drug to treat his depression, was among just 400 chosen.

Not encouraging consumption

Cannabis is legal for medical use in the wealthy Alpine nation, but only in extreme cases, such as pain relief for cancer patients.

Low-potency cannabis can also be purchased legally for non-medical use, but only when it contains below one percent tetrahydrocannabinol (THC) – the
component that gets recreational users high.

And while more potent cannabis is illegal, carrying up to 10 grammes of more potent cannabis for one’s own consumption is not punishable by law.

But while there are already a few ways to consume the drug without risking run-ins with police, pressure has been mounting for legalisation.

Paul smokes at home cannabis with a vaporizer during a two-year pilot for the legal sale of recreational cannabis in Basel, on March 7th, 2023.

Paul smokes at home cannabis with a vaporizer during a two-year pilot for the legal sale of recreational cannabis in Basel, on March 7th, 2023. (Photo by Fabrice COFFRINI / AFP)

In 2021, around 70 percent of the population favoured liberalising the laws, up from 58 percent three years earlier, according to the Swiss health ministry.

“We have to get out of the illicit cannabis framework, but ensure strict regulation,” said Barbara Broers, vice president of a federal commission on issues surrounding addiction.

“It is important that people have access to controlled and regulated products, but we are proposing to ban advertising and to have plain packaging, as with cigarettes in some countries,” she told AFP.

“This is not about encouraging consumption.”

Small steps

The Swiss government has opted for a small-steps approach, and authorised trials to take place over the coming decade.

In Basel, participants are aged 18 to 76, and the aim is to study “the effects of regulated cannabis sale… on mental health and on consumption behaviour,” Marc Walter, a psychiatry professor at the University of Basel and head of the study, told AFP.

So far, participants have been especially drawn to “products with a very high level of THC,” he said.

The five-gramme packs that Meister keeps in his pharmacy safe contain products with THC levels ranging from 4.5 to 20 percent.

They are priced at between eight and 12 Swiss francs ($8.70-$13) per gramme, depending on the THC level, in line with black market pricing.

The pricing level was very deliberate, according to Marc Brungger, an executive at the Swiss company Pure Production, which is producing cannabis
for the Basel trial.

“If prices are too low, people would try to resell the product, and if they are too high, they would turn to the black market,” he told AFP.

Other major Swiss cities, including Zurich, Geneva and Lausanne, are planning to launch similar trials.

‘Pure and organic’

In Basel, Paul said he is thrilled to leave street dealers behind and to finally know with certainty what he is getting: “Pure and organic cannabis”, grown in Switzerland and quality-guaranteed by the Swiss authorities.

“I want to consume cannabis, not chemicals made in China,” he told AFP, voicing horror at the arrival on the street of synthetic cannabinoids – laboratory-made molecules that mimic the THC effect.

The marketing specialist said it was a shame Switzerland had not taken a more direct route to legalisation, as in some US states, Canada and Uruguay.

But Walter said he was happy “Switzerland has chosen another route”.

“As a scientist, I prefer that.”

Frank Zobel, head of Addiction Switzerland, agreed, pointing out that taking things slow and steady to see how the population responds was a very Swiss approach.

That model proved itself in the 1990s, he said, noting how Switzerland had slowly introduced prescribing heroin for medical use.

“There too, there were four years of pilot trials, and today it is a treatment that is covered by medical insurance,” he said.

By Agnès PEDRERO

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