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HEALTH

Burnout on the rise among Swiss doctors

Almost 200 doctors sought help due to stress, anxiety and self-doubt in Switzerland last year – this figure is double that seen six years ago.

geneva university hospital
File photo of Geneva University Hospital (HUG) from 2014. Hospital doctors have struggled with a massive increase in workload as result of the pandemic. Photo: FABRICE COFFRINI / AFP

Professional exhaustion in the medical profession is on the rise, a spokesperson from the Federation of Swiss Doctors (FMH) told Swiss newspaper NZZ am Sonntag.

The Covid-19 pandemic significantly increased doctors’ workloads last year, particularly for those who work in hospitals.

More than half of the 1,500 doctors surveyed in a FMH poll this week reported that they “usually or frequently” experienced stress over the last year.

Some said they felt they could no longer meet the requirements of the job.

But the amount of work they have to do isn’t the only reason for the increase in burnout, which is around twice as common in doctors compared to other professionals.

A shortage of qualified staff is also contributing to the rising exhaustion rates, with hospitals struggling to fill empty posts.

This is particularly bad in rural areas where some establishments receive hardly any applications for vacant position.

Some clinics have to wait for months before they can hire someone and, in the meantime, other staff have to take on the extra work, irrespective of how heavy their workload is already.

According to VSAO, the Swiss Association of Junior and Senior Physicians, every second junior doctor is on duty longer than the 50 hours permitted each week.

And two out of every three doctors work more than the law allows.

It’s not surprising, therefore, that in 2021, a total of 189 doctors sought help from support network for doctors in crisis Remed, due to anxiety, depression, self-doubt or overwhelming workloads.This number has almost doubled since 2015.

Two out of every three of those calls were made by female doctors.

These are often conscientious, competent and sensitive women who are exhausted by their dual role of mother and doctor, ReMed psychiatrist Mirjam Tanner explained to the German-speaking newspaper.

They expressed admiration for colleagues who seemed to get things done so easily while they themselves felt incapable of being a good doctor.

But Tanner explained that just because male doctors were less likely to ask for help, that did not necessarily mean they were coping better, simply that they have a higher inhibition threshold when it comes to seeking advice.

Nor did the psychiatrist expect calls for help to decrease, noting that more people were aware of the ReMed service now and that more people were open to getting support.

And what about a solution? The FMH spokesperson said the only way out of the situation in the short term would be to reduce capacity – ie to close beds or even entire departments.

Longer term, they are calling for more doctors to be trained.

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HEALTH

Can you avoid high costs of medication in Switzerland by getting drugs abroad?

Most drugs, including generics, are quite a bit cheaper in other countries. But can you have your Swiss prescription filled abroad and bring the meds back?

Can you avoid high costs of medication in Switzerland by getting drugs abroad?

Not only are medicines more expensive in Switzerland than in many European countries, but their price continues to climb.

For original meds whose patents have expired, Swiss consumers now pay 14.3 percent more than patients abroad.

A year ago, the price difference was 10.8 percent, according to the health insurance association Santésuisse and the group for research-based pharmaceutical companies Interpharma . 

As has been the case for years, the price differences are particularly significant not only for brand drugs, but also for generics and biosimilars.

In a comparison with Germany, Austria, Belgium, Denmark, Finland, France, Great Britain, the Netherlands, and Sweden, the price of generics in Switzerland is 45.3 percent higher, while bio-similars cost nearly 30 percent more.

How is the price of drugs determined in Switzerland?

“The price of medicines covered by statutory basic medical insurance is not set on the open market but through complex state interventions,” according to Interpharma.

The prices of drugs that are reimbursed by the basic insurance are controlled by the Federal Office of Public Health (FOPH).

In order to determine the price of a medicinal product, the FOPH first considers the cost of therapy with products authorised to treat the same disease.

It then compares the prices of the same products in other countries with a pharmaceutical industry that is economically comparable to that of Switzerland’s.

The final price of drugs reflects Switzerland’s high-cost economy in general: research and development are more expensive in Switzerland than elsewhere, and production costs are higher as well.

Increasing healthcare premiums are an important factor as well.

And prices are set to increase even further. 

FOPH is adapting a new model for calculating the distribution margin. 

A distribution margin is the difference between the distributor’s cost of acquiring goods and the price at which those goods are sold.

From July 1st, 2024, inexpensive medicines whose factory price is less than, or equal to, 15 francs will become more expensive.

This change will affect more than half of medications currently being sold in Switzerland.

As a result of this move, “additional costs of several hundred million will be passed on to patients,” according to Intergenrika, which represents generic drug manufacturers in Switzerland. 

How much cheaper are medicines in neighbour countries?

Swiss-German news platform 20 Minuten compared the prices of some common drugs in Switzerland and Germany. 

For instance, painkiller Ibuprofen (400 milligrams, 20 tablets), costs €3.45 in Germany and 5.90 francs in Switzerland — a surcharge of 71 percent. 

A box of pantoprazole (a popular drug used to treat gastric reflux) is 12.95 francs in Switzerland compared to around 2.62 euros in Germany – a markup of 394 percent.

Similar price disparities also exist between Swiss drugs and those sold in France and Italy.

Can you import medicines to Switzerland to save money?

According to Switzerland’s drug regulatory agency, Swissmedic, people “may import a month’s supply of medicines into Switzerland for their own use but not for third parties”.

This rule is for both residents and tourists.

This means that you are only allowed to bring medications you will use yourself, and not sell them to others.

What about prescription medications?

While doctor’s orders issued within the European Union are valid throughout the EU, Switzerland is not covered by the agreement on recognition of cross-border prescriptions.

Therefore, pharmacists in neighbour countries — or elsewhere within the EU, for that matter — are not obliged to accept prescriptions from Switzerland.

You will have better luck in the UK, however,

From January 1st, 2021, a prescription issued in the EU, Iceland, Liechtenstein Norway or Switzerland can be dispensed in the UK if the prescriber is from a medical profession recognised in Britain.

Keep in mind, however, that names of drugs may be different there, so your doctor should write out the prescription accordingly.

Yes, but will your Swiss health insurance pay for the medicines you purchased abroad?

According to FOPH, “the costs will only be reimbursed for medicines that you require because of illness during a temporary stay abroad.”
 
If, on the other hand, you bring in meds for use while in Switzerland, then you must pay for them out of your own pocket.

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