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Prescriptions & Pharmacy

Everything you need to know about getting, filling, and paying for prescriptions in Switzerland — including when you pay nothing and when you pay everything.

Key rule: Only medications listed on the federal Spezialitätenliste (SL) are covered by basic insurance. Everything else — including all over-the-counter products — comes entirely out of your pocket.

How prescriptions work

In Switzerland, your doctor writes a prescription (Rezept / ordonnance) either on paper or electronically. You take this to any pharmacy (Apotheke / pharmacie) to have it filled. Unlike some countries, there is no centralized national e-prescription system yet, although digital prescriptions are becoming more common.

Prescriptions are typically valid for a limited period. Standard prescriptions are valid for one month, while repeat prescriptions (Dauerrezept) for chronic conditions can cover up to one year of refills. Your doctor specifies the number of repeats allowed.

Pharmacy billing: Tiers payant vs. Tiers garant

How you pay at the pharmacy depends on the billing model:

  • Tiers payant (third-party payment): The pharmacy bills your insurer directly. You pay only your share (franchise/Selbstbehalt portion) at the counter. This is the most common model in Switzerland and is standard with most major insurers.
  • Tiers garant (guarantor payment): You pay the full price upfront and submit the receipt to your insurer for reimbursement. Some smaller pharmacies or certain insurers use this model.

Ask your pharmacy which system they use with your insurer. Most large pharmacy chains (Amavita, Sun Store, Benu, TopPharm) use Tiers payant with all major insurers.

The Spezialitätenliste (SL): what is covered

The Spezialitätenliste (SL) is the federal list of medications covered by basic insurance. It is maintained by the BAG (Federal Office of Public Health) and includes approximately 3,000 preparations. A medication must be on this list to be reimbursed.

  • Your doctor and pharmacist can check the SL status of any medication.
  • If a medication is NOT on the SL, you pay 100% out of pocket — no insurance contribution at all.
  • Some medications on the SL have conditions (Limitatio) — they are only covered for specific diagnoses or after other treatments have failed.
Pro tip: You can search the SL yourself at spezialitätenliste.ch or via the official BAG list to check whether a medication is covered before your appointment.

Generic substitution: save with generics

Swiss pharmacies are required to inform you about generic alternatives when they exist. The financial difference is significant:

  • Generic medication: You pay the standard 10% Selbstbehalt (after franchise).
  • Brand-name medication when a generic exists: You pay a higher 20% Selbstbehalt if you insist on the brand version.
  • Brand-name with no generic available: Standard 10% Selbstbehalt applies.

Your doctor can indicate on the prescription that a specific brand is medically necessary (e.g., for narrow therapeutic index drugs). In that case, the standard 10% applies even for the brand version.

Practical pharmacy tip: Always ask your pharmacist: "Is there a generic available?" You can also request that your doctor writes prescriptions using the active ingredient name (INN — international nonproprietary name) instead of a brand name. This gives the pharmacist flexibility to dispense the cheapest available equivalent. For ongoing medication, the savings over a year can be CHF 200–500+.

Over-the-counter (OTC) medications: not covered

Medications you can buy without a prescription are NOT covered by KVG basic insurance. This includes common products like:

  • Paracetamol and ibuprofen
  • Cough and cold medications
  • Vitamins and supplements
  • Allergy medications (antihistamines) — note that some require a prescription and are on the SL
  • Topical creams and ointments (unless prescription-only)

Some supplementary insurance plans cover a portion of OTC medications. Check your VVG policy if you have one.

Expensive medications and pre-approval (Kostengutsprache)

For high-cost specialty medications — particularly biologics, cancer drugs, and certain new therapies — your insurer may require a Kostengutsprache (pre-approval / prior authorization) before they agree to pay.

  • Your doctor initiates the Kostengutsprache request with a medical justification.
  • The insurer reviews and typically responds within a few days to two weeks.
  • If approved, the medication is covered under normal cost-sharing rules.
  • If denied, you can appeal through the cantonal arbitration board (Schlichtungsstelle).
Important: Never start an expensive specialty medication without confirming the Kostengutsprache is approved. If you start treatment before approval, your insurer may refuse to cover the costs retroactively.

Pharmacy hours and emergency pharmacies

Most Swiss pharmacies are open Monday to Friday 8:00 -- 18:30 and Saturday 8:00 -- 16:00. Sunday and late-night needs are handled by the Notfallapotheke (emergency pharmacy) system:

  • Every city and region has a rotating emergency pharmacy schedule.
  • Find the current emergency pharmacy by searching "Notfallapotheke [your city]" or calling your local pharmacy for a recorded message.
  • Emergency pharmacies may charge a surcharge (typically CHF 5 -- 15) for after-hours service.
  • At major train stations in cities like Zurich, Bern, and Basel, pharmacies often have extended hours (open until 21:00 or later).

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Independent guide — not affiliated with BAG or any insurer. Information is for guidance only. About this site