Switzerland taps medicine reserves over 100 times a year as funding dispute persists

Switzerland is drawing on its compulsory medicine stockpiles increasingly often, with more than 100 releases a year since 2022, compared with 17 in 2018. At a presentation in Burgdorf on Wednesday, representatives of the stockholding system and Switzerland’s national economic supply organisation explained how this safety net works — and where it faces pressure. Their assessment was reassuring on availability: reserves have always proved sufficient. How to fund them remains unresolved.

The issue affects medicine supplies across Switzerland. Shortages of antibiotics and painkillers have been a concern for years. Parliament is meanwhile debating the popular initiative “Yes to security of medical supply” and the Federal Council’s counterproposal. The question is not simply how to bridge an immediate shortage, but how to make supplies more resilient over the longer term.

A safety net inside a working warehouse

The Burgdorf warehouse shows how closely everyday distribution and emergency planning overlap. Millions of medicine packs are stored in a building covering an area equivalent to five football pitches and standing 15 metres high. Only a small proportion belongs to the compulsory stockpile. These reserves are intended for severe shortages and cannot simply be released for normal sale.

Alloga director Bernhard Megert illustrated the distinction with an example. If a warehouse holds 10,000 packs of a medicine, of which 3,000 form part of the compulsory reserve, 7,000 can be sold freely. Releasing the remaining 3,000 requires federal authorisation. What matters is therefore not just how many packs are available, but how many must be held back.

That separation protects supplies for an emergency. Authorising a release makes otherwise protected stock available to the market. It does not, however, replace production: once reserves have been used, replenishment still depends on medicines being manufactured and delivered.

Emergency releases become more frequent

The comparison with 2018 reveals how sharply demand on the system has risen. That year, compulsory stocks were released 17 times. Since 2022, the annual number has exceeded 100. Access to the emergency buffer is now needed far more often than it was just a few years ago.

Peter Huber, president of Helvecura, attributed the increase to the pandemic and armed conflicts. The cooperative coordinates the establishment of compulsory medicine stockpiles. Despite the additional strain, Huber said, reserves had always been sufficient. That is the reassuring part of the assessment: the system has so far fulfilled its purpose.

The number of releases alone does not reveal how many packs were required each time, or how long an individual shortage lasted. It is therefore not a direct measure of the overall scale of medicine shortages. It does, however, show that supplies depend much more frequently on a buffer designed for crises.

For patients, that distinction matters. Sufficient compulsory stocks do not mean that every medicine is available at all times. The reserves bridge severe shortages; they do not cover the entire range of medicines. Their success so far is good news, but it does not mean that all supply problems have been resolved.

Who pays for secure supplies?

For Huber, funding is the central point of contention. The costs of compulsory stocks of petrol, animal feed and food are passed on to consumers. With medicines, he said, regulated prices prevent that from happening. The industry does not accept this unequal treatment.

Several million francs are at stake. These are the costs of a precaution that is largely invisible in everyday life, but can become crucial when deliveries fail. The funding dispute is therefore closely tied to the question of how to sustain the safety net over time.

Roland Pfister, the delegate for national economic supply — Switzerland’s arrangements for maintaining essential supplies during severe shortages — expressed understanding for the concern. Finding a funding solution was in everyone’s interest, he said, and the federal government was working on it. No concrete agreement was announced. How costs should be shared in future remains open.

Dependence starts with the ingredients

Beyond stockholding, the origin of medicines remains a fundamental challenge. Urs B. Kientsch, a part-time official in the national economic supply organisation, highlighted dependence on Asia for older medicines whose patents have expired. Manufacturers of their active ingredients are concentrated there. A Swiss warehouse can cushion that dependence temporarily, but cannot remove it.

Kientsch sees one possible way forward in encouraging the return of the relevant manufacturing capacity to Europe, where it could supply the European market. For that to happen, policymakers would need to create suitable conditions. Such a shift would complement stockholding rather than replace it: production and reserves address different stages of the supply chain.

Switzerland therefore faces two tasks in parallel. In the short term, it needs reliably funded stocks that can be released during severe shortages. Over the longer term, it must consider how to reduce dependence on such a concentrated manufacturing base. The fact that reserves have worked so far does not settle either question.

Parliament’s deliberations on the initiative and the government’s counterproposal provide the political framework for that debate. Alongside those discussions, the federal government and industry still need to resolve the financing of compulsory stocks. The immediate challenge is to secure the future of a system that is already being called upon far more frequently than before.