2,200 or 12,900 francs: why the same pacemaker costs so differently

Almost a month ago it struck: the bonus hammer. The perpetrators were quickly found: they were all people who ran to the emergency room or to a specialist because of every pee fax. Health Minister Alain Berset also took a swipe at these people.

The only problem is: these people are not the only cost drivers in healthcare. The ‘Tagesanzeiger’ has exposed the machinations of medical technology manufacturers – and how they make billions thanks to a ‘dark system’ and thus drive up healthcare costs.

According to the newspaper, these medtech manufacturers generate a turnover of 9 billion francs per year in Switzerland with the system. This corresponds to approximately 10 percent of the total costs of the Swiss healthcare system. By comparison, medicines make up about 11 percent.

And this is how it works:

The “Tagesanzeiger” tells the story using the Edora 8 DR-T, a pacemaker from the German manufacturer Biotronik.

The production of the Edora 8 DR-T costs less than 500 francs, experts confirm to the “Tagesanzeiger”. But local hospitals charged between 2,200 francs and 12,900 francs between 2018 and 2020 – a difference of more than 580 percent. According to health insurer CSS, an average of around 4,800 francs has been paid for the pacemaker over the past five years.

Explosive: The “Tagesanzeiger” wrote to twenty Swiss hospitals. Everyone kept the price a secret – only insiders revealed the prices.

Patrick Müller, buyer at Winterthur Cantonal Hospital, explains to the “Tagesanzeiger” how hospitals buy the medical products they need directly from the manufacturer. The price is “very different from that of medicines and is not regulated by the state”. This means: The price is a matter of negotiation between the hospital and the supplier.

How does this affect health insurance premiums? At least in the outpatient sector, hospitals receive the full amount reimbursed by the health insurer, according to the “Tagesanzeiger”.

Müller further tells the newspaper that hospitals have no interest in creating transparency in prices. An analysis of data from 2018 to 2022 by the “Tagesanzeiger” showed: “Biotronik Schweiz AG paid almost 5.6 million francs in this country, for example to dozens of hospitals. Including a university hospital that received more than 400,000 francs.” Biotronik did not want to answer the newspaper what consideration would be required for this.

The Swiss Medtech Association disputes this, saying the prices of specific products are not secret. This gives the hospitals the opportunity to exchange ideas with each other.

There is no official data “that would show how much the price differences for medical devices affect premiums,” the “Tagesanzeiger” continued. Nevertheless, he calculates how much savings potential there would be with pacemakers alone. About 8,500 pacemakers were implanted last year.

If the price differences between all manufacturers were comparable to those for the Edora 8 DR-T, more than 20 million francs could have been saved in 2020 alone. “And that only applies to one subcategory of medical devices, of which there are thousands,” said the “Tagesanzeiger”. And the newspaper is not the only one to come to this conclusion. The Federal Audit Office (SFAO) and the Federal Price Monitor have already found something similar.

(yam)