BERN. Pharmacists in Zurich, Bern and Ticino will be allowed to treat a defined list of everyday complaints without a doctor's appointment from January, under a three canton pilot agreed on Wednesday by the cantonal health directors. The scheme is the most concrete response yet to a shortage of family doctors that has left some districts with waiting times of three weeks for a routine consultation.
The list is deliberately unglamorous: uncomplicated urinary tract infections, seasonal allergies, minor skin conditions, and the renewal of selected repeat prescriptions. Each case will be recorded in the patient's electronic record, and any presentation that falls outside the list will be referred. The Swiss Pharmacists' Association estimates that the four categories account for roughly 12 per cent of current GP visits in the three cantons.
Training is the condition that made the deal possible. Participating pharmacists must complete a cantonal certificate, covering diagnosis, red flags and documentation, before they can treat. About 280 pharmacies have already applied. The cantons will cap the first cohort at 200, to keep the evaluation manageable.
Doctors' associations have given the pilot a qualified welcome, which in Swiss health politics counts as enthusiasm. Their concern is not the principle, which they have supported in position papers for years, but the boundary. They want a review after twelve months, with the power to shrink the list if referrals back to practices rise rather than fall. The health directors have agreed to both.
Insurers are watching the tariff. A pharmacy consultation will be reimbursed at a rate below a GP visit, which is the point, and the difference is expected to save the compulsory insurance system an estimated CHF 40 million a year if the pilot is extended nationally. Whether that saving materialises depends on whether patients use the pharmacy instead of the doctor, or in addition to the doctor.
The shortage the pilot is meant to ease is not evenly spread. Urban practices in Zurich and Bern still take new patients. Rural districts in the same cantons, and much of Ticino, do not. The pharmacies that will matter most are the ones in those districts, and the cantons have weighted the first cohort accordingly.
Patients, for now, will notice little until January. Information campaigns are planned for November, timed to land after the premium letters, in the hope that a visible expansion of access will soften the annual argument about cost. “Patients notice the premium letter. Everything else is process,” a cantonal health director said.
The legal basis already exists in the Therapeutic Products Act, which allows cantons to extend pharmacists' dispensing and prescribing rights by ordinance. No federal legislation is required, a fact that has allowed the three cantons to move faster than the parliamentary timetable for a national scheme, which remains in committee.
If the evaluation is positive, the conference of cantonal health directors will recommend a national rollout for 2028. If it is mixed, the list will shrink and the argument will return to how to train more family doctors, a pipeline that takes a decade. The pilot is, in that sense, the shorter route to a problem that the longer route has not yet solved.