Go directly to legislation of specific CAM therapies in Switzerland:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) - Other treatments
Legal and regulatory status
Following a referendum in 2009, complementary medicine was included in the Federal Constitution of the Swiss Confederation (Art. 118a BV): „Bund und Kantone sorgen im Rahmen ihrer Zuständigkeiten für die Berücksichtigung der Komplementärmedizin“. Core demands were the inclusion of certain CAM therapies in mandatory basic health insurance (‘Grundversorgung’) and establishing nationally recognised diplomas for non-medically qualified practitioners (see below).
CAM can be practised by physicians/medical doctors who have also completed medical specialisation (‘Facharzt’) and further training in complementary medicine, as well as by non-medically qualified practitioners. In general, regulation of the Swiss healthcare system is characterised by a federalized structure and the 26 cantons have a high degree of independence within the federal legal framework, which also applies to the provision of CAM.
All complementary medicinal products including herbal, traditional, anthroposophic and homeopathic products require marketing authorization. This applies to all medicinal products irrespective of whether they are available prescription-only or over-the-counter. Complementary and herbal medicinal products fall under the Therapeutic Products Act of the Federal Act on Medicinal Products and Medical Devices (‘Heilmittelgesetz’, HMG; SR 812.21) and the Ordinance on Simplified Marketing Authorisation of Complementary and Herbal Medicinal Products.
Governmental supervision of CAM practices
Federal law (Federal Health Act 1 January 1996) defines criteria for the medical profession including chiropractors; the Federal Law on Health Professions (Gesundheitsberufegesetz, GesBG), which includes osteopaths, regulates the training requirements, accreditation, practice and maintains the health care professional register.
Professional regulation of non-medically qualified practitioners of CAM was established in 2015, when the State Secretariat for Education, Research and Innovation (‘SBFI’) recognised two professional qualifications on a federal level. They are protected and registered in the Swiss Register of Professions (‘Berufsverzeichnis’):
- Naturopath, ‘Naturheilpraktiker’ (dt), ‘naturopathe’ (fr), ‘naturopata’ (it) in either Ayurvedic medicine, homeopathy, Traditional Chinese Medicine or Traditional European Naturopathy. The Organization of the Working Environment Alternative Medicine ('Organisation der Arbeitswelt Alternativmedizin Schweiz (OdA AM)' performs the federal examinations in alternative medicine.
- Complementary therapy practitioners, KomplementärTherapeut (dt), Therapeute complementaire (fr), Terapista complementare (it) can since September 2015 obtain a federal diploma through the Higher Professional Examination (‘HFP’). Currently (July 2019) 19 complementary therapy methods are recognised. The Organization of the Working Environment Complementary Therapy (Organisation der Arbeitswelt KomplementärTherapie (OdA KT) develops national standards for the higher vocational education and is responsible for the recognition of complementary therapy methods, accreditation of training, an equivalence procedure for practitioners as well as the selection of supervisors.
For medicinal products (including all complementary medicinal products) Swissmedic, the Swiss Agency for Therapeutic Products, ensures that the main authorisation requirements are fulfilled. For CAM products a simplified procedure is possible; the authorisation procedure depends on the composition of the particular medicinal product and its intended use. Swissmedic has also issued specific guidelines for Asian medicinal products.
Reimbursement status of CAM practices and medicinal products
CAM provided by physicians/medical doctors
The Health Insurance Act of 1996 regulates mandatory health insurance (‘obligatorische Krankenpflegeversicherung’, OKP), which covers some CAM methods provided by physicians and chiropractors.
Acupuncture, Anthroposophic Medicine, Traditional Chinese Herbal Medicine, Classical Homeopathy, Herbal Medicine/Phytomedicine provided by physicians are reimbursed through the compulsory health insurance (OKP). Physicians need to have completed medical specialisation (‘Facharzt’) as well as training in CAM; i.e. only treatments provided by physicians who have completed further training in conventional and complementary medicine are covered by the compulsory health insurance (OKP).
Reimbursement of other practices are restricted to supplementary insurances (“Zusatzversicherung nach dem Bundesgesetz über den Versicherungs-Vertrag”, VVG). Reimbursement depends on the respective health insurance plans concluded with an insurer on a voluntary basis.
CAM provided by non-medically qualified practitioners
Treatments provided by non-medically qualified practitioners are not covered by compulsory health insurance (OKP) but are restricted to supplementary insurances (VVG). Generally, insurers require practitioners to meet certain criteria in terms of training, experience and continuous education in order for a treatment to be reimbursed.
Most insurance companies require non-medically trained practitioners to be registered with the private registry of experience medicine (‘Erfahrungsmedizinisches Register’, EMR), which requests practitioners to comply with certain quality criteria.
Some insurance companies also reimburse non-registered AM practices, according to individual contracts. Other non-medical AM practices are paid out-of-pocket.
Reimbursement of medicinal products
CAM products registered by Swissmedic in a special list (‘Spezialitäten-Liste’, SL) are reimbursed under the OKP; others are reimbursed according to individual contracts with supplementary insurance providers (VVG) or paid out-of-pocket.
