Switzerland: Swissmedic Approval and Specialty List Rules for GLP-1 Weight-Management Drugs

Switzerland separates market authorisation from insurance coverage. Swissmedic decides whether a medicine may be sold and for which indications, while the Federal Office of Public Health (BAG/OFSP) decides whether mandatory basic health insurance pays for it by listing it on the Specialty List (Spezialitätenliste), often with a detailed 'limitation' attached. For GLP-1 weight-management drugs, that limitation is where most of the practical rules sit.

According to the BAG's listing decision, Swissmedic approved Wegovy (semaglutide) on 15 February 2022 for weight management in adults with a BMI of 30 or more, or 27 to under 30 with at least one weight-related condition. Swissmedic's public summary report states that Mounjaro (tirzepatide), first approved for type 2 diabetes in November 2022, received an extended indication for chronic weight management on 9 July 2024, using the same BMI thresholds.

The BAG added Wegovy to the Specialty List from 1 March 2024, with a limitation that runs until 28 February 2027. Mounjaro's listing was extended to weight management from 1 January 2026, limited until 31 December 2027. In both cases, the published limitation restricts coverage to adults with a BMI of 35 or more, or 28 or more with prediabetes or type 2 diabetes, hypertension, or dyslipidaemia, alongside a documented 500 kcal-per-day deficit diet, nutritional counselling, and increased physical activity.

The texts also require prior cost approval from the insurer after consulting its medical adviser, prescribing and follow-up only by endocrinology/diabetology specialists or qualifying obesity centres, and stopping rules: treatment must end if patients miss set weight-loss thresholds at 16 weeks and again about six months later. Coverage is capped at a maximum of three years in total, including when patients switch between the listed products.

In a May 2025 letter to insurers, written before Mounjaro's weight-management listing, the BAG said that reimbursing Ozempic or Rybelsus for weight control under individual-case rules was unjustified, partly because it could reduce supply for diabetes patients. The same letter said prescriptions of Wegovy and Saxenda arising from online consultations did not meet the limitation's requirements, and that coordination through online services was excluded.

A Swiss patient can be prescribed an approved GLP-1 drug outside these criteria but should expect to pay privately. Anyone hoping for insurance coverage should check eligibility with a qualifying specialist or obesity centre and confirm cost approval with their insurer before starting. Because both listings are time-limited, the BAG's current Specialty List entries are the authoritative place to check for changes after the 2027 expiry dates.