Switzerland’s health insurers are hiring extra staff—not to process claims for surgery or cancer care, but to handle a surge in requests for weight-loss injections, reported SRF.
A survey by SRF’s consumer programme Espresso found that such requests now account for up to a third of all reimbursement applications at several major insurers. At CSS, one in four of the 45,000 reimbursement claims for drug therapies in 2024 concerned weight-loss medications; by 2025 the share had risen to one in three. Helsana and Swica report similar proportions. Groupe Mutuel puts the figure at a quarter, and Visana at one in seven.
Insurers describe the wave of applications as a major challenge and administrative burden. Processing each case takes time, as requests must comply with the strict reimbursement criteria—known as limitations—set by the Federal Office of Public Health (FOPH). Helsana says many applications are incomplete, leading to time-consuming follow-up queries. KPT, another insurer, rejects numerous cases that fail to meet the rules, often prompting appeals from disgruntled clients.
To cope, roughly half of the ten largest insurers have added staff and streamlined their procedures. Most have introduced triage systems to prioritise urgent claims, such as those for cancer or other serious illnesses. All insist that emergency cases face no delays.
The industry group Prio Swiss wants the rules simplified. The criteria are not entirely clear, according to its spokesman. The FOPH should review and streamline the requirements. Several insurers have made similar pleas.
The health office acknowledges that the flood of claims creates extra work but says insurers are expected to assess applications properly. The criteria, it argues, ensure that obesity treatments remain high-quality, sustainable and cost-effective and help weed out ineffective therapies.
Even so, some tweaks may be coming. The FOPH says it is discussing a clarification of the wording of the current limitations with insurers, professional bodies and drug makers. It cautions, however, that any simplification must not expand coverage or compromise treatment quality.
The sums involved are growing as fast as inboxes. Prio Swiss estimates that insurers spent CHF 90 million reimbursing weight-loss injections in the first half of 2025 and expects the total to reach CHF 180 million for the year—up from CHF 143 million in 2024, CHF 120 million in 2023 and just CHF 23 million in 2022.
More on this:
SRF article (in German)
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