Facts
In September 2006, the company P. AG applied for the inclusion of the medicinal product Champix with the active ingredient Varenicline in the Specialty List (SL) for the indication "Smoking cessation in adults". The Federal Office of Public Health (FOPH) rejected the application in 2008, as the effectiveness, appropriateness, and cost-effectiveness of the service had not been proven. The appeal of P. AG against this decision was dismissed by the Federal Administrative Court in 2010, as nicotine dependence is not an independent, treatable disease.
Considerations
The Federal Supreme Court overturned the decision of the Federal Administrative Court and remanded the case to the FOPH for re-evaluation. It concluded that nicotine dependence is generally to be considered a disease within the meaning of the Health Insurance Act, provided that it requires treatment. The FOPH must now, in consultation with the Federal Commission for General Services and Fundamental Issues, determine the conditions under which the need for treatment of nicotine addiction and thus its disease value is to be affirmed.
Furthermore,…