Weight-loss medications and Swiss health insurance: Who should pay?

Against this backdrop, Deloitte carried out a survey of the views of people in Switzerland about weight-loss medications and in particular their financing. The results offer key insights for health insurers and policymakers, and for public debate.

Three messages stand out:

1. Use of these medications is currently moderate but growing, the potential market is substantial.
2. Public opinion on co-financing of such medications is not yet fully formed.
3. There is clear resistance to unconstrained coverage by mandatory health insurance.
    

Limited uptake today: Significant potential tomorrow

At first glance, public appetite for weight-loss medications is modest. Roughly two-thirds of respondents to a survey conducted by Deloitte state that they would not consider using them. For many people, lifestyle changes remain the preferred path to weight loss; others are concerned about side-effects or the long-term impact.

At the same time, use of these medications is growing, and it is no longer a marginal phenomenon. Around 5% of respondents either currently use or have previously used a weight-loss drug. About 5% more are actively considering doing so in future. If this ’interested’ group were to move from intention to action, the potential market would be substantial.

Co-payments: Uncertainty continues to prevail

When respondents were asked whether they would be willing to contribute personally to the high costs of these medications, there is considerable uncertainty. Around one person in three is undecided or prefers not to comment. For insurers and policymakers, this lack of clarity matters: it suggests that public opinion is still forming and can be influenced by how the debate is framed.

Clear scepticism towards unconstrained mandatory health insurance funding

On one point, however, public opinion is clear. An overwhelming majority of respondents reject the idea of unrestricted coverage of weight-loss medications by mandatory health insurance:

• Around 95% do not support unlimited funding through mandatory health insurance.
• Roughly one in three would even reject any financing of these drugs by mandatory health insurance.

This does not mean the Swiss public opposes support for severe obesity or serious comorbidities. Rather, it indicates concern about open-ended commitments that could push health insurance premiums higher for everyone. In a solidarity-based system, the boundaries of that solidarity matter.

What this means for insurers and policymakers

For health insurers, regulators and policymakers, even though the emerging picture is unclear, it calls for early, proactive action.
 

1. Quantify and stress-test the scenarios

Even if actual uptake remains lower than indicated by our survey, weight-loss medications could still become a significant cost driver. Insurers should model a range of demand and pricing scenarios, including:

• restricted coverage to specific medical conditions
• different levels of patient co-payment
• potential knock-on effects on other healthcare costs (e.g. diabetes or cardiovascular treatments).

Such scenario testing is essential for premium planning and for discussions with regulators and policymakers.
 

2. Design smart funding models, not ’all or nothing’

The survey results suggest that the public is open to differentiated solutions. Rather than a binary choice between full reimbursement and no reimbursement, possible options include:

• reimbursement combined with lifestyle programmes
• stricter medical criteria (e.g. BMI thresholds and comorbidities)
• caps on treatment duration
• tiered co-payments that reward proven medical benefit.

Thoughtful design can align individual preferences with the collective interest in a sustainable system.
 

3. Put prevention and lifestyle support centre stage

Weight-loss medications may offer important benefits for specific patient groups, but do not replace prevention, healthy nutrition and physical activity. For insurers, this is an opportunity to double down on prevention programmes, digital coaching and integrated care models that address the root causes of obesity.

If new medications are introduced without a strong prevention and lifestyle strategy, the risk of cost escalation increases – without necessarily improving long-term health outcomes.
 

4. Communicate transparently about trade-offs

Our survey also highlights a communication challenge. Many people are still uncertain about their own position and about the broader implications for premiums and solidarity. Insurers and policymakers should explain clearly:

• how different funding models would affect premiums over time
• which patient groups stand to benefit most
• how alternative options balance individual freedom of choice, medical need and collective affordability.

Open communication builds trust, especially when difficult choices are on the table.

A window of opportunity

Weight-loss medications will not disappear. On the contrary, more products and marketing efforts are likely. What is still unclear is how Switzerland will choose to integrate these treatments into its solidarity-based health system.

Our survey sends a clear message: now is the time to define sustainable funding rules, before usage and costs rise and the debate becomes even more polarised. With data-driven scenario planning, carefully designed co-payment models, and a strong emphasis on prevention, insurers and policymakers can help align innovation in weight management with financial sustainability.

The debate on who should pay for weight-loss drugs is ultimately a debate on the future of our healthcare social contract. It is a vital conversation, worth having early, fact-based and with all stakeholders involved.  

Authors

• Dr. Marcel Thom, Partner, Insurance Lead, Switzerland
• Monika Tschudi, Director, Insurance, Switzerland
• Nadia Stucki, Manager, Insurance, Switzerland
• Nicolas Himmelspach, Manager, Insurance, Switzerland