Vaccination at the insurer’s expense: the pharmacy becomes a firm pillar of prevention

A flu vaccination on the way home, a tick-borne encephalitis booster without a prior doctor’s appointment, or a check of vaccination status directly in the pharmacy: what is already possible in many places today is to be billable as standard through the basic insurance from 1 January 2027.

In June 2026 the Federal Department of Home Affairs (FDHA) decided to include prophylactic vaccinations by pharmacists in the catalogue of services of the compulsory health insurance (OKP). Both the vaccination itself and the associated vaccination counselling are to be reimbursed. The Confederation explicitly links this to the aim of simplifying access to vaccination services for adults and strengthening the role of pharmacies in primary care.

For Swiss pharmacies this is far more than a new billing option. The decision marks a shift in health policy: pharmaceutical services are no longer merely tolerated as a supplement, but increasingly recognised as a regular component of medical care.

What changes concretely?

According to pharmaSuisse, the new arrangement applies to people aged 16 and over. Vaccinations and the associated counselling can in future be provided directly in the pharmacy at the expense of the basic insurance, provided the legal and professional requirements are met.

The prerequisite for cost coverage is in principle that it is a prophylactic vaccination recognised by the OKP and that the respective conditions of the Health Care Benefits Ordinance are fulfilled. The recommendations of the Swiss vaccination schedule as well as any restrictions by age, risk group, indication or vaccination scheme therefore remain decisive.

The Confederation names in particular vaccinations against seasonal influenza and tick-borne encephalitis (TBE) as examples where a more accessible service could improve vaccination coverage.

Which vaccinations a pharmacy may actually offer, however, continues to depend on cantonal rules. The new financing through the OKP therefore does not automatically create a uniform Switzerland-wide vaccination authorisation.

Exempt from the deductible, but not entirely free

Since 1 January 2026, all protective vaccinations listed in Art. 12a of the Health Care Benefits Ordinance, as well as the associated vaccination counselling, have been exempt from the deductible. The statutory co-payment, however, remains.

From 2027 the decisive second step is now added: not only vaccinations provided by doctors, but also authorised vaccination services in the pharmacy are to be reimbursed through the basic insurance.

For insured persons this means that they no longer have to bear the costs entirely themselves. That does not necessarily make the vaccination completely free, though. Depending on the individual insurance situation, the statutory co-payment may still apply.

The distinction matters: exempt from the deductible does not automatically mean free of charge.

Why the decision matters so much for pharmacies

Pharmacies have been offering vaccinations for years. Nonetheless, customers frequently had to pay for the pharmaceutical service themselves. Reimbursement of the vaccine was also, depending on the situation, tied to additional conditions such as a medical prescription or particular insurance models.

There was thus an obvious unequal treatment: the same medically recommended vaccination could be reimbursed differently depending on where it was administered.

This financial hurdle has so far held back the potential of pharmacies. According to a population survey published by pharmaSuisse, around a quarter of the population has already been vaccinated or advised about vaccination in a pharmacy. 74 per cent of respondents stated that they would in principle, or rather, use a vaccination in the pharmacy if it were covered by the basic insurance without a medical prescription.

Demand is therefore likely to rise noticeably from 2027. What will be decisive is whether pharmacies can cope with this additional demand in terms of staff, space and organisation.

The pharmacy as uncomplicated access to vaccination protection

The pharmacy’s greatest advantage lies in its accessibility. Many locations have long opening hours, are situated in residential neighbourhoods, shopping centres or at transport hubs, and can offer appointments at short notice or vaccinations without prior registration.

According to pharmaSuisse, around two out of three Swiss pharmacies already enable vaccinations without a prescription and without prior registration.

Precisely for working people, people without a fixed family doctor and those who need a simple booster, this can make access considerably easier.

From a health policy standpoint the decision is therefore understandable. A vaccination that is not carried out because of high organisational or financial hurdles produces no preventive benefit. The closer the service is to people’s everyday lives, the more likely it is to be used.

The Confederation expects that the new arrangement will help avoid vaccine-preventable diseases and reduce severe disease courses.

Relief for medical practices – but not competing medicine

The expansion of vaccination services is sometimes discussed as competition between medical practice and pharmacy. In everyday care, however, it is likely above all to lead to a more sensible division of tasks.

Standardised vaccinations in healthy adults can in many cases be carried out safely and efficiently in the pharmacy. Medical capacity can thereby be used more for complex assessments, at-risk patients or unclear vaccination situations.

The pharmacy replaces neither medical diagnostics nor comprehensive medical care. Rather, it takes on clearly defined preventive services within its professional competences.

What is decisive is functioning triage. In acute illness, relevant allergies, previous severe vaccine reactions, pregnancy, immunosuppression or complex pre-existing conditions, it must be examined case by case whether vaccination in the pharmacy is sensible and permissible or whether a medical assessment is needed.

Cantonal differences remain

The biggest structural weakness of the new arrangement lies in the federal system. While the financing through the basic insurance is regulated at federal level, the actual vaccination authorisation remains determined by the cantons.

Differences may therefore continue to exist regarding:

• the approved vaccines,
• the age limits,
• the requirements for vaccinations without a medical prescription,
• the spatial and operational requirements,
• the notification or authorisation obligation,
• as well as the handling of particular risk groups.

Pharmaceutical continuing education alone does not automatically entitle someone to carry out vaccinations either. Pharmacists must fulfil the applicable cantonal requirements and hold the necessary official authorisation. pharmaSuisse additionally points out that those administering vaccinations need a corresponding certificate of competence as well as a valid, recognised BLS-AED certificate.

From a patient’s perspective the offering may therefore remain hard to understand. A person may receive a particular vaccination directly in the pharmacy in one canton, while different rules apply in the neighbouring canton.

Reimbursement will become more national from 2027. The actual vaccination offering remains federally shaped for the time being.

The tariff question is not yet fully resolved

The political decision in principle has been taken, but practical implementation requires a robust tariff basis.

pharmaSuisse and the insurers must determine how the individual components of the service are remunerated. These include, for example:

• checking vaccination status,
• history-taking and triage,
• counselling,
• preparation and administration of the vaccine,
• documentation,
• post-vaccination observation,
• as well as material, infrastructure and hygiene costs.

In June 2026 pharmaSuisse stated that the tariff bases would have to be worked out rapidly together with the health insurers so that Switzerland-wide cost coverage could actually be implemented by 1 January 2027.

For pharmacies this is a critical point. A new service is economically viable only if the remuneration adequately reflects the actual staffing and infrastructure costs.

If only the injection itself is paid for, but not the professionally necessary preparation and follow-up, underfunding threatens. An overly complicated billing process could in turn increase administrative effort and exclude smaller pharmacies from the offering.

The tariff therefore helps decide whether the reform leads in practice to a comprehensive vaccination offering or can mainly be implemented by larger, already well-equipped businesses.

New opportunities – but no sure thing

The new arrangement opens up several opportunities for pharmacies. Vaccinations can become a visible component of the service portfolio and strengthen the perception of the pharmacy as a health centre.

At the same time, vaccination services can be combined with further offerings, for instance:

• vaccination record checks,
• travel and prevention counselling,
• seasonal health campaigns,
• counselling on risk factors,
• or the structured approach to older and chronically ill people.

Economically too, an adequately remunerated vaccination service can be attractive. Unlike classic medicine sales, it rests directly on pharmaceutical expertise and personal care.

It does, however, require investment. Pharmacies need suitable counselling and vaccination rooms, trained staff, clear emergency procedures, adequate time slots, reliable documentation and adapted stock and appointment planning.

Added to this is communication with customers. Many insured people will initially not know which vaccinations are covered, whether they need an appointment or what costs remain despite the deductible exemption.

The pharmacy will therefore not only have to vaccinate, but also explain the new arrangement.

What pharmacies should prepare now

Only a limited window remains until entry into force on 1 January 2027. Businesses wanting to take up or expand vaccinations should check their prerequisites early.

Of central importance are in particular:

Authorisation and qualification: Are the necessary cantonal authorisations, certificates of competence and emergency certificates in place and valid?

Spatial requirements: Is a suitable area available that allows discretion, hygiene and appropriate post-vaccination observation?

Staff planning: Which employees carry out vaccinations, and how are these time slots integrated into everyday pharmacy work?

Documentation and billing: Are the systems ready to record vaccination counselling, vaccine, service and insurance data correctly?

Emergency management: Are emergency materials, procedures and responsibilities clearly regulated and regularly trained?

Communication: How are customers informed about the offering, eligibility requirements, co-payment and appointment options?

Anyone starting these preparations only at the end of 2026 could struggle to make full use of the new possibilities from day one.

A health policy milestone facing its test

The inclusion of pharmaceutical vaccination services in the basic insurance is a significant step for the profession. It confirms that prevention need not take place exclusively in medical practices and that the competences of pharmacists are to be deployed more purposefully.

The decision alone, however, does not yet guarantee successful implementation. Decisive will be a fair tariff, workable billing processes, sufficient qualified staff and cantonal framework conditions that are harmonised as far as possible.

If this succeeds, 1 January 2027 could become a turning point: from the pharmacy as an occasional additional vaccination site to a permanently established pillar of Swiss vaccination provision.

For pharmacies this means more responsibility, more visibility and the chance to further expand their place in primary medical care.