Switzerland is caught in the pharmaceutical trilemma: it wants access to new medicines at affordable prices and at the same time a flourishing pharmaceutical industry.
January 21, 2026, 1:51 p.mJanuary 21, 2026, 1:51 p.m
Florence Vuichard / ch media
Roche President Severin Schwan doesn’t waste much time. After a few words of praise for Basel as a pharmaceutical location, he immediately turns to the dangers that lurk for it. He is afraid that Switzerland’s strengths could turn into its weaknesses in this currently dramatically changing world. Namely the stability and durability.
“We would have to react quickly, but in Switzerland it takes forever to change something.”
Roche President Severin Schwan warns of Swiss weaknesses at the WEF in Davos.Image: keystone
Schwan naturally sees a great need for action in his industry, as he made clear on Tuesday morning at the panel organized by the Canton of Basel-Stadt on the local life sciences location on the sidelines of the WEF. And he leaves no room for doubt: Roche cannot ignore the pressure from the USA, the market is too big for the Swiss pharmaceutical company. The USA and China are the two most important markets for Roche, emphasized Schwan. Europe “only” accounts for around 18 percent of business.
So if the USA and China link their market access to local production, then the pharmaceutical companies have to adhere to this. At the laying of the foundation stone for a research and development building in Basel last October, Schwan spoke of “tectonic shifts that are underway.” And he let it be known at the time that, given the new framework conditions, Roche would hardly be able to invest as much in the Basel location in the future.
And even if Donald Trump introduces a reference price system under which the new drugs cannot cost more in the USA than in the cheaper comparison country, this will have unpleasant consequences for Switzerland. Because it belongs – albeit unintentionally – to the group of comparison countries chosen by Trump.
The price in Switzerland has side effects
This could mean that pharmaceutical companies will no longer launch their new medications in this country in the future, as pharmaceutical representatives have been warning for months. What sounds like a threat actually contains a real danger. Because of its business logic, no company will launch a drug at a comparatively low price on the relatively small Swiss market if it thereby indirectly lowers the price that it can achieve on the large and therefore lucrative US market.
Or to put it another way: No pharmaceutical company will allow its US business to be ruined by Swiss regulations and premium concerns. Neither do local companies. Helene Budliger, head of the State Secretariat for Economic Affairs (Seco), spoke on the podium of a “trilemma” in which three contradictory concerns had to be brought together: Firstly, health care costs should remain affordable for the population, which is already suffering greatly from the increasing burden of premiums. Secondly, according to Budliger, access to the latest medicines must remain secure, and thirdly, Swiss pharmaceutical companies should be able to continue to do good business.
Helene Budliger wants to solve the pharmaceutical trilemma.Image: keystone
Ultimately, the industry contributes a lot to Swiss prosperity. It has around 90,000 jobs, around a third of which are in the greater Basel area, as Basel District President Conradin Cramer emphasized. It is also the largest taxpayer in the country and is responsible for almost half of Swiss exports, making it the “export champion,” as Budliger put it.
A working group set up by the federal government is now supposed to solve the trilemma. She has started her work. It won’t be easy, said Budliger. The first results should be available at the end of the year. In Switzerland everything takes a little longer.