Who supervises prescriptions and pharmacies?

Prescribing: responsibility and supervision

According to the Federal Office of Public Health (FOPH, German: BAG), physicians have been able to prescribe cannabis medicines, where medically indicated, without an exceptional authorisation from the FOPH since 1 August 2022 (Art. 8 para. 5 let. b BetmG). Responsibility for the treatment lies with the treating physician. Narcotics may be prescribed only to the extent required by the recognised rules of medical science, and prescribing otherwise is a criminal offence (Art. 11 para. 1 and Art. 20 para. 1 let. e BetmG).

Supervision is cantonal. According to the FOPH, cantonal physicians supervise compliance with the medical duty of care and can, in extreme cases, withdraw a licence to practise (Art. 12 BetmG; Art. 41 MedBG). The FOPH also states that the cantons can restrict the use of medicines exempt from authorisation within their enforcement powers.

The narcotics prescription form

Swissmedic supplies the official forms for the narcotics prescription (Betäubungsmittelrezept) to the cantons, which pass them on to physicians entitled to prescribe (Art. 47 para. 5 BetmKV). According to the cantonal pharmacists, pads are issued only to physicians with a valid licence to practise and activity in the canton (KAV position paper 0025).

Each form is numbered and carries a barcode, so that pharmacies can check whether it is valid or blocked (Swissmedic notice of 8 November 2017). Swissmedic also publishes a list of blocked forms, for example lost or stolen ones.

Pharmacies: the cantonal pharmacists

Cantonal pharmacists enforce federal and cantonal law on therapeutic products, in particular the Therapeutic Products Act and the Narcotics Act. They supervise pharmacies and other dispensing businesses, part of medical activity and the trade in medicines (KAV, job profile). Nationally, they coordinate through the Association of Cantonal Pharmacists (KAV), which publishes position papers, for example on medical prescriptions.

Each of our canton pages names the office that supervises medicines and narcotics in that canton; some cantons share an office.

Swissmedic and the FOPH

Swissmedic, the Swiss Agency for Therapeutic Products, is a public-law institution of the Confederation with its own legal personality. It authorises ready-to-use medicinal products, grants licences for manufacturing and trade, and is the licensing and control authority for narcotics, including cannabis for medical purposes (Art. 68 and 69 HMG; Art. 4 and 5 BetmG).

According to its own description, the FOPH is responsible for the health of the population and for Swiss health policy. In the cannabis field, it runs the MeCanna data collection, authorises pilot trials, which are non-medical studies separate from medical treatment, and grants exceptional authorisations for research outside the medical field (Art. 8 para. 5, Art. 8a and Art. 8b BetmG). MeCanna serves scientific evaluation and statistics; treating physicians record the data in pseudonymised form (Art. 8b and 18f BetmG).