US company provided kickbacks to doctors in Switzerland

Doctors were paid CHF10,000 per procedure performed. © Keystone / Gaetan Bally

US medical device company Nevro promised to pay doctors in Switzerland if they used the company’s pain relief implant according to reports from the SonntagsBlick.

According to a 2019 contract obtained by the German language paperExternal link, California-based Nevro, which specialises in the treatment of chronic pain in the trunk and limbs, offered Swiss doctors CHF10,000 ($10,181) for each Nevro spinal cord stimulator implanted in a patient.

Doctors that placed CHF800,000 worth of Nevro stimulators received CHF160,000 in exchange. The outpatient procedure typically costs CHF50,000.

Kickback schemes like this are considered a major driver of high healthcare costs because they create incentives for more office hours, more treatments, and more surgeries. The federal Therapeutic Products ActExternal link prohibits kickbacks for prescription drugs but medical devices such as implants, instruments or apparatus are not covered by the law. 

However, in March 2019, parliament passed an extension of the kickback ban to medical devices, which should come into force in 2023. In some cases, reimbursement or discount schemes are allowed if they are passed on to patients or insurers.

Starting this year, the Federal Office of Public Health has tightened its oversight of kickbacks, requiring that price discounts are shown in the accounts and disclosed to the health authorities if requested. Article 55 of the revised Act states that price discounts or refunds granted on medical purchases may be allowed, provided they have no influence on the choice of treatment.

The kickback scheme, which has now been terminated, has been running since 2017 under the auspices of the “Nevro Partnership Program”. A Nevro spokesperson told the paper, that the company tightened its discount policy last year and is now in line with Swiss legislation. “As a result, some contracts in Switzerland have been adjusted to meet new company standards.”