The high-cost protection scheme for pharmaceuticals is an important part of Sweden’s healthcare system, designed to limit patients’ out-of-pocket costs for prescription drugs. Since 2012, public spending on pharmaceuticals has risen faster than patient co-payments, meaning the state now covers a larger share of costs, affecting the system’s long-term sustainability. The goal is to ensure effective, cost-effective and equitable access to medicines based on need, with sustainable financing.
The government’s proposal increases the cost ceiling for out-of-pocket payments from SEK 2,900 to SEK 3,800 over a 12-month period. It also raises amounts within the high-cost ladder at each step and adjusts the first step, requiring patients to pay 75% instead of 50%. This means individuals could pay up to SEK 900 more annually. The total increase in patient fees is expected to be SEK 540 million in 2025, SEK 2.16 billion in 2026 and SEK 2.7 billion from 2027. The changes will take effect on 1 July 2025.