Since 1 July 2026, physicians in Switzerland can, for the first time, prescribe a digital health application at the expense of mandatory health insurance. What this milestone means for everyday clinical practice was the subject of the opening talk at the 3rd St.Galler Ärztesymposium, delivered by Prof. Dr. Tobias Kowatsch, Co-Chair of the Centre for Digital Health Interventions (CDHI).

On Thursday, 20 August 2026, the School of Medicine at the University of St.Gallen (HSG) hosted the third edition of its Ärztesymposium in the SQUARE building, welcoming primary care physicians from the region to an afternoon dedicated to pioneering developments in clinical practice, teaching, and health economics. At the invitation of Dr. med. Telemachos Hatziisaak, MME, Head of the Teaching Area for Primary Care and Family Medicine, Tobias Kowatsch opened the programme with his talk “Apps auf Rezept: Die ersten kassenpflichtigen digitalen Gesundheitsanwendungen sind da! Was nun?” (Apps on prescription: The first digital health applications covered by mandatory health insurance are here. What now?).

A milestone for digital therapeutics in Switzerland

Live audience polls at the outset confirmed how new the topic still is: a clear majority of the attending physicians reported limited familiarity with digital health applications (dGA). Against this backdrop, Tobias Kowatsch first introduced digital therapeutics as software-based interventions to prevent, manage, or treat disease, illustrating the concept with two CDHI research projects: MAX, a health literacy intervention for children with asthma that achieved an average adherence of 80.4 percent and significantly improved asthma knowledge in a multisite pilot study, and Breeze, a playful biofeedback breathing training for mental and physical well-being.

He then traced the regulatory path that led to the current situation. Germany’s DiGA directory, launched in October 2020, today lists 79 applications, 50 of them permanently, all conceived as standalone treatments. Switzerland followed in December 2025, when the Federal Office of Public Health announced amendments to the Health Care Benefits Ordinance under which dGA for the treatment of depression are reimbursed by mandatory health insurance from 2026. The decisive step came on 1 July 2026 with the new position 40.01.01.00.1 in the list of aids and items (MiGeL): interactive dGA delivering cognitive behavioral therapy for depression as pure self-management programs are now reimbursed at up to CHF 193.32 per 90-day license, with the position under evaluation until 30 June 2029.

One application, several restrictions

Currently, deprexis is the first and only dGA available under this position. The web-based programme builds on more than 15 years of clinical use, over 275,000 treated patients, and 16 randomized controlled trials, and is available in ten languages, including the Swiss official languages German, French, and Italian. Reimbursement covers adults with mild or moderate depressive episodes or recurrent depressive disorder, used either as an adjunct to psychotherapy or to bridge the waiting time until therapy begins. In practice, the prescription is issued via the MiGeL position (Pharmacode 1187001) and sent by email to one of two partner pharmacies, which then provide the access data; patients pay the difference of CHF 78 between the product price and the maximum reimbursement amount, plus any applicable franchise and statutory copayment.

The most consequential restriction, however, concerns who may prescribe: only specialists in psychiatry and psychotherapy, specialists in child and adolescent psychiatry and psychotherapy, and physicians holding the interdisciplinary focus in psychosomatic and psychosocial medicine (SAPPM). A live poll made the tension tangible: 76 percent of the physicians in the room do not hold one of these qualifications and therefore cannot prescribe deprexis at the expense of basic insurance. Early experiences from the first month reflect this gap. Prescriptions issued by family physicians have been rejected, individual patients pay out of pocket rather than wait for a specialist appointment, patients on waiting lists actively ask how they can use the program, and psychotherapists who would like to employ it must first refer to a psychiatrist.

What primary care can do now

Tobias Kowatsch closed with four concrete options for primary care despite the current prescription restrictions: recognizing and screening depressive symptoms early, since mild-to-moderate cases typically surface first in primary care; informing patients about digital therapy options while they wait for a psychotherapy slot; referring suitable patients to psychiatry or psychosomatic medicine with a pointer to deprexis as an option; and contributing to the professional and health-policy discourse on whether the current restrictions best serve patients. The subsequent discussion showed that this discourse has only just begun.

The symposium continued with contributions on psychedelics in the treatment of depression, drug pricing, advanced practice nurses in primary care, and digital teaching in medicine, and concluded with an apéro riche.

Further information

• BAG fact sheet: Reimbursement of dGA under mandatory health insurance (November 2024)
• FMH fact sheet on dGA
• FMH report: Use and reimbursement of dGA in everyday medical practice
• List of aids and items (MiGeL)
• Calculation model for the maximum reimbursement amount (HVB) of dGA in the MiGeL
• Assessment basis: Reimbursement of dGA under the KVG

Contact: Prof. Dr. Tobias Kowatsch | tobias.kowatsch@unisg.ch | med.unisg.ch | www.c4dhi.org