Switzerland reverses the usual pattern. Diagnosis is comparatively achievable, with 33 SGSSC-certified sleep centres and a dedicated national network for rare sleep disorders, SNaNe, that few countries can match. The problem starts after diagnosis. No medication is Swissmedic-approved for idiopathic hypersomnia, so everything is off-label, and Swissmedic eventually followed the 2010 European decision that stripped IH from modafinil’s indication, even though the AASM gives modafinil its only strong recommendation for the condition. Reimbursement therefore runs through Articles 71a to 71d KVV, a case-by-case cost approval requiring that the illness can cause severe chronic impairment, that no effective alternative exists, and that high therapeutic benefit is expected. Insurers approve around 75 percent of oncology requests, but a federal evaluation found unequal treatment in the complex remainder, which is exactly where a rare sleep disorder sits. Swiss specifics that matter: the Limitatio system builds step therapy into the reimbursement list, pitolisant is authorised but still needs individual cost approval, your chosen franchise between CHF 300 and 2,500 caps annual exposure between CHF 1,000 and CHF 3,200 and can be changed each November, and unlike most of Europe there is no mandatory duty to report daytime sleepiness to driving authorities.