Switzerland’s Evaluation of Homeopathy: The End of an Endless Loop

Guest post by Udo Endruscheit

Two years ago, in a guest post on this blog, I described the long and winding history of homeopathy in Switzerland — a story marked by political expectations, institutional entanglements, and repeated attempts to reconcile a lack of evidence with a desire for legitimacy. I ended that article with the hope that the country would not embark on yet another “honour lap” around the same unresolved questions.

In 2024, however, Switzerland initiated a new evaluation of homeopathy — a renewed attempt to clarify its role within the national health insurance system. It was, in many ways, the beginning of yet another loop in the same story.

Now, in 2026, that loop has come to an unexpected end. The evaluation was halted.
Not postponed, not softened, not watered down — simply stopped.

And this stop is not merely a political gesture. It marks the structural endpoint of a system that has exhausted its internal possibilities.

A system designed to avoid the evidence question

To understand why Switzerland has arrived at this point, one must look beyond the political headlines and examine the institutional landscape that has shaped the country’s approach to homeopathy for more than a decade.

Three elements are central:

• The political mandate created by the 2009 referendum, which placed homeopathy and other CAM modalities into the basic health insurance package.
• The professional environment, in which thousands of Swiss physicians hold CAM qualifications and the national medical association (FMH) views integrative medicine positively.
• The academic anchor, the Institute for Complementary and Integrative Medicine (IKIM) at the University of Bern, which provides an appearance of scientific legitimacy without producing evidence capable of resolving the core question of efficacy.

This combination created a system in which homeopathy became institutionally normalised — not because of evidence, but because of political and professional expectations.

The HTA as a detour — and the beginning of the dead end

When the Federal Office of Public Health (BAG) was tasked with evaluating homeopathy after the referendum, it faced an impossible dilemma:

• The clinical evidence was weak to non‑existent.
• The political expectation was strong.
• A direct assessment of the evidence would have produced a negative result.

The solution was a detour: a Health Technology Assessment (HTA). But HTAs are not designed to determine efficacy. They assume efficacy has already been established through robust clinical research. Their purpose is to assess cost‑effectiveness, safety, and system impact.

The Swiss HTA did the opposite. In its conclusion, it stated:

“The effectiveness of homeopathy can be considered as proven when internal and external validity criteria are taken into account.”

This is a remarkable inversion of the HTA principle. The report asserted efficacy — without the evidence required to do so — while simultaneously admitting that the actual HTA questions (such as cost‑effectiveness) could not be answered reliably.

In retrospect, this HTA was not the beginning of a solution. It was the beginning of a dead end. A system that asserts efficacy without evidence cannot move forward. It can only circle around itself.

The IKIM: an academic structure without academic function

The IKIM at the University of Bern has played a central role in stabilising this circular logic. Its research output is broad in appearance but narrow in substance. It avoids the central question of efficacy and instead focuses on:

• sociological aspects,
• patient satisfaction,
• model validity,
• and experimental approaches that are not independently reproducible.

The IKIM does not produce evidence. It produces normality — the impression that homeopathy is a legitimate academic field simply because it is housed within a university.

This normality has been crucial for maintaining the political and professional acceptance of homeopathy in Switzerland. But it has also contributed to the structural dead end: an academic institution that cannot resolve the evidence question because it is not designed to ask it.

The 2026 decision: not a surprise, but a consequence

Against this background, the 2026 decision to halt the renewed evaluation of homeopathy is not really surprising. It is the logical endpoint of a system that has exhausted its internal possibilities.

• The evidence has not improved.
• The HTA detour has failed to provide a foundation.
• The institutional structures have stabilised expectations but not knowledge.
• The political mandate cannot be fulfilled without contradicting scientific standards.

The result is a dead end. Not because anyone wanted it, but because the system was built in such a way that no other outcome was possible.

A lesson beyond Switzerland

The Swiss case is often cited by proponents of homeopathy as a model of political and professional acceptance. But the 2026 decision reveals a different lesson:

A system that tries to reconcile political expectations with a lack of evidence will eventually reach a point where it can neither move forward nor turn back.

Switzerland has reached that point. The “endless story” of homeopathy in the Swiss health system has not been resolved — but it has reached its structural conclusion.

And unfortunately that conclusion is not a triumph of evidence. It is the recognition that evidence cannot be replaced by institutional normality. But one thing it certainly isn’t: an endorsement of homeopathy, even if its advocates will once again try to interpret it that way.