Pharmaceutical public policy tends to be conflictive in its nature attracting numerous stakeholders with competing and sometimes diametrically opposed interests. Due to its complexity pharmaceutical policy has to address diverging challenges such as access to and dispensing of medicines, quality of use, safety and efficacy, funding, drug innovation, or patent questions, embracing industry to welfare policies. In its efforts to deal with these challenges Switzerland adopted a new act on pharmaceutical regulation in 2002 being up to revision in 2009. This paper aims in a first step to analyse the competing interests trying to influence federal pharmaceutical policy in their favour. In a second step the paper compares political decision-making and legislation processes on member states level regarding pharmaceutical dispensing policies. In reference to the subsidiary federal structure in Switzerland it is argued that member states still have room for manoeuvre in the regulation of dispensing medicines, and that vested interests and political actors in the Cantons use their power differently depending on the member state’s institutional setting and legal base. It is therefore assumed that medicines dispensing policies are sometimes not conflictive at all, and sometimes highly disputed by the involved actors, seeking support not only in the course of pre-parliamentarian will-formation and decision-making, but also in the public arena by referendum, or before the high court
