However, cost-effectiveness is not systematically assessed according to a well-defined and rigorous methodology and the decision-making process lacks transparency. As financial pressures from the health system increase, ensuring that investment is driven by evidence on cost-effectiveness would be worthwhile. At a time when Switzerland will need to rely increasingly on primary care personnel to coordinate and support patients living with chronic disease, the number of general practitioners has been declining relative to specialists, and there are substantial differences across cantons. The Swiss medical and nursing workforce is ageing and a significant number are expected to retire in the next two decades.