Pharmaceutical Group of the European Union

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Cross Border Health Care

The scope of cross-border health services and their coverage by national healthcare systems is highly complex across EU Member States. The greatest concern for citizens is the conditions under which they have the right to receive healthcare in another EU MS, including the recognition of their prescription. The recently adopted Directive makes this mandatory.

Following the legislative proposal by the European Commission in 2008, and after much negotiation, the European Parliament on 19 January, 2011 adopted a Directive on cross-border healthcare that permits patients to seek treatment in another EU country and be reimbursed at home provided certain conditions are fulfilled.

It also made recognition of prescriptions from another EU Member State mandatory. When Implementing the Directive EC puts in place a set of measures and guidelines to facilitate this recognition, including a proposal for development of a non-exhaustive list of elements to be included in the cross-border prescription.

The role of the pharmacists in relation to the prescription goes beyond what is usually perceived by the patient or authorities. From a public health perspective, pharmacists need to assess, authenticate and validate the prescription. They also need to provide advice to the patient on the medicines’ use and follow the rules of substitution in the countries where substitution is in force. In some countries they need to consider different alternatives to the prescribed medicine in cases of urgent need.

Moreover there is a significant burden of bureaucracy related to the management and authentication of the prescriptions. Pharmacists need to record prescriptions for reimbursement purposes, keep records or register the dispensing of medicines under special provision (narcotics, etc). Additionally, it is important to ensure that contact between the prescribing party and a dispensing pharmacist is possible, allowing to identify and prevent potential medication errors and clarify any other issues that may arise.

PGEU has worked closely with DG SANCO and other relevant stakeholders in the scope of Roadmap ‘Implementing measures for improving the recognition of prescriptions issued in another Member State.

In March 2014 the PGEU attended the eHealth Governance Initiative (eHGI) ePrescription and eIdentification (eID) workshops in Brussels where we argued for appropriate adherence to / interpretation of the Cross Border Health Directive i.e. to keep to national dispensing rules (for example on substitution and reimbursement) as the working group forms the guidelines on cross boarder ePrescriptions. A final round of consultation on these guidelines will take place in mid-September in Brussels which PGEU will attend.