Recipes for medicines: Aut idem & Co.

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With the prescription, the doctor instructs the pharmacist to hand over a medicine to a specific person. Several medications can be on one prescription form. Nowadays, medical professionals almost always prescribe finished drugs. Individual recipes that are prepared in the pharmacy have become rare.

Pharmacists may only dispense prescription drugs if they have a valid prescription. You can also sell non-prescription drugs without a prescription ("over the counter", OTC).

For health insurance, the prescription proves that the drug was obtained from the pharmacy for medical reasons. As a rule, health insurances will only reimburse the costs for pharmaceuticals upon presentation of a receipted medical prescription.

Who can write a prescription?

Doctors, dentists and veterinarians are allowed to write prescriptions, but only within their area of ​​activity. This means that a dentist cannot prescribe contraceptives, for example, and a veterinarian cannot prescribe cardiac pills for his mother. Specialists are not limited to their specialty. A dermatologist may, for example, also prescribe a rheumatic drug.

What information does a prescription contain?

A pharmacy may only accept prescriptions with the following information:

• Name, address and job title of the doctor
• Date of issuance
• Name of the drug, drug form (e.g. capsules, drops, etc.) and amount of active ingredient per unit (e.g. tablet, ampoule, etc.)
• Quantity or package size
• First name, surname and address of the patient
• Validity period (only for private prescriptions; without this note, a private prescription is valid for three months)
• signature of the doctor

The following information is useful, but not mandatory:

• The introductory formula "Rp.", An abbreviation of the Latin word "recipe" (= "take")
• Doctor's phone number for queries.
• Instructions for the patient (signature, abbreviated "S."), for example "S. Take one tablet daily for lunch"
• For recipes for children: the age of the child

"Aut-idem" rule

The "Aut-idem" box on the prescription plays a decisive role as to which preparation you get with a prescription in the pharmacy. "Aut idem" comes from Latin and means "or the same": If the doctor ticks the "Aut-idem" box (and thus crosses it off), the patient in the pharmacy will get exactly the preparation prescribed by the doctor.

If, on the other hand, the doctor does not tick the "Aut-idem" box, the pharmacist basically has the option of giving the patient a more cost-effective preparation (generic) with the same active ingredients instead of the prescribed medication. In addition to the same active ingredient, this must have the same potency and pack size as the prescribed drug and be approved for the same clinical picture (indication). In addition, it must have the same or an interchangeable dosage form (e.g. capsules instead of tablets).

However, there is a difference between statutory and privately insured patients:

• Statutory health insurance: If the "Aut-idem" box is not checked, the pharmacist usually has to give the patient a preparation (generic) with the same active ingredients but less expensive.
• Private health insurance: If the "aut-idem" is not ticked or has not been excluded in a note by the doctor on an informal private prescription, the pharmacist may only give the insured person a cheaper preparation with the same active ingredients if he agrees. If he is not, the pharmacist has to give him the prescribed medication that is on the prescription.

"noctu"

By ticking "noctu" on the prescription, the doctor makes it clear that the prescription is an emergency. When redeeming the prescription in an emergency pharmacy (at night or on Sundays and public holidays), the patient therefore does not have to pay the emergency service fee of 2.50 euros (per emergency service visit, regardless of the number of medications prescribed). The fee will then be covered by the health insurance company. However, the patient must redeem the prescription immediately after it is issued and not, for example, the next day.

GKV prescription (health insurance prescription)

The red (pink) prescription applies to reimbursable drugs for patients with statutory health insurance. This prescription is a so-called "sample 16 form": In addition to the prescription, it contains some additional information for the cash register. The status number provides information on whether the patient is an insured person, a family member or a pensioner. In addition, the cash register number, insurance number, contract doctor number, period of validity of the insurance card and the date of issue are noted in a machine-readable manner.

A doctor may prescribe a maximum of three drugs on a prescription. The health insurance company covers the costs of the prescribed preparation up to four weeks after the date of issue. The prescription can then be used as a private prescription for another two months - that is, the patient can still redeem it in the pharmacy during this time, but then has to bear the costs of the drug completely himself.

Private prescription

Private prescriptions are primarily issued to patients with private health insurance. A doctor can also give a person with statutory health insurance a private prescription for a prescription drug if the costs for the preparation are not covered by the statutory health insurance. This applies, for example, to the "pill" as well as remedies for hair loss and erectile dysfunction. The patient has to pay for such drugs himself.

No specific form is required for a private prescription. As long as all mandatory information is available, an informal piece of paper is sufficient. However, doctors very often use blue forms for the private prescription, which are similar to the pink prescription. This makes billing easier for the cash registers.

As with the prescription, the following also applies to the private prescription: A maximum of three medications can be prescribed on it. The prescription can be redeemed in the pharmacy up to three months after the date of issue.

Narcotic prescription

A special prescription (a yellow form) is required for certain drugs, so-called narcotics. According to the law, narcotics include not only "narcotic" substances such as morphine, but also "stimulants" such as methylphenidate. These substances act on the central nervous system and, if used improperly, are easily addictive. The prescription of narcotics is therefore particularly strictly regulated.

The yellow prescription is used for both statutory and privately insured patients. It is only valid for seven days.

Green recipes

On a green prescription, the doctor can write down over-the-counter medicines (and any number) that he recommends to the patient. The preparations have to be paid for by the patient himself.

A green recipe is valid indefinitely. After "redeeming" it in the pharmacy, the patient is allowed to take it back with him so that he can use it again if necessary.

The patient can claim the drug costs of the green prescription in his tax return as an extraordinary burden.

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