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c/glp1eu·posted 1 year ago by u/emeka_beaulieu

the Netherlands: EMA, and what it actually costs here

Question Cold Box ×3 Slow Clap ×1

Something I keep coming back to: the Netherlands: EMA, and what it actually costs here.

Asked in my own language at a local pharmacy and got a clearer answer in five minutes than a fortnight of forum reading.

On cross-border prescriptions, since the assumption behind half these threads is wrong.

There are EU rules on the recognition of prescriptions issued in another member state, and they are conditional: the prescription has to meet requirements about its form and content, certain categories are excluded, and pharmacies retain discretion in practice.

The result is that "my prescription will be accepted anywhere in the EU" is not a safe assumption, and members here have discovered it at a counter in another country. If it matters for a trip, check before you travel with the pharmacy and with somebody qualified where you are. Nothing on this board is advice about that, and the rules are national in their application whatever the framework says.

How to compare prices across borders without misleading yourself.

Normalise the pack size first. Presentations differ between member states and a headline figure for one pack is not comparable to another. Then separate reimbursed from private prices, which are set by entirely different mechanisms. Then note the dispensing fee structure, which is nationally regulated.

When members here have done all three, the interesting finding has consistently been that variation between pharmacies within a country is often as large as the variation between countries — which makes the cross-border shopping most of these threads are really about far less attractive than it looks.

Ask me anything specific. Anything general I will probably get wrong.

1,161 up / 160 down88% upvoted33 commentsid z212w17 Jun 2025

33 comments

27 in this archive, depth 5

best — the order this archive was captured in

u/marit_coelho170 points·1 year ago

Nothing here is medical or legal advice, and eligibility questions have national answers that a pharmacist where you live can give you in minutes.

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u/ahmed_fonseca94 points·1 year ago

Is the prescription from the same country as the pharmacy?

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u/tuva_aalto26 points·1 year ago

EU-wide advice is almost always wrong somewhere

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u/santiago_rasmussen-1 point·1 year ago

Right, and a shortage notice in one country tells you very little about the next one along.

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u/anya_moreau0 points·1 year ago

Right, and a shortage notice in one country tells you very little about the next one along.

Adding the practical step — read your own country’s published criteria. They exist and they are definitive.

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u/nadia_bakker1 point·1 year ago

Published reimbursement criteria exist in most member states and are usually available in the national language. They are the authoritative answer to eligibility questions that this board can only guess at.

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u/bilal_adebayo1 point·1 year ago

Published reimbursement criteria exist in most member states and are usually available in the national language.

Disagreeing with this bit: that criterion belongs to one member state and is being quoted as general.

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u/rohan_steiner1 point·1 year ago

Cosigning on cross-border prescriptions. The rules exist and they are narrower than the summaries suggest.

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u/zaid_grimaldi1 point·1 year ago

Small fix — those two prices are for different pack sizes, which accounts for most of the gap.

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u/hydration_hank-1 point·1 year ago

Kept the prescription and the receipt for a claim, purely because a thread here told me to. Both were requested.

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u/farid_jansen1 point·1 year ago

That is an authorisation question and you have answered a reimbursement one. They are decided by different bodies.

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u/elin_lindqvist1 point·1 year ago

That shortage notice was national and does not apply where the question is coming from.

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u/sten_bhattacharya60 points·1 year ago

Read the published reimbursement criteria where I live rather than asking. Took twenty minutes and answered everything.

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u/amira_dumitru46 points·1 year ago

Marketing authorisation is granted centrally for these products; reimbursement, pricing and prescribing criteria are national competences. Those are decided by different bodies with different processes.

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u/diego_iyer15 points·1 year ago

say which country or the thread is useless

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u/joaquin_trevino12 points·1 year ago

the language barrier is a real cost and nobody budgets for it

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u/anya_moreau10 points·1 year ago

The variation between pharmacies inside my own country was larger than the variation I had been chasing across the border.

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u/anya_moreau42 points·1 year ago

Cross-border prescription recognition exists under EU rules but is conditional and narrower than commonly assumed, with requirements about the prescription’s form and content.

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u/still_here_202632 points·1 year ago

Correction: that is the authorisation position, and the question was about reimbursement. Different bodies, different answers.

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u/plateau_patrol18 points·1 year ago

pack sizes differ, so per-month comparisons need care

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u/nadia_bakker25 points·1 year ago

The translation cost of dealing with a foreign pharmacy was the thing I had not budgeted for.

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u/dario_bakken14 points·1 year ago

Compared prices across two neighbouring countries and found the difference was mostly pack size once I normalised it.

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u/cato_batista19 points·1 year ago

Pharmacy margins and dispensing fees are regulated nationally, which explains price differences that otherwise look arbitrary.

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European access, country by country: prescription routes, reimbursement reality, pharmacy stock, EMA notices and the fact that "EU rules" is usually a national question wearing a European hat.

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