The medical prescription is a document, filled in by a doctor (with a degree in Medicine and Surgery) licensed and registered in the professional register, which allows the citizen to collect medicines (drugs) that require a medical prescription from the pharmacy. Even dentists can prescribe medicines, limited to those necessary for the exercise of their profession
There are two main types of commonly used recipes:
- red or electronic recipe, compiled in the regional recipe book, for medicines borne by the National Health Service (SSN)
- white recipe, compiled on the doctor's personal recipe book, for medicines with a cost completely borne by the citizen
In some special cases, different recipes are used, such as:
- ministerial recipe in tracing, to prescribe psychotropic and narcotic substances (which are active on the nervous system and therefore can modify the psychophysical state of the person) such as, for example, anxiolytics, substances used in pain therapy and for the prevention, treatment and rehabilitation in drug addiction situations. It is compiled on a different recipe book, in three copies, one for the doctor, one for the person who needs the drug and one for the pharmacist
- limiting recipe, filled in only by specialist doctors from centers authorized by the Regions that issue a therapeutic plan (prescription containing information on the disease, dosage and method of use of the drug and the duration of therapy). It allows the citizen to have reimbursement by the NHS for special medicines that are otherwise non-refundable. It is also used for those medicines that can only be used in a hospital setting
There red recipe or pink in paper form, it belongs to the regional recipe book and is named after the red color of the edges of the fields that the doctor fills out. It is used exclusively to prescribe drugs reimbursable by the National Health Service (SSN) that fall within Band A. It can be filled in only by doctors employed in public structures or affiliated with the SSN and exclusively in the context of the exercise of their activity as doctors of the SSN. The doctor who works as a freelancer or the hospital doctor who carries out private activity for a fee in the hospital itself (intramoenia), cannot use the regional recipe book in this context, but must only use the so-called "white recipe" present in his own recipe book personal. The family doctor will then write the prescriptions suggested by the specialist on the red prescription, if he shares them.
The red prescription is valid in all pharmacies in the Italian territory and ensures that citizens can collect medicines that require a medical prescription wherever they are. However, outside their region of residence, the person will have to pay the full amount, even if they have the exemption (right to have the drug for free). In your region, however, you can collect the drugs for free or by paying a small share fee or ticket, which varies from region to region. With the introduction of the electronic prescription, the problem of regional validity has been overcome.Electronic recipe
More and more often theelectronic prescription or dematerialized replaces the red paper recipe. It is a real virtual prescription identified by a unique number (NRE) that the doctor compiles on the computer using a specific program of the Regional Health Service, entering the same information required by the red paper prescription. Through the computer system, the pharmacist will have direct access to the electronic prescription and the data of the holder. The doctor, however, even if the prescription is electronic, will print a paper memo and deliver it to the person.
Due to the emergency due to the spread of the new Coronavirus infection (Covid-19), in order to avoid the movement of citizens and the spread of the infection, an order of the Civil Protection allows the citizen not to withdraw the memo but to have the electronic prescription number through a telephone message (sms, or other messaging or even verbal telephone communication) or e-mail.
There is no substantial difference between the electronic recipe and the old red paper recipe, but the former has the advantage of saving the cost of the special watermarked paper used for the red recipe. The electronic prescription has the same temporal validity and, exactly like the red one, is used to prescribe Band A medicines. However, unlike the paper one, the electronic prescription allows you to collect medicines in any region without paying the full price of the medicine. but only the ticket provided for by your region of residence and any difference compared to the reference price. In cases where there are problems with the computer connection, the citizen can still collect the drugs prescribed using the paper memo printed by the doctor. In these cases, however, the pharmacist is required to apply the ticket provided by the region in which he operates and not the one applied by the region of residence of the citizen. If you miss the reminder you can still withdraw the drug because the prescription is registered in a database (electronic archive) accessible to all pharmacies.
The electronic recipe cannot be used for the following prescriptions, for which the red recipe is still required or special recipes are required:
- narcotic drugs (which modify the psychophysical state of the person)
- psychotropic substances (which act on the nervous system)
- drugs that require a treatment plan
- drugs prescribed at the patient's home or in nursing homes
In March 2020, a first decree of the Ministry of Economy and Finance introduced the possibility of using the electronic prescription also for drugs that require a treatment plan and for drugs distributed through methods other than the conventional regime. With a subsequent decree, the electronic format was also activated for the white recipe identified with a unique number (NBRE). In this case, the doctor enters the tax code and customer data, the name of the drug and the number of the white electronic prescription, and can leave a paper memo to the patient or send it via email, or even send it directly to the pharmacy.White recipe
The so-called recipe White, Regardless of the real color of the card, it is the one that the doctor compiles on his personal recipe book to prescribe Band C medicines, that is, not reimbursable by the National Health Service (SSN) but completely paid by the citizen. It is used for those medicines which, despite being paid for by the citizen, require a medical prescription. A private doctor can prescribe medicines or benefits reimbursable by the NHS on a white prescription, however, to obtain reimbursement, the prescription must be repeated by the NHS doctor with a red prescription.
The following must be indicated on the white prescription: name, surname, tax code and any membership structure and doctor's signature, place and date. However, the client's name is not required.
Other medicines that are not reimbursable by the NHS, such as over-the-counter medicines, and those without a prescription (SOP), can be sold without a prescription.
The white recipe can be:
- repeatable, is used to prescribe a drug that can be dispensed several times to the same person over a certain period. By law, a prescription drug pack with a repeatable prescription can be sold up to 10 times within 6 months, unless otherwise instructed by the doctor. For this the pharmacist must return the prescription to the citizen each time. If the doctor, on the other hand, prescribes more than one package of the drug on the same prescription, repeatability is lost and only that quantity can be withdrawn at one time. Drugs and psychotropic substances are an exception, such as drugs to treat anxiety, insomnia or depression, for which repeatability is limited to 3 times in 30 days
- not repeatable, serves to prescribe a drug, in sufficient quantity for therapy, to be withdrawn only once within 30 days. It is used for those medicines which with prolonged use could cause health risks. In this case, the pharmacist collects the prescription when the medicine is delivered
Validity of medical prescription for drugs
The validity, i.e. the period within which the prescription can be used to collect medicines, depends on both the type of prescription and the type of drug prescribed.
The red or electronic prescription, belonging to the regional recipe book, has a validity of 30 days, that is to say that the package or packages of medicine prescribed can be collected, for one time only, within 30 days from the date of compilation visible on the prescription.
The white prescription, belonging to the doctor's personal recipe book, is valid for 6 months when it is repeatable. This means that it can be used to purchase the prescribed drug up to 10 times within six months from the date of compilation, unless otherwise indicated by the doctor. The white prescription that prescribes prescription drugs not repeatableinstead, it can only be used once within 30 days. In the case of narcotic and psychotropic active substances (which act on the nervous system), the repeatability of the recipe is limited to 3 times in 30 days.Maximum number of prescriptions per recipe
Maximum number of prescriptions per recipe
On a recipe from the regional cookbook (red or electronic), no more than 2 packs per drug can be prescribed. For people with chronic disease exemption, up to 6 packs per prescription can be prescribed, up to a maximum of 180 days of therapy, provided that the drug has already been used by the person for at least 6 months and is specific to his or her chronic disease. In the case of the first prescription of a drug, or of a change in therapy, the doctor can prescribe only one package of that drug per prescription and only one prescription per day.Recognition of the recipe in European Union (EU) countries and cross-border recipe
Recognition of the recipe in European Union (EU) countries and cross-border recipe
A prescription issued by an Italian doctor or a doctor from another European Union (EU) country is valid in all EU countries. For it to be recognized, it is necessary to ensure that the doctor has entered all the necessary information about the person, the drug prescribed, the doctor who prescribes it and the date of issue (according to Directive 2012/52 / EU which facilitates the recognition of medical prescriptions in Union countries).
The electronic prescription is not accepted in all EU countries, so it is useful to have a hard copy also issued by the doctor. In addition, the doctor must indicate the common name of the active ingredient of the medicine, the strength and the pharmaceutical form (for example, tablets, ampoules, syrup, etc.) because a medicine prescribed in Italy may have a different trade name in a Another country.
A medicine that is collected in a pharmacy in an EU member country with a prescription drawn up in Italy, must be paid in full at the time of purchase. Subsequently, with the receipt (or receipt) issued by the foreign pharmacy, the request for reimbursement can be submitted to the competent Local Health Authority (ASL), of course only for Class A drugs reimbursed by the National Health Service.Non-prescription drug delivery in case of urgency
Non-prescription drug delivery in case of urgency
The ministerial decree of March 31, 2008 provides for situations of necessity and urgency that allow citizens to have a drug, for which a medical prescription is required, even without a prescription.
They are the following:
- need to continue treatment for some chronic diseases (for example, diabetes, hypertension, chronic obstructive pulmonary disease). The pharmacist can deliver the medicine to the person if there are elements that demonstrate the use of that drug (previous prescriptions in which it is prescribed, document certifying the chronic disease for which it is indicated, showing a prescription that has expired for no more than 30 days )
- need not to interrupt a cure, for example antibiotic therapy. The pharmacist can deliver the requested medicine in the presence of elements that confirm that the person is being treated with the drug, such as the presence in the pharmacy of a previous prescription or the display of an unusable package
- need to continue treatment after discharge from the hospital, the pharmacist can deliver the medicine requested in the presence of documentation certifying discharge from the hospital in the last two days and the need to continue that therapy
In all these cases the citizen is required to sign and deliver to the pharmacist a "declaration of assumption of responsibility" and the pharmacist to deliver to the citizen a card to take to the attending physician.
The pharmacist can deliver only one package, the smallest existing, of the requested drug. The corresponding cost is fully borne by the citizen.
On the other hand, the delivery of medicines included in the tables of narcotic substances is prohibited.In-depth link
Italian Medicines Agency (AIFA). Medicines supply regime