unrelated but nobody here can tell you what is legal in your country and the mods stop that conversation early
#eu 2025-07-03
Thursday42 messages9 participantstimes are UTC
Highlights from this day
- monoisotopic — the great Polish pharmacy tourism of 2024 20:27
- vienna_vial — rough picture as of 2025, all from members in each country, all subject to being wrong by the time you read this 21:12
- reading_the_pins — that spread is enormous for one continent and one drug 21:14
- monoisotopic — finding the one who has read it is the whole game 21:51
update from 21 months ago: nothing changed on reimbursement where i am and the price went up anyway
prices moved since
anyone compared the price for the same dose in two eu countries properly
the honest position is that eu reimbursement is a moving target and nothing said in here stays true for a year
german pharmacies will order in what they do not stock. mine took three working days when i asked in 2024
that is the thing people get wrong constantly. approved and paid for are two completely different processes in the eu
ema approval is a licence, not a payment decision. every member state decides reimbursement separately and they do not agree with each other
you can carry a personal quantity between eu countries in practice. the rules on quantity and prescription vary and i would not rely on my reading of them
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coming back after 16 months, has anything changed on reimbursement anywhere
[edited]how do you deal with a supplier whose support is in one language only
if the EMA approved it, isnt it the same everywhere in the EU
the approval is the same everywhere. the price, the paperwork and whether anyone pays for it are not
one authorisation, then twenty-seven separate arguments about money
so what actually differs
in Germany the statutory insurance side treats weight-loss medicines as excluded. so in practice you get a private prescription and you pay
a private prescription even though you have insurance
yes. Privatrezept, out of pocket, pharmacy price. my insurance is excellent and completely irrelevant here
the Dutch version is that there is reimbursement but with conditions tight enough that most people who want it dont meet them
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and it changed at least twice while i was paying attention, so anything i say is a snapshot
Spain, for obesity, private. the diabetes indication is a different story and during the shortage years pharmacies were actively told to protect it
Poland was for a while noticeably cheaper cash, which is why half of this channel suddenly developed an interest in Polish pharmacies
the great Polish pharmacy tourism of 2024
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it was less funny from here. local supply got very thin at points
fair, and thats an honest cost of cross-border buying that nobody in the buying country thinks about
worth remembering that sentence exists
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rough picture as of 2025, all from members in each country, all subject to being wrong by the time you read this
| Country | Weight indication paid by state scheme | Typical private monthly | Notes |
|---|---|---|---|
| Germany | no | €170-€300 | Privatrezept, pharmacy-priced by dose |
| Netherlands | conditionally, tight criteria | €180-€260 | criteria moved more than once |
| Spain | no | €150-€250 | diabetes supply protected in shortage |
| Poland | no | €110-€190 | cheapest cash prices many of us saw |
| Sweden | no | €200-€300 | high list prices, easy access if paying |
| Ireland | no (weight) | €200-€280 | separate system to the UK entirely |
that spread is enormous for one continent and one drug
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welcome to European pharmaceutical pricing. the list price is a starting position in a negotiation you are not invited to
and the pharmacy margin rules differ too, so two pharmacies in different countries with the same pack cost you different money
one correction to my own row. that range was a year ago and it has drifted up since
*drifted up per month not per week, before anyone panics
that would have been quite a drift
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the other thing that differs is who can prescribe. some countries any GP, some effectively specialist-gated
and how willing they are. i went through three doctors. the third one had actually read the trial data and the conversation took four minutes
finding the one who has read it is the whole game
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how do you find that person
badly, slowly, and by asking around. i wish i had a better answer
and to be fair to the German system, the exclusion is a policy choice about what insurance is for, not an accident
i know. i think it is the wrong choice and it is a coherent wrong choice
that is the most European sentence ever typed in this channel
framing it
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