Using UK prescriptions in the EU post-Brexit

[helvella]

For anyone who is considering prescription medicines post-Brexit:

helvella - Using UK prescriptions in the EU post-Brexit

We are currently allowed to use UK prescriptions in the EU using the mutual cross-border prescription arrangements. (Summary and link pasted later.)

I have seen absolutely nothing which in any way asserts that these arrangements will continue after Brexit. Without such arrangements, UK prescriptions will cease to be valid. Even if arrangements are made, there could be issues with sending/delivering packages, customs and taxes (VAT).

Given the logistics, it seems likely that EU pharmacies will stop fulfilling UK prescriptions before Brexit actually occurs. After all, they will have to change procedures as anything sent to the UK would be treated as an export. I suspect that will avoid any possibility of being caught by things changing between accepting a prescription and it being delivered.

If you need to obtain medicines by ordering from the EU, I suggest that you do so as soon as possible.

If you intend to visit the EU, your UK prescription seems unlikely to be valid. If you need to have any prescription medicines dispensed you will most likely have to obtain an EU prescription which will likely require you to visit a doctor.

I intend to update this document should there be any further information.

Do note that I do not have access to any information not available to all. If you know anything more, please let me know so I can include it.

Saturday, 14 December 2019

dropbox.com/s/5ytv76qm330yu...

Please note: This is NOT the place to argue or even discuss the political issues.

[SlowDragon Administrator]

Anyone who currently gets their T3 private prescription written by their endocrinologist to enable them to get cheaper T3 from EU, needs to underline this imminent supply issue to their endocrinologist.

It's a matter of urgency that thousands of UK patients, currently forced to get T3 on private prescription from EU, need to be able to have continued access to reasonably priced T3.

Anyone in this situation, write or, even better, go see your (new) MP.

[Treepie]

It may not happen straight away but best to be cautious.

[StitchFairy in reply to Treepie]

What may not happen straight away? If, as is promised, we officially leave on 31 Jan 2020, then surely no-one in Europe will honour any UK prescriptions. It will be a case of "you're not welcome here any more".

[Treepie in reply to StitchFairy]

Much will remain as now whilst a new trade agreement is negotiated for 12 months. Whether that will apply to prescriptions I have no idea . I think the EHIC will continue to apply during this period subject to the Withdrawal Agreement being passed ,which should not be a problem now assuming the new Speaker is different to the last one ,although whether individual doctors will see it that way.........

[helvella in reply to Treepie]

According to the UK government website, EHIC ceases the day we leave:

European Health Insurance Cards (EHIC)

Visiting an EU country

UK-issued EHICs will remain valid until the UK leaves the EU, or if your trip or treatment started before exit day.

gov.uk/guidance/uk-resident...

I don't think we have even the slightest evidence UK prescriptions will be recognised cross-border after exit day, nor any indication it has even been discussed with a view to keeping it going (e.g. in the withdrawal agreement).

[Treepie in reply to helvella]

I think there is leaving and there is leaving ,those who think a clean break will happen at the end of January will be disappointed. During the transition period things supposedly remain the same although the language used is capable of different interpretations .

Google the question re the EHIC and and some sites including ABTA would appear to suggest continuance.

[helvella in reply to Treepie]

Unless and until there is a clear agreement, I think we have to go with EHIC ceasing the moment we leave.

[StitchFairy in reply to Treepie]

I don't understand all the details but I'm pretty certain it's not a trade agreement. More like a reciprocal arrangement. Isn't it much the same as last time when we were being warned that our passports would cease to be valid (if we didn't renew them in time or something like that). And don't forget it's the UK that decided to cut the strings, so why would Europe have any reason to be kind to us poor souls wanting thyroid meds from them!

[Treepie in reply to StitchFairy]

I think a trade agreement is the main agenda but there is much more than that e.g . security , european arrest warrants ,continuing involvement in various agencies and regulatory bodies. Probably unlikely that prescriptions will continue to be accepted after December 2020 but until then possibly , just do not rely on it.

[StitchFairy in reply to Treepie]

That's almost a whole year of potential uncertainty from Jan2020 to Dec 2020! Clarification is needed asap so that we know where we stand. I'm assuming the worst scenario will apply.

[Treepie in reply to StitchFairy]

Someone I cannot recall advised : “Plan for the worst, hope for the best.”

[Catseyes235 in reply to Treepie]

I may have the t-shirt!

[FancyPants54 in reply to StitchFairy]

Good luck with your clarification! There has been no help with that at all for the past 3 years for business.

Everything will change immediately. My shippers have been warning their customers for months that from 1st February (or whatever date we were aiming for at the time) everything about import/export will be different. Much more paperwork, delay and much more expense in the form of duties.

Pharmacies abroad get paid by UK for the prescriptions they fill. That will cease so they won't be fulfilling any prescriptions. It remains to be seen if we will be able to buy the medicines and have them shipped over. But that will cost more of course.

[helvella in reply to FancyPants54]

Talking about clarifications...

Pharmacies abroad get paid by UK for the prescriptions they fill.

As I understand, when we use an NHS (or UK private) prescription to get a medicine dispensed by a German pharmacy and sent to us in the UK, the only money that is involved is what we pay the pharmacy. That is, the pharmacy has to process the prescription (check it is valid and store the information for any form of audit) and then send the goods just like with any other goods we might buy.

Are you suggesting otherwise?

[Hidden in reply to FancyPants54]

"Pharmacies abroad get paid by UK for the prescriptions they fill".

Are you sure about that? That sounds very complicated for the pharmacies in various countries. Also, many have said that German pharmacies usually fill prescriptions and send drugs very quickly, even the same day...would the NHS or any other health care provider be able to react that fast...?

My own experience is that if I use my prescription in a different country than the one it was issued in, I will pay the cost to the pharmacy, and then will have to request reimbursement from my health care provider using the invoice/receipt provided.

[UrsaP]

I am not just sure it is going to be just an EU issue. A source I know of has recently been stopped from distributing from India due to FDA regulations, which now insist on all packaging being identifiable. And certain medications, not all, are being stopped from being distributed to the UK. Guess what T3 is affected.

I can’t pretend to understand all the political goings on, but why are the FDA already dictating what we can have delivered to the UK?

I have thought for a long time that ‘cost’ being the issue with T3 was a red herring. Cost could have, and should have been sorted out long ago. Plus the NHS themselves telling us all to focus on the cost (that they allowed to be price hiked?) was telling. IMO it is the benefit that is of greater risk to BP. The cost would be to their profits!

In Greece earlier this year they themselves were struggling to get T3. One pharmacist said they thought the supplies were being sent to the UK as could charge so much more for it. Wonder who is getting it? The private sector? Stock piling ready to charge through the nose under private when all other doors closed?

Is it ‘supply and demand’? Make it scarce then can price hike?

So much more to this than any of us know, again, benefit is key imo, but I wonder just what deals have been done behind the veil of Brexit. Brexit has been dragged out and out again...a reason for everything?

I also suspect that the increase in articles and programmes in general media regarding the dangers of ’self medicating’ (other drugs generally but there was something recently re T3) is a targeted attempt to get the general public support for stopping self sourcing and medicating. Sadly experience is highlighting too many people happy to read a headline in big print and decide that they know the whole story. Too many gullible people believing everything they read on social media. People who have lived long enough and seemingly intelligent enough to know better.

[StitchFairy in reply to UrsaP]

Wow, just want to check that I understand what you're saying... that the FDA may already be controlling what meds we can get here in the UK? Even if they're not coming from the USA?

[UrsaP in reply to StitchFairy]

I think I am saying that, imo, who knows who has agreed to what over the last three years behind the veil of Brexit. But I don’t like what I’m hearing and I feel there has been an increasing focus on 'the harm’ of self sourcing and medicating without consideration for the fact that so many are pushed into doing so by neglect elsewhere. Time will tell.

[Treepie in reply to UrsaP]

There have been many drugs affected by supply problems over the past few years , I recall hearing a pharmacy spokesman saying that there were many different issues such as factory closures, production line problems, and logistical problems in the supply chain. The overall cause being globalisation of production whereby the ingredients may be produced in one country ,turned into tablets/capsules in another and packaged in a third then shipped to middle men and so on.

[UrsaP in reply to Treepie]

Oh yes and the UK have such exacting superior standards for medications made elsewhere? Which in my view does not add up. How can they claim to have superior standards and be sure of controls when medication is produced elsewhere?

I think we need to start looking deeper into what in happening and start questioning what is happening out of sight.

I’m starting to suspect that by the time we the public get a ‘say’ in something the decision has already been made.

[Lovecake]

I wouldn’t want to change brands either.

So I’ll be contacting my endo in the new year and hope he/his secretary have some answers.

[milupa]

May I add: The German pharmacies still dealing with UK prescriptions (some stopped a year ago) are happy to supply a year's worth of Thybon or more, if that is stated on the prescription.

They won't accept prescriptions until the 31.01. though, they will want to send parcels well before then.

[helvella]

I think that German pharmacy prices are controlled by the German government. So, whilst it might be possible for them to increase P&P and there could even be the possibility of some sort of extra fee, the selling price probably cannot be changed.

However, I could be entirely wrong and would welcome any evidence to the contrary.

[helvella]

Think even he wasn't around - nor even the first duke of Marlborough.

In or around 46 BC, Cicero wrote to a friend saying, "you must hope for the best"; but the first known use of the full expression is in The Tragedie of Gorbuduc by Thomas Norton and Thomas Sackville in 1561 which was performed by the Gentlemen of the Inner Temple before Queen Elizabeth in 1562. It is believed that Norton wrote the first three acts and Sackville the last two.

[helvella]

Yes - I thought that was possibly what you meant but wanted to make it 100% clear to anyone following...

[Treepie]

I now recall last read it said by Jack Reacher !

[StitchFairy]

That's assuming we'll actually continue to have the right to buy non-prescription meds in the future 😟 It's all looking very worrying indeed right now.

[ThyroidThora]

Thank you for posting this information, Helvella. This will prove very useful for patients who need to source their meds from the EU on private prescription. Do you what the position is regarding free repeat prescriptions from GP's for medication that is made in the EU?

TT.

[helvella in reply to ThyroidThora]

The government has been insisting for a long time that there will be no issues with medicines being imported - at the same time we have seen more medicine shortages than ever before. Not at all clear whether the shortages are in any way connected with leaving the EU. Or not.

[ThyroidThora in reply to helvella]

Thank you for your prompt reply. I hope this is the case because my diabetes tablets are a German brand and my insulin is French. My thyroid meds are UK made and I've had enough problems over the last couple of years with my GP/Pharmacy trying to fob me off with brands that I'm allergic to just to keep costs down.

[Catseyes235]

It has been suggested that if Scotland leaves the UK I can apply for a Scots and hence an EU passport. A glimmer of hope in a gloomy looking future!

[LAHs in reply to Catseyes235]

Good observation! What about Southern Ireland too, could all transactions be done there too? Ireland is not too far away for a medical trip.

[helvella]

I have just written an email to my MP asking about this issue and requesting both further information and that he work towards ensuring continued mutual prescription recognition.

The email has bounced as I was writing this - but I shall send again and again until it gets through!

[helvella]

Because he isn't there. He is in London.

[jimh111]

This may be helpful gov.uk/guidance/prescriptio... . I haven't studied it as I'm working on my website and don't have time to get into the technical detail. It shows how the UK will treat EU and EEA prescriptions if there is 'no deal'. I can only assume it will work in a similar manner the other way around.

[helvella in reply to jimh111]

Thanks Jim, that is of use/interest. Trouble is, it only says what UK pharmacists should do and doesn't say anything about EU27/EEA pharmacists and whether they should or will continue to recognise UK prescriptions.

I'll also add that the document is already out of date referring, as it does, to 31 October 2019 and only if no deal.

This guidance takes effect from 31 October 2019, if the UK leaves the EU with no deal.

[jimh111 in reply to helvella]

Yes, it seems to be the best we have at the moment.

[LAHs]

You know, I think it will all boil down to supply and demand. Thinking as a pharmaceutical company I wouldn't want a large section of my market suddenly lopped off. I think we need to know each manufacturer's market before we can take a guess as to what will happen. If Thybon Herring (sp) suddenly finds they are going bankrupt (say because 80% of their customers were British) I think all sorts of concessions will be made, i.e. British prescriptions will be welcome.

Come to think of it, when I was looking to buy NDT via the Internet you could buy it from virtually any country although they would specify that a prescription was necessary, they did not specify which country the prescription should come from.

Of course, on the down side, Britain will probably slap an import tax on the meds.

Oh gosh, what a horrible situation, I am so sorry. Perhaps it is better to muddle through something ugly with Europe than do business with the US. We have the supply but oh the cost. We have many people having to choose between medication and food. An ad. floated across my TV a while back said, "Medications can't be effective if no one can afford to buy them".

[helvella in reply to LAHs]

I understand but...

Henning Thybon is part of Sanofi Deutschland which is part ofthe gigantic Sanofi group. Sanofi already supply medicines in the UK - but not Henning Thybon.

Sales of Thybon to UK patients is probably a tiny, tiny part of their business.

Had they wished, they could have applied for a UK licence and supplied the NHS. (Even charging several times the price in Germany, it would have been cheaper to us.) Indeed, they still have that option.

Currently, for modest imports, most items are subject to Value Added Tax (currently 20%) on the value including postage. And then a charge by the company that processes the customs clearance - at least £8.