Cross-Border Pharmacy Services in the EU: How Generic Drug Mobility Works Today

Imagine needing your regular blood pressure medication while on vacation in Italy, but your local pharmacy back home is closed. In the EU, you don’t have to panic. Thanks to a digital system called ePrescription, you can walk into a pharmacy in Rome, show your ID, and get your prescription filled - even if it was issued in Germany, Poland, or Spain. This isn’t science fiction. It’s real, and it’s changing how millions of Europeans access generic drugs across borders.

How the EU’s Cross-Border Pharmacy System Actually Works

The backbone of this system is the eHealth Digital Service Infrastructure (eHDSI), branded as MyHealth@EU. Launched in 2011 under Directive 2011/24/EU, it lets patients use electronic prescriptions issued in one EU country at pharmacies in another. Today, 27 EU and EEA countries are connected. That means if you’re prescribed a generic version of metformin in France, you can pick it up in Austria, Portugal, or Finland - as long as the pharmacy is connected to the system.

Here’s how it works in practice:

1. You get a digital prescription from your doctor at home - no paper needed.
2. You log into your national health portal (like Germany’s eGK or Spain’s SNS) and authorize your prescription to be shared abroad.
3. You travel to another EU country and visit a participating pharmacy.
4. The pharmacist scans your ID or uses your e-Health card to pull up your prescription securely from your home country’s system.
5. They dispense the medication - usually a generic version - and the transaction is recorded in both systems.

This isn’t just about convenience. It’s about access. In rural areas or border towns, the nearest pharmacy might be across the border. A German living near the Dutch border might find it easier to fill a prescription in the Netherlands than in their own town. That’s why the system was built - to remove geographic barriers to care.

What Medications Can You Get Across Borders?

The system works for most prescription medications, especially generics. That’s because generics are cheaper, widely available, and have the same active ingredients as branded drugs. Common examples include:

• Atorvastatin (for cholesterol)
• Levothyroxine (for thyroid)
• Metformin (for diabetes)
• Omeprazole (for acid reflux)
• Amoxicillin (antibiotic)

But here’s the catch: not every generic is the same across countries. A pill made in Poland might look different from the same drug made in Spain - different shape, color, or inactive ingredients. That’s okay for safety, but it can confuse patients. One user in a Reddit thread described being handed a blue pill in Belgium that looked nothing like the white pill they took at home. The pharmacist had to explain it was the same medicine, just made by a different manufacturer.

Specialized drugs - like those for rare diseases or advanced therapies - are often not available everywhere. If your medication is rare or requires special storage, the pharmacy abroad might not stock it. The system doesn’t force pharmacies to carry every drug - only to fill prescriptions for ones they already have.

Where It Works Best - And Where It Falls Apart

Cross-border pharmacy services work best in border regions. A 2025 survey by Copenhagen Economics found that 78% of patients in the Netherlands-Germany border area successfully filled prescriptions abroad. In contrast, only 42% of people in non-border areas had the same success.

Why? Because border towns often have established networks. Pharmacies there are used to handling foreign prescriptions. Pharmacists speak multiple languages. They know how to navigate the system. In places like southern France or northern Italy, cross-border pharmacy use is common. But in countries like Ireland or Greece, the system is less familiar.

Ireland has strict rules: prescriptions from outside the EU/EEA - including the UK - are invalid. Even if you got a prescription from a UK telehealth service, Irish pharmacists are legally required to refuse it. That’s because the UK is no longer part of the EU’s health data network. The same goes for non-EU countries like Switzerland or Norway - even though they’re in the EEA, their systems aren’t fully synced yet.

The Regulatory Patchwork: Not All Countries Are Equal

Here’s the biggest problem: the EU sets the rules, but each country implements them differently. Only 8 out of 27 EU countries have clear, detailed rules for how pharmacists should handle cross-border e-prescriptions. That means a pharmacist in Sweden might be trained and confident handling foreign prescriptions. One in Bulgaria might have never seen one before.

Training gaps are real. A 2025 EAEP study found pharmacists need about 40 hours of specialized training to handle cross-border workflows. That includes understanding:

• Different prescription formats
• Language barriers (medication names vary)
• How to verify prescriber credentials
• How to check if a drug is approved in their country

And then there’s the new Italian rule: since February 2025, prescriptions must include a GS1 DataMatrix code - a barcode that holds all the drug info. Older prescriptions without it are being rejected. That’s great for security, but it’s a headache for pharmacies still using old systems.

Why This Matters for Generic Drug Prices

Cross-border mobility isn’t just about convenience - it’s about competition. When patients can easily buy generics from countries where prices are lower, it puts pressure on national drug pricing systems. For example, a 30-day supply of omeprazole might cost €12 in Germany but only €4 in Poland. That’s a huge difference.

The European Commission estimates that better cross-border access could reduce overall EU drug spending by up to 15% over the next decade. That’s billions of euros saved - mostly on generics. But it also creates tension. Some national health systems fear losing control over pricing. Others worry about stock shortages if too many patients buy abroad.

To address this, the EU introduced the Critical Medicines Act in 2025. It now requires drug makers to report supply and demand data across borders. If a generic drug is running low in one country, the system can redirect supply from another. This is the first time the EU has created a real-time monitoring tool for medicine shortages.

What Patients Need to Know Before Trying It

If you’re thinking of using cross-border pharmacy services, here’s what you need to do:

1. Confirm your prescription is digital. Paper prescriptions won’t work across borders.
2. Check if your country is connected. Use the MyHealth@EU portal to see if your e-prescription can be shared.
3. Call the pharmacy ahead. Ask if they accept foreign e-prescriptions and if they stock your specific generic.
4. Bring ID and your e-Health card. Some countries require both.
5. Know your rights. Under EU law, you’re entitled to get the same medication abroad - even if it’s a different brand or manufacturer.

Don’t assume it’s automatic. Many patients don’t even know this service exists. Eurobarometer found only 38% of EU citizens are aware of their cross-border prescription rights. Awareness jumps to 72% in border areas - proof that education and exposure matter.

The Future: What’s Coming Next

By 2027, the MyHealth@EU system will expand to include lab results, hospital discharge summaries, and even medical images. That means if you have a heart condition and need a specialist abroad, your full medical history will be available - not just your prescription.

Iceland will complete its integration by August 31, 2025, making the system truly pan-European. The EU is also pushing for standardized reimbursement rules. Right now, if you buy a drug abroad, you might have to pay upfront and then apply for reimbursement later - a messy, slow process. New rules in 2026 aim to fix that.

But challenges remain. The EAEP warns that without faster regulatory alignment, digital inclusion will stay uneven. Some countries are moving fast. Others are stuck in paper systems. The goal is clear: no EU citizen should be denied medicine because of a border. But getting there takes more than technology - it takes political will.

Frequently Asked Questions