All prescriptions must be issued electronically as from 1 January 2017. However, the following will still be issued on a paper prescription:
- Pro Auctore prescriptions
- medical gases
- special licence preparations specific to a patient or institution
The doctor is obliged to issue the patient with an electronic prescription (the Act on Electronic Prescriptions). However, the patient has the right to refuse an electronic prescription until 31 December 2016. As from 1 November 2015, this right does not apply to prescriptions for CNS drugs and narcotics.
The healthcare unit must inform the patient about the electronic prescription and record that this has been done in the patient records system. The information is provided either verbally, in writing, or via an electronic service. The information need not be given each time, but once is sufficient. The patient always has the option of obtaining the information also in writing.
Before prescribing a medicine, the doctor should check the Prescription Centre for the patient’s existing prescriptions. The patient’s verbal consent must be obtained before viewing the prescription information. The Prescription Centre also shows dispensing details for the prescriptions; i.e., the names of products dispensed to the patient at the pharmacy, when medicines were last picked up and the amount of the medicine left on an existing prescription.
What may be prescribed
All preparations in the Pharmaceutical Database may be prescribed electronically, such as
- drug preparations subject to sale licenses (incl. narcotics and CNS drugs)
- preparations with temporary special licenses
- reimbursable base creams
- reimbursable clinical nutrition preparations
You can also prescribe electronically using
- the chemical drug name (generic prescribing),
- medications prepared in the pharmacy, and
- preparations not included in the Pharmaceutical Database. These include e.g.
- medical consumables
- non-reimbursable dietary supplements
- non-reimbursable base creams
The doctor may include a note to the pharmacy with an electronic prescription. In the note, the doctor may give instructions on dispensing the drug, e.g. that the drug may be dispensed only after a certain date.
For persons without a personal identity code, their name and date of birth can be used to issue a prescription. This kind of a prescription can be dispensed by a pharmacy only with a patient instruction sheet or summary.
Doctors may issue an electronic prescription for themselves. Nurses or medical students with prescribing rights may not issue electronic prescriptions for themselves.
Patient instruction sheet
The electronic prescription is stored in the Prescription Centre. A patient instruction sheet to be given to the patient is printed out at the same time with issuing prescriptions.
The patient instructions need not be given if the patient is not present at the prescriber's surgery or clinic when the prescription is issued. Similarly, the patient instructions need not be given if this is not possible for technical reasons or if the electronic prescription is issued using a device with no fixed position.
The patient instructions contain details of the drugs prescribed and directions on dosages. The patient instructions can be printed off from the patient records system for 12 hours from the issue of the electronic prescription. It can also be printed off from amended and repeated prescriptions. The patient instruction sheet includes a barcode which individualises the prescription and speeds up the transaction at the pharmacy.
Summary of electronic prescriptions
Patients can request for a print-out summarising their prescription data stored in the Prescription Centre at the place of their treatment or in the pharmacy. The summary can be printed with
- all of the patient's electronic prescriptions
- all prescriptions issued within a certain period, or
- all prescriptions with drugs outstanding.
The patient may also print a summary of his or her electronic prescriptions in My Kanta Pages.
Copy of electronic prescriptions for travelling abroad
For travelling abroad, patients may ask the prescriber of their medicines or the pharmacy for a signed English-language summary printout "Copy of electronic prescriptions" on their prescription details stored in the Prescription Centre. The copy may only be issued on dispensed prescriptions.
Using electronic prescriptions abroad
With an electronic prescription, you can buy prescribed medicines also in European pharmacies that are set up to dispense medications on a foreign electronic prescription. At this time, medicines can be bought from Estonian pharmacies.
Before buying a prescribed medicine, go to My Kanta and give your consent to the release of your prescription information to pharmacies in other European countries.
The following are not available from foreign pharmacies on an electronic prescription:
- narcotics and CNS drugs
- medications prepared in the pharmacy
- over-the-counter products that are not medications (e.g. base creams and clinical nutritional preparations)
- medical consumables, dietary supplements and dressings.
- preparations prescribed for a specific period of time (such as when the prescribed amount of medicine is expressed verbally as for example “medication for 12 months’ use”
- preparations that can be dispensed at specific intervals of for example one month. Such prescriptions have the words ‘iter semel’, ‘iter bis’ or ‘iter ter’ on them.
- combination packages containing several preparations
- special license preparations for compassionate use that are patient specific
- preparations associated with a doctor’s fee that have not yet been dispensed in Finland.
Any medicines dispensed abroad are shown in the prescription details in the same way as medicines dispensed in Finland. If the medicine was dispensed by a pharmacy in another European country based on a different unit of measurement (such as in millilitres rather than vials), the amount of medicine left on the prescription is reset to zero and no more medicine can be dispensed on the prescription. The prescription will have to be renewed.
Prescriptions for purchasing medication abroad
The prescriber can write a prescription titled “Prescription for purchasing abroad” if the patient needs to buy medication while staying in a foreign country other than Estonia. In place of the patient instructions, the prescriber prints an English-language prescription in this case. The prescription cannot be used to purchase medicines in Finland. Information about medicines dispensed abroad is not recorded in the Prescription Centre.
The following drugs cannot be prescribed for purchasing abroad
- CNS drugs containing narcotics or requiring an original prescription
- medications prepared in the pharmacy
The EU countries must recognise prescriptions issued in other member states. A pharmacy may refuse to dispense a prescription issued in another member state if it has doubts regarding the authencity or propriety of the prescription. The pharmacy dispenses the medicines in accordance with the legislation of its own country.