“My doctor tells me that he is no longer allowed to write” non-substitutable “on my prescription”
Since 1999, pharmacies could substitute a generic drug for the one prescribed on the prescription, but it was enough for the doctor to note “unsubstitutable” on the prescription for the pharmacist to be required to dispense the original drug (or princeps). But since January 1, they must specify on the prescription the medical reason that led them to make this decision.
And this reason must conform to the decree of November 12, 2019 which is pretty strict. Basically, there are three cases where the doctor can request the delivery of the original drug or princeps rather than that of the generic:
– Medicines with a “narrow therapeutic margin”, that is to say whose dosages are very finely adjusted (it will then be written MTE on your prescription) such as Levothyrox or medicines to avoid transplant rejection
– generic drugs which do not have a pediatric form (it will then be indicated CFG on the prescription)
– and finally when the patient presents ” a formal and demonstrated contraindication to an excipient with known effect present in all available generic medicines “(It will be marked CIF on the prescription)
“If I refuse the generic, I will not be reimbursed”
The care remains unchanged in case of acceptance of the generic drug by the patient: he does not make the advance of the costs and has no remainder to be paid, explains health insurance.
In the absence of the mention “not susbstituable” justified by the doctor, the pharmacist delivers the drug but makes the whole pay for it to the patient, who then does not benefit from the third-party payer (as has been the case since 2012). The novelty is that when the patient then sends their care sheet to their health insurance fund, it is reimbursed on the basis of the price of the generic, the difference remaining at its expense.