Most medications are prescription-only drugs. This serves the safety of patients since when administering certain strong active agent-containing medicines, medical supervision (follow-up) is required.
Prescription-only drugs are exclusively available in pharmacies (while some OTC drugs can be purchased at drugstores, too). Based on their distribution, we differentiate the following medicine categories.
I. group: drugs distributable without prescriptions (VN) – over-the-counter (OTC) drugs
II. group: drugs distributable exclusively with prescriptions:
- prescription-only medications (V);
- medications that require special prescription order or other restrictions:
- narcotic and psychotropic drugs (KP),
- drugs if administered differently than recommended bear a risk of abuse and addiction (H),
- new medications, which mechanism of action and side effects needs to be further investigated (Ú) (For further information: Safe application of medicines)
- drugs for particular specialties:
- medications available for outpatients after the diagnosis is established by a specialist/in inpatient care (J),
- medications available with regular specialist follow-up after the diagnosis is established by a specialist/in inpatient care (Sz),
- medications applicable at inpatient or outpatient health care facilities (I).
Where can I find this classification of medicines?
You can find the classification on the website of the National Institute of Pharmacy and Nutrition (OGYÉI, Országos Gyógyszerészeti és Élelmezés-egészségügyi Intézet) .
You can find the drug database on the OGYÉI’s website. You can search by the name, the active agent, or by the characteristics of the drug. If you click on the drug you are interested in, by scrolling down on the drug’s profile, you will find the one or two-letter indications in the “Distribution” column.
The abovementioned abbreviations indicate, what type of prescription you need for the drug (for example: J – GPs can prescribe the medication after specialist indication, KP – the drug is considered narcotic or psychotropic agent, and its prescription is strictly regulated).
Which drugs have special prescription regulations?
Drugs considered narcotic or psychotropic agents
Handling narcotics and psychotropic agents are precisely regulated by legislation, so as their prescription and distribution. The most important regulations for prescribing narcotics or psychotropic drugs are below.
The prescription must include:
- well-readable medical seal,
- instead of package units, dosing units must be indicated (instead of “one box”, or “10 tablets”),
- the dosing units must be indicated with Roman numbers and written in Latin, too,
- the potency (strength) of the drug also must also be indicated: with Arabic numbers (and with letters, in Latin, if written by hand),
- Clear and short instructions: e.g. “if necessary” – this is not an adequate command for application, but “if necessary, 1 tablet, 3 times/day maximum” is a clear instruction.
Important to note. Initially, doctors can prescribe a 15-day-supply of the narcotic or psychotropic drug for the patient. Drugs must be purchased within 5 days.
If the patient needs to take the specially controlled drug continuously, the GP can prescribe them later (except the case when the drug can be prescribed only by a specialist). GPs can prescribe a 30-day-supply of specially regulated drugs (except in special cases, e.g., traveling abroad, then a 90-day-supply). When the doctor prescribes the medication, they are required by Annex No.1 of the 43/2005 EüM directive to fill in a form, called Notice, which notifies the pharmacy chosen by the patient of the continuous or regular prescription of the drug.
The prescription and the notice are handed over to any pharmacy the patient or their relative chooses, and they purchase the drug there (from that time on, this pharmacy will be the only pharmacy where they can have access to this medication).
New notice is required if the original expires (after 3 months), or the doctor’s prescription changes (if the medication or the dosage changes).
Drugs that can be prescribed only by particular specialists
Certain medications can be prescribed by particular specialists only, or GPs can prescribe them by the indication of particular specialists. The following regulations apply to these drugs.
GPs can prescribe them by medical specialist’s indication: The drug is used to treat conditions, which diagnosis must be established in inpatient facilities or in facilities with appropriate diagnostic equipment, even though the administration of the drug and the follow-up care – after medical indication – can be conducted in an outpatient manner.
Only specialists can prescribe the medication: The drug is used to treat outpatients, but its side effects might be so severe that special consideration and surveillance by a specialist is necessary during the treatment. This also indicates the drug’s prescription by specialists.
Drugs that cannot be prescribed and can be administered only in the healthcare facility: The drug – due to its pharmacological and public health-related properties or because of its novelty- is used during special treatments conducted by in- or outpatient facilities.
Can the GP prescribe the medication? If so, how?
In the abovementioned table, drugs included in the J category (medications available for outpatients after the diagnosis is established by a specialist/in inpatient care) can be prescribed by GPs upon medical specialist indication.
Medications requiring medical indications are usually used for prevention or for continuous, lifelong treatment of severe illnesses. These diseases – if not managed appropriately- might lead to life-threatening conditions or might significantly impede patients’ quality of life. With a medical indication, drugs can be purchased with raised coverage thereby treatment will be more easily manageable financially for the patient. Hence, the financial burden is somewhat decreased on patients in hard life situations.
The medical indication is restricted to a certain illness. Therefore, in order to receive medical indication for a particular drug, one must have a medical diagnosis listed among the indications of the drug. BNO codes (Betegségek Nemzetközi Osztályozása, International Classification of Diseases, ICD) written on the prescriptions indicating the reason for the application of the given drug.
The form required for medical indications can be accessed here (both handwritten and typed fill-in forms are available):
- medical indication for one drug,
- medical indication for multiple drugs,
Specialists can submit the “medical indication for drug prescription with raised coverage” or the “medical indication for multiple drug prescription with raised coverage” forms by post or electronically, via the EESZT system, including the following data:
- the “medical indication for drug prescription with raised coverage” title,
- date of issuance of the medical indication and the expiration date,
- the name, place of residency, date of birth and TAJ (Social Security Code) of the patient,
- the BNO code of the diseases,
- the name of the physician and the number of the doctor’s medical seal, the address of their workplace (medical office), the phone number and if they work as entrepreneurs, their license number must be indicated, too,
- the indication of eligibility for the medical indication, the coverage category (emphasized, raised), and the amount of coverage (percentage) in the case of the raised category,
- the prescribed drug’s active agent, potency, route of administration and recommended dosage,
- if the form is filled out manually, it must indicate the medical seal and the signature of the physician, if the form is submitted electronically via the EESZT, the physician’s medical license number must be indicated, too.
On the medical indication, the specialist indicates as an example a particular product containing the prescribed active agent, however, the physician who prescribes the drug later on upon the medical indication can prescribe any type of product for the patient containing the same active ingredient.
Medical indications of patients with no complaints who are in stable condition expire in 24 months.
What medications cannot be prescribed upon medical indications?
In the abovementioned list, there are two categories that cannot be prescribed by GPs, not even upon medical indication:
„Sz” – drugs, that can only be prescribed by physicians of a particular specialty, which administration requires continuous medical follow-up and surveillance by a specialist (e.g., drugs used for treatment of certain diseases, such as rheumatoid arthritis, sclerosis multiplex and certain anti-cancer drugs, etc.). These diseases usually treated with strict medical follow-up, hence the patient inevitably visits the healthcare facility, where they receive the prescription for the drug.
„I” – drugs, that can only be administered in healthcare institutions, hence they are not prescribed for the patient, but the healthcare facility orders it for the patient for in-facility administration (e.g., chemotherapy drugs, radioactive element-labelled drugs, certain antibiotics).