What is Paperless Revenue?
The "Paperless Prescription", or "Electronic Dematerialization of the Prescription", is a new electronic model, in force since 2015, which includes the entire prescription cycle, from prescription at the doctor, dispensing at the pharmacy and checking invoices at the Control and Monitoring Center of the National Health Service.
This project, which started in June 2013, aims to gradually replace paper prescriptions by sending data electronically.
What has changed for the user with the introduction of the Paperless Prescription?
The user has access to the prescription information through SMS, email and/or through the issuance of the Treatment Guide made available by the doctor who issues the prescription. However, the user will always be able to access the prescription data through:
With the information from the Paperless Prescription, the user can go to any pharmacy in the country and dispense the medicines that have been prescribed as long as they are within the expiration date. You'll be able to buy one pack at a time, buying only what you need, when you need it, and where you need it.
Can the Paperless Prescription apply to all types of medicines and health products?
All types of medicines or health products can be prescribed, whether reimbursed or not, with the exception of biological medicines and assistive products.
Paperless Revenue is only applicable to Responsible Financial Entities (EFR), whose ultimate responsibility lies with the National Health Service and complementary entities.
Are the additional health benefits for users with the solidarity supplement for the elderly also applicable to the Paperless Prescription?
Yes. The Ordinance No. 66/2023, of March 6, created the dematerialized alternative procedure, adjusted to the socioeconomic condition of the beneficiaries of the solidarity supplement for the elderly.
In this way, the reimbursement of additional health benefits (BAS) will be applied directly at the time of dispensation, at the pharmacy, without the need for the user to request reimbursement.
However, for this to be possible, the user will have to have the benefit validated in the National Registry of Users (RNU) on the date of prescription, and the prescribed medication will have to be reimbursed by the National Health Service.
Is the reimbursement of medicines applied in the same way?
Yes. All data regarding reimbursement and the financial entities responsible are centrally recorded and applied, regardless of the revenue model.
What is the reimbursement given to additional health benefits?
With the implementation of dematerialization, the calculation of the benefit is now carried out at the time of prescription, based on the information registered in the National Registry of Users (RNU).
The amounts to be reimbursed depend on the type of product:
- Medicines: 50% of the part paid by the user
- Glasses: 75% of the amount paid by the user, with a maximum value of €100 in a period of 2 years
- Removable dental prostheses: 75% of the amount paid by the user in the purchase or repair, up to a maximum of €250 over a period of 3 years
That is, at the time of dismissal, this benefit is applied and the user pays the corresponding amount after applying the benefit.
In the Paperless Prescription, can what the doctor prescribes be changed?
No. The Paperless Prescription is registered in the National Prescription Database after it is issued, and it is not possible to change it.
How many packages can be prescribed in a Paperless Prescription?
In the case of medicines intended for long-term treatment, there is no limit to the number of packs, and the necessary packs may be prescribed to guarantee treatment for 12 months.
In the case of medicines for short/medium term treatments, up to two packs or, in the case of unit dose medicines, four packs may be prescribed. Where necessary, the doctor may prescribe a higher amount, appropriate to the duration of treatment, upon justification. In this case, the validity of the prescription is changed to 12 months.
How many packs can be dispensed at the community pharmacy?
The necessary packaging can be dispensed to guarantee the treatment of the user for 2 months, and the new dispensing of medications, for renewal of therapy, can be carried out up to 15 days before the end of the 2-month interval.
What is the validity of Paperless Recipes?
According to Ordinance No. 263/2023, of August 17, prescriptions are valid for 12 months, except:
- Manual prescriptions that are valid for 30 days
- paper prescriptions (materialized) for medicines intended for short/medium term treatments that are valid for 30 days
- Lines of paperless (dematerialized) prescriptions for medicines intended for short/medium term treatments, the prescribed quantity of which does not exceed 2 packs, or 4 packs of unit dose, which are valid for 30 days
How can the user request the renewal of the Paperless Prescriptions with their chronic medication?
The patient may request the renewal of the prescription for chronic therapy in the following situations:
- Doctor's Consultation
- in the administrative services of the health center
- by sending an e-mail to the health center
- through the Personal Area of the SNS 24 portal
If the prescription is not printed, how do I receive your information?
After the prescription is issued by your doctor, the information about it is made available to the patient through the following means:
- sending a text message to your mobile phone (SMS) and/or
- sending an e-mail, to which the treatment guide is attached, and/or
- through the printing of the treatment guide, by the prescribing doctor
All these means contain the codes necessary to dispense medicines or health products (access and dispensing code and right of option code) and can be used at the same time.
If I delete the SMS or email sent to me, can I retrieve my prescription information?
Yes. If you accidentally delete the SMS/email that was sent to you, you can:
- request the resending of the SMS and/or e-mail by your doctor or by contacting the health unit
- consult and/or print your treatment guide, through the personal area of the SNS 24 portal
- consult the treatment guide via SNS 24 mobile app
- Ask the pharmacy to check your prescription and dispensing history
How can the pharmacy check my prescription and dispensing history?
The pharmacy will be able to access your prescription and dispensing history through your National User Number, and by providing a new access and dispensing code that will be sent, upon request from the pharmacy, by SMS, to your mobile contact registered in the National User Registry.
What is the treatment guide?
The treatment guide is a personal and non-transferable document that contains, in addition to information on the medicines and health products prescribed, the prescription number, the dosage and the codes necessary (access and dispensation code and right of option code) to dispense the medicines/health products prescribed by your doctor.
What is the right of option code?
The right of option code is a personal and unique code that appears in the SMS, email and paperless prescription treatment guide and must be used by the user at the time of dispensation when he or she intends to exercise his or her right to opt for a prescription line.
In other words, when the user wants to opt for a more expensive medicine, with the same International Non-Proprietary Name, pharmaceutical form, dosage and package size, similar to the one prescribed, he must use the right of option code.
Do I have to provide the right of option code every time the pharmacist requests it?
Nope. The user should only provide this code to the pharmacist if they wish to opt for a medicine with a price higher than the 5th cheapest similar medicine.
Do I have access to the medicine leaflet in the Paperless Prescription?
You have access to the leaflet of the medicines dispensed through the SNS 24 App. To do this, simply access the menu "My health" > "Recipes" > Medicines. When selecting a medicine that has already been dispensed, click on the "i" icon to access the patient information leaflet.
Can I opt for the cheapest medications?
Yes. Pharmacies must have available for sale at least three medicines with the same active substance, pharmaceutical form and strength, from the group of the five cheapest similar medicines.
At the time of dispensation, the pharmacist must inform the user about the marketed medicine that is similar to the one prescribed and has the lowest price.
If I receive the Paperless Revenue data in an SMS, do I need more information to make the waiver?
Nope. With the data sent to you via SMS, the pharmacy can consult all the information on your prescription.
If there is no paper, how does the pharmacy access the prescription?
With the prescription number and the access and dispensing code, the pharmacy can access all the prescription information through the computer software.
If you do not have this data, the pharmacy will be able to access your prescription and dispensing history through your National User Number, and by providing a new access and dispensing code that will be sent by SMS to your mobile contact registered in the National User Registry.
With the Paperless Prescription, what documents do I need to present at the pharmacy to dispense?
At the pharmacy, the user will have to provide one of the following sets of information:
- Citizen's card + access code and dispensation available in SMS/email and treatment guide
or
- Prescription number + access code and dispensation, available in SMS/email and treatment guide
or
- National User Number + new access code and dispensation, sent, at that moment, by SMS to the mobile contact registered in the National User Registry
If you opt for a more expensive medicine than the 5th cheapest medicine, you must provide the right of option code.
Is the prescription on the Citizen Card?
Nope. The Citizen Card is only the means that unequivocally identifies the user in the community pharmacy.
If there is no paper, what proof is there of the prescription?
When the prescription is issued, it is digitally signed by the prescribing physician, confirming authenticity. After signing, the Paperless Prescription is automatically recorded in the National Prescription Database, with all the information indicated at the time of prescription.
Does the Paperless Prescription have to be waived in one go and in its entirety?
Nope. The user may choose not to dispense the entire prescription at the same time, without this implying that it becomes unavailable. You can split the dispensing of prescribed medicines and health products according to the availability of medicines, the price or other reasons inherent to the user.
However, according to Ordinance no. 263/2023, of August 17, the user can only dispense, at most, the amount to guarantee the treatment for 2 months.
In situations where it is not possible to determine the amount necessary to guarantee the treatment for 2 months, the user may only dispense a maximum of 2 packs, per drug, or 4 packs, in the case of packs in unit dose, per month.
Exceptionally, the user may dispense higher monthly amounts in the following situations:
- Loss, loss or theft of medicines
- Prolonged absence from the country
How do I know if my Paperless Prescription still has packaging available for dispensing?
To check if your paperless recipe still has packaging available for dispensing, you can:
- Consult the recipe through:
- Request this information from your pharmacy
How can I know the dosage if there is no paper?
The prescribed dosage is available in the treatment guide and can be consulted via the SNS 24 personal area or the SNS 24 mobile app.
However, at the time of dispensing, the pharmacist must inform you about the dosage of each medication.
Source: Shared Services of the Ministry of Health (SPMS)