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

Imagine needing your regular blood pressure medication while on vacation in Spain, but your local pharmacy back home is closed. In the EU, you don’t have to panic. Thanks to the ePrescription system, you can walk into a pharmacy in Barcelona, show your digital ID, and get the exact generic drug you take at home - no paper script, no delays. This isn’t science fiction. It’s happening right now, across 27 EU and EEA countries.

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. It’s not a single app or website. It’s a secure digital bridge connecting national health systems. When you’re prescribed a generic drug in Germany, your doctor uploads the prescription electronically to your country’s health portal. That same prescription can then be accessed by a pharmacy in Austria, France, or Poland - as long as both countries are connected to the network.

You don’t need to carry anything physical. Just log into your national health portal (like Germany’s eGK or France’s Ameli) using your electronic ID. From there, you can authorize a pharmacy in another EU country to access your prescription. The system also sends a Patient Summary - a short, translated list of your allergies, current meds, and key medical history - so the foreign pharmacist understands your needs, even if they don’t speak your language.

This isn’t optional. It’s a legal right under Directive 2011/24/EU. Every EU citizen has the right to get their medication abroad under the same conditions as local patients. That includes generics, which are often cheaper and just as effective as brand-name drugs.

What’s Actually Available Across Borders

Not every drug is available everywhere. While the system works for most common generic medications - like metformin for diabetes, atorvastatin for cholesterol, or levothyroxine for thyroid issues - there are limits. Some countries restrict access to certain controlled substances or specialized treatments. A pharmacy in Italy might not stock the exact generic version you use in Poland if it’s not approved there.

The system also doesn’t automatically cover reimbursement. If you buy your medication abroad, you usually pay upfront. Then you submit the receipt to your home country’s health authority for partial or full refund, depending on your national rules. Some countries, like the Netherlands and Denmark, have streamlined this process. Others still require paperwork and long waits.

In border regions - think northern Germany near the Dutch border or southern Austria near Italy - cross-border pharmacy use is common. A 2025 survey found 78% of patients in these areas successfully filled prescriptions abroad. In non-border areas, that number drops to 42%. Why? Because people in border towns have built routines around it. They know which pharmacies accept foreign ePrescriptions. They’ve done it before. In cities far from borders, most people don’t even know the system exists.

The Real Bottlenecks: Regulation, Awareness, and Trust

Here’s the problem: the rules aren’t the same everywhere. Only 8 EU countries have clear, detailed regulations governing how pharmacists handle cross-border ePrescriptions. That means in countries like Ireland, a prescription from a UK telehealth service is automatically rejected - even if it’s perfectly valid under UK law. Pharmacists are legally required to check how the prescription was issued. If it came from an online clinic, they can’t dispense it. This catches many travelers off guard.

Even worse, awareness is shockingly low. Only 38% of EU citizens know they have the right to get medication across borders. In the UK, which is no longer in the EU, the situation is even more confusing. While UK-issued prescriptions are still accepted in Ireland if they meet specific formatting rules, prescriptions from UK-based telehealth platforms are not. That’s a legal gray zone many people stumble into.

Then there’s the tech. The system requires you to log into your national portal, give consent, and sometimes go through multiple authentication steps. One patient in Sweden told a 2025 survey she spent 45 minutes trying to authorize a pharmacy in Finland. She gave up and bought her medication locally at full price.

What’s Changing in 2025 - And Why It Matters

2025 is a turning point. The EU rolled out major updates to make the system more reliable. Italy now uses GS1 DataMatrix codes on prescriptions instead of old-fashioned stickers. These barcodes hold encrypted data about the drug, patient, and prescriber, making counterfeiting harder and verification faster. Iceland will complete its integration into the eHDSI network by August 31, 2025, bringing the system to all 28 EEA countries.

The new Critical Medicines Act forces drug manufacturers to report supply issues in real time. This helps prevent shortages - a major reason people cross borders in the first place. If a generic drug runs out in France, the system can flag that and redirect patients to pharmacies in Belgium or Germany where it’s in stock.

The European Shortages Medicines Platform (ESMP) is now live, giving pharmacists and doctors a shared dashboard to track availability across borders. It’s still early days, but early data shows it’s reducing delays by up to 19% in pilot regions.

Who Benefits the Most?

The biggest winners are people with chronic conditions who need steady access to generics. Elderly patients on multiple medications, diabetics, and those with autoimmune diseases often face supply issues at home. Cross-border access gives them a safety net. It’s also a lifeline for expats and retirees living in one EU country but receiving prescriptions from another.

It’s also helping pharmacies. Digital e-pharmacies are growing fast. The EAEP reports 120 registered e-pharmacies across 15 countries, and the market is projected to grow at 14.3% annually through 2030. These pharmacies aren’t just selling drugs - they’re offering teleconsultations, medication reviews, and refill reminders, all tied into the ePrescription system.

But traditional brick-and-mortar pharmacies are catching up. Many now offer digital services to compete. In Spain, for example, over 60% of pharmacies can now process foreign ePrescriptions - up from just 22% in 2022.

What You Need to Do to Use It

If you’re planning to get a generic drug abroad, here’s what actually works:

1. Check if your country is connected to MyHealth@EU. All 27 EU/EEA countries are.
2. Make sure your prescription is issued electronically. Paper scripts won’t work across borders.
3. Log into your national health portal and enable cross-border access for the country you’re visiting.
4. Carry your EU health card and a form of digital ID (like a national eID or mobile authentication app).
5. Call the pharmacy ahead of time. Ask: “Do you accept ePrescriptions from [your country]?”
6. Keep your receipt. You’ll need it to claim reimbursement at home.

What Still Doesn’t Work - And Why

The system breaks down in three main areas:

• Language gaps: Patient Summaries are translated, but they’re brief. Complex conditions still require in-person help.
• Medication differences: A generic in Germany might use a different filler or dosage form than the one you’re used to. Not dangerous, but can cause confusion.
• Reimbursement delays: Getting your money back can take 3-6 months in some countries.

And don’t try to use prescriptions from outside the EU. Ireland, for example, rejects all non-EEA prescriptions - even if they’re from the UK, Switzerland, or the US. That includes telehealth prescriptions from American-based clinics. They’re not valid.

What’s Next?

By 2027, the MyHealth@EU system will include lab results, medical images, and hospital discharge summaries. That means if you have a heart attack in Portugal and are treated there, your home doctor in Sweden will see the full record - including the generic drugs you were given.

But the real test is political will. Without more funding, better training for pharmacists, and clearer rules, the system will stay patchy. Right now, pharmacists need about 40 hours of training to handle cross-border prescriptions properly. Many don’t get it.

The potential is huge. IQVIA estimates cross-border access could cut medication disparities in the EU by 35% by 2030. But that only happens if people know it exists - and if governments make it work.