How to buy prescription medicines and other prescription products

Apoteket sells both non-prescription and prescription medicines. In order for you to pick up prescription drugs at a pharmacy or order them online from apoteket.se a doctor or other prescriber must write a prescription for you.

Prescriptions are usually sent to the pharmacy electronically, but sometimes they are printed out on paper for you to take to the pharmacy. When you receive a paper prescription, you must bring it to the pharmacy in order to pick up the medicine. No matter what kind of prescription you have, you must show identification to pick up your medicine.

Pharmaceutical Benefits Scheme

You pay a maximum of SEK 2.600 a year for medicines covered by the ‘pharmaceutical benefit scheme’. This is called the high-cost threshold (Högkostnadsskydd). The county council pays for costs exceeding that amount.

Medicines covered by the Pharmaceutical Benefits Scheme

• Most prescription medicines
• Stoma care products
• Disposable items needed to administer medicines
• Disposable items needed to check your medication

The agency that decides which medicines are covered by the high-cost threshold is called the Dental and Pharmaceutical Benefits Agency (TLV). When you buy prescription medicines, your purchase is registered if you are a member of a high-cost database. The system keeps track to make sure that you get the right discount every time you purchase prescription items.

You are entitled to the pharmaceutical benefits if you

• Resident in Sweden.
• Work here or have a European Health Insurance Card.
• Have prescriptions that were written in Sweden.

Please note that the high-cost threshold database does not keep a record of what medicines you received or which doctors prescribed them. The database keeps a record of your personal identity number, co-payment paid, date of purchase, the amount you have reached in the high-cost threshold system, and the starting date of the high-cost threshold period.

Joining the Pharmaceutical Benefits Scheme

The easiest way to benefit from the high-cost threshold is to enrol in the high-cost threshold database. If you are not enrolled, the easiest way to do so is to talk to the pharmacy staff when you pick up your medicine.

When you are enrolled in the high-cost threshold database the system keeps track of what you have spent and when you reach the threshold. Since all pharmacies are connected to the same database, you can shop at any pharmacy.

Free for children

Since 1 January 2016 prescription medications covered by the Pharmaceutical Benefits Scheme are free of charge for children under age 18. In cases where additional costs are incurred because you choose a different drug than the least expensive equivalent option (see below – Rules for interchangeable medicines), you pay for it yourself, as previously. You also pay for products prescribed for children that are not covered by the Pharmaceutical Benefits Scheme, just as before. Nothing has changed regarding foodstuffs prescribed for children under 16 years; they still cost SEK 120 each time.

Incremental discount system

Once you have purchased medicines for a total of SEK 2.600 during a twelve-month period, you are entitled to a free pass within the high-cost threshold system for the remainder of this twelve-month period.

Although the free pass only applies after you spend SEK 2.600, you receive incremental benefits when you spend a certain amount according to the discount system shown below. 

The incremental discount system below shows the co-pay corresponding to certain medicine prices. The discount for each new purchase is based on the previous purchase.

You do not pay anything for disposable items needed to check your medication and disposable items needed to administer medicines.

Total cost	Your share	Your maximum payment
- SEK 1.199	100 %	- SEK 1.199
SEK 1.200	50 %	SEK 1.200
SEK 2.291	25 %	SEK 1.745
SEK 4.256	10 %	SEK 2.237
SEK 5.890	0 %	SEK 2.600

Rules for refills

For your medicine purchase to be counted within the high-cost threshold system the following applies

• The prescription may be filled with a maximum of a three-month supply of the medicine.
• The prescription cannot be filled again until after 2/3 of the time covered by the previous refill, based on the dosage in the prescription. In other words, the earliest that a new refill for a three-month supply can be approved under the pharmaceutical benefit scheme is after two months.
• The workplace of the prescriber (the doctor or other person who gave you the prescription) must be on the prescription as a readable barcode. The prescriber must also note on the prescription that the pharmacy should dispense the medicine under the pharmaceutical benefit scheme.
• If you do not want to enrol in the high-cost threshold database, but still want to take advantage of the high-cost threshold, you must always bring the high-cost threshold certificate with you when you buy prescription medicines.

Exemptions

• You may purchase a larger amount of medicine at one time, or more often than the limit for the benefit, but then you must pay the full cost for the amount that exceeds one prescription refill.
• Under special circumstances, such as a longer stay abroad, you may pick up a supply of medicine that will last longer than three months and still qualify for the discount. You must be able to prove the special circumstances.
• Birth control medicines (oral contraceptives/contraceptive injections) are generally exempt from the three-month rule.

Request records from the high-cost threshold database

You may at any time request a printout of the information available in the high-cost threshold database about you and the children for whom you are the guardian. You may do so by completing and submitting a form to the e-Health Agency.

Benefit system and discounts for prescription foodstuffs

Foodstuffs for specific nutritional purposes are not covered by the regular pharmaceutical benefit rules. For children up to age 16 there is a national benefit system under which prescriptions (or ‘food prescription forms’ as they are also called) are dispensed at pharmacies at a cost of SEK 120 per refill. The Swedish Medical Products Agency decides which products are covered by this benefit system.

For people over age 16 there is no national benefit system. However, most counties have discount models under which those who need such foodstuffs do not have to pay the full cost. How much you have to pay and what products are covered varies among the counties.

Some counties have chosen to use sources other than pharmacies for the products included in the discounted product range. Your dietitian or doctor can advise you on the situation applicable in your particular case.

Apoteket offers a broader total product range under the various discount systems than what is sold here at apoteket.se. The range includes gluten-free products, tube feeding formulas and products for congenital diseases such as PKU. In many cases, the individual relies on such products to be able to live as normal a life as possible.

Rules for interchangeable medicines

To receive full coverage under the Pharmaceutical Benefits Scheme, you must choose the product recommended by the Dental and Pharmaceutical Benefits Agency (TLV). The names, appearance and packaging of the medicines may differ, but they contain the same active substance and provide the same effect.

How the interchangeability rules affect you

Apoteket must always offer to switch the medicine you have been prescribed if a less expensive interchangeable drug is available. The substituted medicine must be the medicine approved by the TLV. The pharmacist may not substitute a medicine if the prescriber objects to substitution on the prescription.

Substitution is not permitted if you as the customer object to substitution. In such cases you must pay the difference between the prescribed medicine and the least expensive drug on the market. The difference is not covered by the Pharmaceutical Benefits Scheme.

You may request substitution with an interchangeable medicine other than the least expensive option (the one approved by the TLV), but in this case you must pay the full cost yourself without coverage under the Pharmaceutical Benefit Scheme.

Since the least expensive medicine on the market may vary from period to period, each time you fill your prescription the medicine may look different, but it contains the same active substance. It is therefore important to pay attention to make sure that, for example, you do not take a double dose of the same active substance.

The Medical Products Agency decides which medicines are interchangeable

For medicines to be interchangeable the Medical Products Agency must assess that they are medically equivalent in effect and that substitution by the pharmacy is safe for the patient. Substitution is sometimes called generic substitution.

Buying medicine for someone else

If you are going to pick up prescription medicine for someone else, you need that person’s permission through a power of attorney.

You need a power of attorney to

• Order or pick up medicine prescribed for someone else
• Charge someone else’s account when buying on credit (if he or she already has such an account with Apoteket AB)
• Obtain a printout showing all saved prescriptions that the person for whom you are doing pharmacy errands may have
• Order medicine for another person at apoteket.se

Bring a completed and notarised power of attorney from the person for whom you are shopping, to the local pharmacy. In order to shop and do errands at Apoteket for another person for whom you have a power of attorney, you must show the power of attorney, your own valid identification and the identification of the grantor of the power of attorney.

You can find the power of attorney form at the e-Health Agency website

Guardian shopping for own child

Guardians of children under age 18 may shop without a power of attorney at Apoteket stores or online at apoteket.se from electronically saved prescriptions (e-prescriptions). Just show your own valid identification at the pharmacy. When you log in to apoteket.se on Mina sidor (My account) you can automatically see for whom you have the right to pick up medicines. However, anyone who is not the child’s guardian must have a power of attorney.

You can find the form to give someone else power of attorney to buy medicine for your child at the e-Health Agency website.

Payment on credit

Payment on credit allows you to avoid large expenditures when purchasing prescription drugs.

You can apply for an account to make payments on credit if you are of legal age, resident in Sweden, enrolled in the high-cost threshold database or have multi-dose packaged medications (Apodos).

Credit approval requirements

Apoteket performs a credit check on all new customers who purchase medicines and who want to make payments on credit. The same applies to individuals who wish to be invoiced for their purchases on separate occasions.

When you apply for an account to make purchases on credit at Apoteket, you usually receive the answer immediately.

Payment on credit with free pass

Once the co-pay reaches SEK 2.600 you will receive a free pass, but you must continue to make payments on the balance in the charge account until the debt is repaid.

View your filled prescriptions

You may request a summary of all of your filled prescriptions. The summary (Medication List) gathers information about the medicines for which you have filled prescriptions at the pharmacy over the past 15 months. Bring valid identification to your local pharmacy to get a printout from the database.