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

Imagine you’re on vacation in Spain and your blood pressure medication runs out. Back home, you get it for €5 a month. In Spain, the same pill costs €22. You have a valid prescription from your doctor in Germany. Can you walk into a Spanish pharmacy and get it? Yes-if you know how the system works.

How the EU Lets You Buy Generic Drugs Across Borders

Since 2011, EU law has guaranteed patients the right to get medicines in any member state. But it wasn’t until 2025 that the system started working smoothly. The key is the ePrescription and eDispensation service, now active in all 27 EU and EEA countries. This isn’t just a digital form. It’s a secure, encrypted link between your home country’s health system and the pharmacy abroad.

When you’re in another EU country, your doctor’s prescription is sent electronically to a pharmacy there. You show your national ID or health card, and the pharmacist pulls up your prescription through the MyHealth@EU platform. No paper. No fax. No waiting. The pharmacy dispenses the generic version-same active ingredient, same safety standards, often half the price.

This system works because of the eHealth Digital Service Infrastructure (eHDSI). It’s not a single app. It’s a network connecting national health portals. Germany, France, Austria, the Netherlands, and others have fully integrated it. Even Iceland, which isn’t in the EU, will be fully connected by August 2025.

What You Can Actually Get-And What You Can’t

Not every drug is available everywhere. The system lets you get medicines that are legally sold in the country you’re visiting. If your generic blood pressure pill is approved in Spain, you can get it. If it’s not on Spain’s market, you can’t. That’s not a flaw-it’s regulation.

You also can’t use prescriptions from outside the EU. Ireland, for example, rejects all prescriptions from the UK, even if they come from a licensed telehealth service. Pharmacists there must check the prescriber’s location, method of consultation, and registration status. A UK doctor’s e-prescription? Invalid. A German one? Valid.

And here’s the catch: some medications are classified differently across countries. A drug sold as a generic in Poland might be classified as a branded medicine in Italy. That affects pricing and availability. Pharmacists abroad don’t always know your home country’s classification system. That’s why you might get a different brand name-even if the active ingredient is identical.

Why This Matters for Generic Drugs

Generic drugs are the backbone of affordable healthcare in the EU. They make up over 80% of prescriptions in countries like Germany and Sweden. But price differences are huge. A 30-day supply of metformin (a common diabetes drug) costs €2.50 in Bulgaria but €18 in Denmark. Cross-border mobility lets patients shop for the best price.

The European Commission estimates this could cut medication costs for chronic disease patients by up to 30% over the next five years. For elderly patients on multiple generics, that’s hundreds of euros saved annually. And it’s not just about saving money. It’s about access. In rural areas of Eastern Europe, local pharmacies often run out of stock. A patient in Romania can now get their insulin from a pharmacy in Hungary if their local one is empty.

The 2025 Critical Medicines Act is pushing this further. It requires manufacturers to report real-time supply data to a new EU-wide platform. If a generic drug is running low in France, the system can flag that and redirect supply from Germany or Poland. This isn’t just convenience-it’s a safety net.

The Real Problems: Patchwork Rules and Confused Pharmacists

Here’s the truth: the system works well in theory, but not always in practice.

Only 8 EU countries have clear rules for how pharmacists should handle cross-border e-prescriptions. In the rest, pharmacists are left guessing. Many don’t know how to access the eHDSI portal. Others fear liability if they dispense the wrong drug. A 2025 study by the European Association of E-Pharmacies found pharmacists need an average of 40 hours of training to handle these cases confidently.

Language is another barrier. A patient from Poland gets a prescription in Polish, but the pharmacy in Portugal doesn’t have a translator. The Patient Summary feature-designed to show allergies, current meds, and history in the local language-isn’t always activated. Patients report having to print out their own summaries and carry them in their wallets.

Even consent is a hurdle. To share your health data abroad, you must log into your national portal (like Germany’s eGK or Italy’s SPID), select which countries can access your records, and set a time window. Some users say it takes three separate logins and two-factor authentication steps just to get one refill. That’s not user-friendly. That’s bureaucratic.

Border Regions Are Winning. Everyone Else Is Struggling

The biggest success stories are in border towns. In the Netherlands-Germany border region, 78% of patients report seamless access to cross-border pharmacy services. Why? Because they’ve been doing it for years. Local pharmacies have trained staff. Doctors coordinate across borders. Patients know the drill.

In non-border areas, that number drops to 42%. In countries like Ireland, Greece, and Latvia, awareness is low. Only 38% of EU citizens even know they have the legal right to get medicines abroad. Most assume they need to fly home or pay full price.

The European Commission’s 2025 review found that regions with high cross-border traffic-like the French-Spanish Pyrenees or the Austria-Czech border-have the most functional systems. They’ve built local networks. They’ve trained pharmacists. They’ve made it routine.

What’s Changing in 2025 and Beyond

The EU is pushing hard to fix these gaps. Italy replaced paper prescription stickers with GS1 DataMatrix codes in February 2025. These scannable codes hold all the drug’s info-batch number, expiry, prescriber ID-making verification faster and more secure. Other countries are expected to follow.

The European Shortages Medicines Platform is now live. It tracks stock levels of 150 critical generic drugs across all member states. If a shortage hits Belgium, the system alerts pharmacies in Poland and Slovakia to increase supply. It’s not perfect yet, but it’s the first time the EU has a real-time map of generic drug availability.

By 2027, the system will expand to include lab results, medical images, and hospital discharge reports. That means if you have a heart attack in Croatia and are treated there, your home doctor in Finland will automatically get your ECG and discharge summary.

What You Should Do Right Now

If you take regular generic medications and travel often:

• Check if your country participates in the ePrescription system. Most do-visit your national health portal to confirm.
• Enable cross-border access to your health data. Don’t wait until you’re abroad.
• Carry a printed copy of your Patient Summary (allergies, current meds, dosages) in English.
• Know the name of your generic drug in the local language. Use apps like Medscape or Epocrates to translate.
• Call ahead to pharmacies in your destination. Ask: “Do you accept ePrescriptions from [your country]?”

If you’re a chronic illness patient, ask your doctor to issue your next prescription electronically. Don’t wait for paper. Digital is faster, safer, and legally protected across the EU.

What’s Next for EU Generic Drug Mobility

The goal isn’t just cheaper drugs. It’s equal access. Right now, if you live in Luxembourg, you can get your meds anywhere. If you live in Malta, you’re stuck with local stock. The EU wants to fix that.

The 2025 regulatory overhaul is a turning point. But progress depends on two things: political will and public awareness. If patients don’t know they can use this system, they won’t ask for it. If pharmacists aren’t trained, they won’t offer it.

The numbers show it works. Cross-border pharmacy services reduced medication errors by 22% and improved chronic disease compliance by 17% in pilot regions. That’s not theoretical. That’s real health outcomes.

The future isn’t about moving pills across borders. It’s about moving care-seamlessly, safely, and without paperwork. The EU has built the system. Now it’s up to patients and pharmacies to use it.