Can we refuse to replace a drug with a generic?

Verified 06 March 2024 - Directorate for Legal and Administrative Information (Prime Minister)

Yes. It is possible to refuse the replacement of a drug by a generic drug.

A generic drug is made from the same molecule as a reference drug. It's cheaper.

However, your refusal has consequences for the benefit of the third-party payer, the time limit for reimbursement and the level of reimbursement. 

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Third Party Paid

You will not benefit in principle of the paying third party in pharmacy (dispensation of advance fees).

HoweverHowever, you can benefit from the advance fee waiver (third party fee) in certain cases.

This is particularly true when your doctor has stated that: " non-substitutable is justified on the prescription, the change of medication may cause you problems, given your medical situation.

The same is true when the price of the generic drug is greater than or equal to the price of the original drug.

Please note

As with your doctor, you can ask your pharmacist questions or discuss with your pharmacist any difficulty with the generic medicine (for example, a taste you do not like or a less convenient tablet form).

Repayment period

The pharmacist shall establish a care sheet paper for the medicine concerned, which you send, together with the prescription, to your health insurance fund for reimbursement.

You must first advance the costs for the entire prescription and then get reimbursed by your health insurance organization.

The therefore, the period for reimbursement is longer because of the time it takes to process your care sheet.

Reimbursement Level

You will be reimbursed on the basis of the flat rate liability (TFR).

This tariff sets an identical reimbursement amount for the original medicinal product and for generic medicinal products.

If you want a brand name drug that is more expensive, the The extra cost is at your expense.

Example :

A doctor prescribes a brand name drug that costs €20 and which has a TFR of €18.

If you don't want the pharmacist to give you a generic, you pay for the brand name €20, or €2 more expensive than the generic. You are reimbursed on the basis of €18 instead of €20 after having made the advance to the pharmacist, since you do not benefit from the paying third party.

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