Dispensing,
Medical prescription – Substitution
Evolution of the prescription
Handwritten Printed
E-
prescription
E-prescribing
• More accurate prescriptions
• Eliminating illegible prescriptions:
– no handwriting for the pharmacist to interpret,
– Less errors caused by similar-sounding MP
• The Implementation of warning and alert systems
• Improves medication safety
E-prescribing
• Better management of medications costs
• Actual information
• Reduce time
E-prescribing
• Increase patient convenience and medication
compliance.
• Feedback and Statistical reports
E-prescribing
Repository of E-prescription¨:
Information available for:
• Prescribers
• Pharmacists
• Public ?
Central repository of e-prescription in
CZE
• Central repository of electronic prescriptions has been established as an
organisational part of SIDC (SUKL) according to Act No 378/2007 Coll. On
Pharmaceuticals and related legal changes (Act on Pharmaceuticals).
• Similar to the written prescritpion
• Digital signatures
• 2013
• 2015
• 2018
E-prescripion
• Forms:
Printed (paper form) with code
SMS
E- mail
• The structure: 12 positions, alfanumeric
Paper form of medical prescription:
- CD
- Exceptions from e-prescription:
- „Emergency“, failure of Central repository,..
- Prescription for MP, if the patient would like to také the MP
in other EU country
- Veterinary prescription
E-prescription only:
- Rx drugs with restriction
Insurance in CZE
• Compulsory health care insurance system
• Consists of not-for-profit health insurance
companies
• Health insurance company - freedom of
choice, can be changed
Insurers
• 111 General Health Insurance Company (VZP CR)
• 201 Military Health Insurance Company of the Czech
Republic (CR VoZP)
• 205 Czech industrial health insurance company (ČPZP)
• 207 Departmental Health Insurance Company
employees of banks, insurance companies and
construction (OZP)
• 209 Skoda Insurance Company (CLS)
• 211 Health Insurance Company of the Ministry of
Interior (ZPMV CR)
• 213 Coalfield Brotherhood Cash Office (RBP)
Patient information
• Name
• ID
• Address
• Telephone number - only with agreement of the
patient
• Year of birth - only if it isn't in the ID
• Weight of preschool children - if it is unusual
Patient ID
YYXXDD/SSSC
• YY – year of birth
• XX=MM (month of birth) for male (numbers 01-12)
• XX=MM+50 for female (numbers 51-62),
• DD = day
• SSS is a serial number separating persons born on the same date and C is a
check digit.
• 701020 - 20. 10. 1970
• The whole number must be divisible by 11.
• For people born before 1 January 1954 the form is YYXXDD/SSS (without the
check digit).
• This enables the system to work until the year 2054.
Medical Prescription
Medical prescription:
• 2 different medicinal products,
• limit - 3 months therapy;
• More than 3 months – prescription for repeating
dispensing
• 1 medicinal product – narcotic drugs or psychotropic
given lists
Medical order:
• No limit for medicinal products
• 5 different medicinal products – narcotic drugs…
Medical Prescription
• Brand name, dosage form, strenght, package
• INN of the substance, dosage form, strenght,
package
Name of the substance written in the
Pharmacopoeia, synonym or abbrevitation in the
Pharmacopoeia - prepared medicinal products
Diagnosis - ICD
• International Classification of Diseases (ICD)
by the United Nations and World Health
Organization
• "standard diagnostic tool for epidemiology,
health management and clinical purposes“
Medical Prescription
• Prescription „with blue stripe“
– 1 original + 2 carbon copy
• Original + 1st copy – in the pharmacy
• 2nd copy – the physician
• Medical order „with blue stripe“
– 1 original + 3 carbon copy
• Original + 1st, 2nd – in the pharmacy
• 3rd – the physician / health care facility
Prescribers
• Physicians – human, veterinary - providing preventive health care
• Physicians not providing preventive health care (i.e. university employees,
pensioners etc.) if:
– Mini-license with the insurance company where they are insured
– Possibility of prescribing Medicinal products for themselves and family
members if they are insured with the same insurance company
– Note in the prescription "for familiy member" or "Ad usum proprium"
Medical Prescription
Validity:
• 14 days
• 5 days
• 1 day after prescribing
Substitution – hand written medical
prescription
• Only from paper medical prescription
• In the original medical prescription prescribed more
packages of one product, than you have on stock
• In the original medical prescription prescribed two
different products, in the pharmacy isn‘t one on stock
• Medical prescription for repeating dispensing
• No specimen
Substitution – hand written medical
prescription
• the same information like the medical
prescription, stamp (pharmacy), signature,
date
• Original medical prescription – Note •
„Substitution has been written“
•
Substitution
• Original prescription – pharmacy; Substitution -
patient
• Medical prescription for repeating dispensing Original
prescription – patient; Substitution -
pharmacy
• Validity – as the original prescription