White and Blue Prescriptions in Norway. How to Qualify for Reimbursement?

The Norwegian healthcare system differs from the Polish one, among other things, in how prescriptions are handled for patients. In January 2022, new regulations came into force in Norway stating that doctors who mistakenly approve reimbursement for a medication must be prepared to pay a hefty fine.

Copy link

White and Blue Prescriptions in Norway. How to Qualify for Reimbursement?

The Norwegian healthcare system is significantly different from the model present in Poland. Fot. Adobe Stock, licencja standardowa

Financial liability for selected healthcare workers was introduced by regulations that have been in force in Norway since January 1, 2022. Medical professionals who unjustifiably issue a blue prescription, which reimburses the prescribed medication, will face a penalty. The smallest violations will incur a fine of 10,000 NOK. The most serious breaches can result in a sanction of 200,000 Norwegian kroner.

These changes have been negatively received by the medical community. “A doctor does not benefit in any way from issuing a blue prescription. When you have no opportunity for profit and additionally risk having to pay a high fine, it’s obvious that many people will not take the risk,” commented Dr. Einar Nordén to NRK. He also pointed out that patients will be the ones most affected. “I’m not too worried about the doctors, they are a resourceful group. I’m worried about the patients,” he added.

Who is Eligible for Medication Reimbursement in Norway?

According to the guidelines, blue prescriptions can be issued to patients who adequately document the course of their illness or demonstrate the need for therapy. The right to verify the legitimacy of reimbursements has been granted to the Directorate of Health (Helsedirektoratet). On behalf of the institution, representatives of Helfo (Helseøkonomiforvaltningen), the Norwegian equivalent of the Polish National Health Fund, carry out this task. As healthcare representatives argue, doctors who diligently fulfill their duties have nothing to fear. The new measures are intended to help reduce excessive state budget expenditures.

The introduction of new regulations may make it more difficult for people who, due to staff shortages, do not have a family doctor to purchase medications. The problem affects more than 130,000 residents of Norway.Photo: Fotolia

White and Blue Prescriptions in Norway

There are two main types of prescriptions in Norway. The first, white prescriptions, are issued to patients who pay the full price for their medications. The changes that came into effect in 2022 concern the second type—blue prescriptions. Holders of blue prescriptions pay 39% of the medication’s value. These are usually issued to people suffering from chronic diseases or those requiring specialist care.

Citizens of European Union countries, including Poland, are also entitled to medication reimbursement if a doctor issues them a blue prescription. At the pharmacy, they must present an ID and a valid EHIC card.

Patients whose out-of-pocket treatment costs (excluding expenses covered by the state) exceed 2,921 NOK in a year are eligible to receive a so-called frikort. The spending limit (egenandelstaket) is set annually by the Storting. Holders of this document are exempt from paying for blue prescriptions, specialist treatment, and other services provided by the healthcare system. Blue prescriptions are also exempt from charges if more than 520 NOK is spent within a three-month treatment period.

Detailed information about the frikort, also in English, is provided by the Directorate of Health.

In Norway, children and youth up to 16 years old do not pay for reimbursed medications. Special prescriptions (h-resept) are also issued to patients who require specialist treatment, usually after hospitalization. Hospitals are responsible for fulfilling these prescriptions. According to Norwegian regulations, prescriptions can only be filled by the person for whom they were issued. The exception is for patients who give someone a fullmakt, or authorization, to collect their medications. The authorization is only valid with identity documents and applies to a single designated pharmacy.

The Norwegian Medicines Agency specifies which medications can be dispensed on a blue prescription and what conditions must be met to receive them. If the doctor determines that the patient meets the requirements, they can issue a blue prescription. The doctor first reviews the medical documentation—only people suffering from serious and long-term conditions are eligible for reimbursement. The treatment must have at least a good effect relative to the costs incurred by the state. If the decision to cover the medication costs requires longer consideration, the patient can purchase the medication sooner, and a positive decision will result in a refund of the amount paid at the pharmacy. People applying for a blue prescription deal only with doctors. Specialists submit applications to Helfo on behalf of patients.

Children and youth over the age of 16 must issue a fullmakt (authorization) to their parents if they want them to collect prescriptions issued in their name.Photo: Adobe Stock/standard license

As in Poland, prescription medications can only be purchased at a pharmacy or at points authorized by Helfo. Supermarkets only offer basic supplements and other non-invasive preparations. A visit to the pharmacist requires taking a number and waiting in line. At the counter, you must present proof of identity. Purchases at pharmacies are kept to a minimum. Medications prescribed by a doctor are usually sufficient for a three-month course of treatment.

Source: NRK/Helfo/Helsedirektoratet/MojaNorwegia

How do you rate this article?