Medicine discounts

The main ingredient in a medicine is the active substance – this is the substance that treats or alleviates the disease. There may be more than one active substance. In addition, the medicine contains excipients that help deliver the active substance to the body (for example, in the form of a tablet, ointment, or spray).

Since the active ingredient is what affects the body, it is also responsible for the side effects of the medicine. Excipients do not cause side effects, except in rare cases where a person is allergic to one of them (e.g., lactose, nut oil, various sugars).

As a rule, manufacturers of both original and generic (copy) medicines use similar excipients. Only controlled and safe excipients may be used in medicines. Excipients used in medicines must not affect the efficacy or quality of the medicine.

Generic drugs (also referred to as copycat drugs and analog drugs) contain the same active ingredient as the original drug and treat the same diseases. It is as effective, safe, and high-quality as the original drug.

Generic drugs enter the market after the patent protection for the original drug expires, because then other drug manufacturers can also produce drugs with the same active ingredient.

The manufacturer of a generic drug must prove that the drug contains the same active ingredient in exactly the same amount as the original drug and that it has the same effect on the body as the original drug.

This is done through bioequivalence studies, which show whether the same amount of active ingredient from the original and generic drugs reaches the body and whether the amount of active ingredient in the body changes in the same way over time for both drugs. The manufacturer of the generic drug must also prove that the drug's manufacturing process complies with the established requirements.

Since it is a product from another drug manufacturer, the drug is not required to look the same as the original drug. Therefore, a generic drug may differ from the original drug in terms of excipients and appearance, but it must not differ in terms of efficacy, quality, and safety.

Only drugs that have passed the strict control of the State Agency of Medicines are sold in Estonian pharmacies.

When the patent for the original drug expires, other pharmaceutical companies can start producing drugs with the same active ingredient. This creates competition, which drives down the price.

The price of the original drug is initially higher because the manufacturer covers the drug's development costs. When patent protection expires, the price of the original drug may also fall in order to remain competitive with generic drugs.

A more expensive medicine does not mean that it is better. If medicines contain the same active ingredient, they are equally effective, safe, and of the same quality – even if their prices vary greatly. Therefore, it makes economic sense to choose the cheaper medicine.

In Estonia, pharmacies are required to offer you the most affordable equivalent medicine unless your doctor has specified a particular manufacturer on the prescription. If the prescription specifies the active ingredient, you can choose the medicine with the price that suits you best.

There is no medical reason to prefer a more expensive medicine.

No. Generic drugs with the same active ingredient are just as effective, safe, and high-quality as the original drugs.

It is rare to prefer or exclude a drug from a specific manufacturer for medical reasons (e.g., hypersensitivity to a specific excipient). In most cases, choosing a more expensive drug is simply a matter of habit or brand preference, not a medical necessity.

No. What matters is the active ingredient, not the name of the manufacturer on the packaging. During pregnancy, the necessity and safety of a specific active ingredient is always assessed, not who manufactures the medicine.

Original and generic medicines are equally effective and safe, even for pregnant women.

No. Generic drugs are taken in exactly the same dosage as the original drug. The dosage is determined by your doctor based on your condition, the active ingredient, and your health.

For more information, ask your pharmacist, doctor, or read the package insert.

Yes. Generic drugs work in the same way as the original drugs and are of the same quality and safety. Therefore, you do not need to change the dose or frequency of administration. The course of treatment continues in exactly the same way, only the manufacturer of the drug is different.

Regardless of whether you buy a generic drug or an original drug, the Health Insurance Fund's reimbursement rate (50%, 75%, 90% or 100%) remains the same.

Estonia has a price cap system. This means that the Health Insurance Fund does not calculate the discount based on the price of a specific drug, but on the reference price set for a group of similar drugs. Therefore, the choice of drug only affects the size of the co-payment.

Yes, people without health insurance must pay the full price for prescription drugs at the pharmacy.

If a doctor requests compensation for an unlicensed medicine on an exceptional basis, the insured person or their legal representative must submit a free-form application to the Health Insurance Fund. This must contain the following information about the applicant for compensation:

1. first and last name,
2. personal identification code,
3. contact details (address, telephone number, e-mail address).

The application must be accompanied by a statement from the attending physician. These documents must be submitted to the Health Insurance Fund by e-mail info@tervisekassa.ee, by post, or in person.

The decision on exceptional compensation is made by the board of the Health Insurance Fund. An extract of the board's decision will be sent to you and your treating physician. If the decision is positive, you can purchase the medicine from a pharmacy on the basis of a discount prescription. To do this, you must first notify the pharmacy so that it can order the medicine from the wholesaler.

Yes, family doctors can also prescribe birth control pills. If the patient has no contraindications for childbirth, the medication is prescribed at a 50% discount.

If you have health insurance from the Health Insurance Fund and have purchased discounted medicines worth more than €100 per year, you are eligible for additional medication reimbursement. The additional medication benefit is automatic; you will receive the discount together with the usual medication discount when purchasing the medication at the pharmacy, and you do not need to submit an application to the Health Insurance Fund.

If you have purchased discounted medications:

• 100–300 euros per year, the Health Insurance Fund will reimburse you 50% of the amount exceeding 100 euros (up to a maximum of 100 euros per year);
• more than 300 euros per year, the Health Insurance Fund will reimburse you 90% of the amount exceeding 300 euros.

Yes, the Health Insurance Fund reimburses the cost of prescription medicines in the European Union. First, you must purchase the medicine and then apply to the Health Insurance Fund for reimbursement.

To do this, you must fill out the application form Application for reimbursement of healthcare costs in the European Union on the Health Insurance Fund's website and attach the original prescriptions and receipts proving payment. The documents can be sent to the Health Insurance Fund by post or taken to one of the Health Insurance Fund's customer service offices.

The Health Insurance Fund will make an inquiry to the foreign country and, based on the information received, will transfer the reimbursable amount in euros to your bank account.