How a prescription is legally obtained online, country by country

Remote treatment has been permitted since the medical profession lifted its own ban in 2018, and the electronic prescription made the second half of the process ordinary: a doctor consults by video, issues an electronic prescription, and any pharmacy in the country dispenses it, including the one on your street.

What can be checked: the video service itself. The National Association of Statutory Health Insurance Physicians publishes a list of video service providers certified against Annex 31b of the federal framework agreement, and that document is linked in the sources below. Mail-order pharmacies are separately listed in the federal mail-order register.

The practical consequence is that in Germany the prescriber and the seller are usually different companies, and that is a good thing: nobody who decides what you need also earns from selling it.

France is the only one of these four countries where teleconsultation companies hold a formal state approval. A decree of 29 February 2024 created it, and the approval is granted by the health and social security ministers against a list of technical and organisational requirements.

That makes the check unusually simple: either a service holds the approval or it does not, and the list is maintained by the health ministry. The doctor must separately be registered with the medical council, as for any consultation in France.

Prescriptions are dispensed by ordinary pharmacies. The consultation itself is billed and reimbursed like a normal appointment, subject to the usual conditions.

Italy allows the online sale of medicines that do not require a prescription, and only those. Selling prescription medicine online is prohibited, and pharmacies allowed to sell the permitted categories carry the national identifying logo and appear in the ministry's list of authorised sites.

This does not mean Italians cannot use telemedicine. A doctor may consult remotely and issue an electronic prescription, and the prescription is then dispensed by a physical pharmacy. What cannot happen legally is the last step arriving by post from a website.

So any site offering to post prescription medicine to an address in Italy is, by that offer alone, outside the law. That is a rule about the seller, not about the patient, but it is also the clearest single test available in this country.

Online pharmacies are registered with the General Pharmaceutical Council, which publishes both the register and its inspection reports. Services where a doctor prescribes are separately registered with the Care Quality Commission as independent doctor services.

Reading an inspection report before ordering is the single most informative two minutes available in any of these four countries, and almost nobody does it.

One British peculiarity worth knowing: a 50 mg version of sildenafil is sold in pharmacies without a prescription after speaking to a pharmacist. That is genuine, it is legal, and it is not the same thing as buying it from an unregistered website.