The classification of medicinal products can be summarized in the following categories:
- medicinal products subject to repeatable medical prescription (RR);
The repeatable prescription is the most common type of prescription. It has a six-month validity period, during which the patient can use the prescription for a maximum of ten times. A peculiar case is represented by the prescription of psychotropic medicinal products (tranquilizers, sedatives, hypnotics), for which the prescription has a thirty-day validity period and can be used for no more than three.
- medicinal products subject to non-repeatable medical prescription to be renewed each time (RNR);
The non-repeatable prescription is required for all medicines with potential risks of acute or chronic toxicity, or of addiction and tolerance and possibility of abuse by the patient. This kind of prescription is more restrictive than the previous one, as it is based on the patient's inability to access the drug without the intervention of the general practitioner, who issues the necessary prescription each time the patient needs this kind of medicine.
c) medicinal products subject to a special medical prescription (RMS) (Consolidated Law on narcotics Presidential Decree no. 309 of 9 October 1990, as amended);
d) medical products subject to restricted medical prescription, including:
- medicinal products dispensable only with a prescription issued by hospital facilities or specialists (RRL, RNRL);
- medicinal productsthat can only be used in hospital facilities or similar healthcare structures (OSP);
- medicinal products that can only be used by specialists identified according to the provisions of the Regions or Autonomous Provinces (USPL); the pharmacist cannot sell medicinal products of the USPL category to the public but can hold these drugs, which can also be supplied directly to the specialist by manufacturers and wholesalers.
The repeatable restricted prescription and the non-repeatable prescription are used for limiting the prescription and use of certain types of medicines to certain specialists or healthcare facilities. This category includes:
- medicinal products for exclusive hospital use (Art. 92, Legislative Decree no. 219/2006);
- medicinal products provided only if prescribed in hospital facilities or by specialists (Art. 93, Legislative Decree n. 219/2006);
- medicinal products for exclusive use by specialists in the clinic (Art. 94, Legislative Decree n. 219/2006);
e) medicinal products not subject to medical prescription, including:
- over-the-counter medicinal products (OTC);
- other non-prescription medicinal products (SOP).
The medical prescription is valid for 30 days for the number of packs indicated (for magistral preparations not containing narcotic substances, it is valid for three months).
The following table summarizes the classification of medicinal products in relation to the supply system, as regulated by Legislative Decree 219/2006, and to eligibility to reimbursement by the NHS.
The table does not include non-prescription medicines (OTC: over-the-counter medicines; SOP: non-prescription medicines).
Here are the various types of supply system and reimbursement class with the details for filling out the prescription.
As for the restricted prescription it is important to underline the following points:
- the supply system OSP identifies medicinal products that can only be used in hospital facilities or similar healthcare structures;
- the supply system RRL (repeatable restricted prescription) - RNRL (non-repeatable restricted prescription) identifies medicinal products that can be prescribed by specialists belonging to a hospital facilities and/or by specific specialists identified by the CTS: for outpatient care (out of hospital), the prescription of the medicinal product can be carried out by the specialists identified by the CTS, while in hospital facilities or similar healthcare structures, the prescription is not limited to the specialists identified;
- the supply system USPL (medicines subject to restrictive medical prescription, usable only by specialists) identifies medicinal products that can only be used by specific medical specialists identified by the CTS, even in hospital facilities, excluding particular exceptions appropriately specified by the CTS itself.
As regards the non-repeatable prescription (RNR), the legislation does not provide, in addition to the time duration of the prescription and the fact that the prescription is retained by the pharmacist, a maximum number of packages to be indicated in the prescription itself. The attending physician will then specify the number of packs necessary to cover an appropriate treatment period (for example, until the next specialist examination).