Medicines

Welcome to the information page on medicines.

Here you will find essential details about the positive list, which lists the medicines covered by the CNS, the medicines available on the market, and substitute alternatives.

Everything you need to know

In Luxembourg, reimbursement for medicines depends on their inclusion in a positive list published in the Mémorial, where medicines are classified into three categories with specific reimbursement rates.

Reimbursement rates for medicines

Medicines on the positive list are divided into three classes, each with its own reimbursement rate:

  • Reduced reimbursement rate (40%): For medicines of moderate interest in current medical practice and intended for the symptomatic treatment of mild conditions.
  • Normal reimbursement rate (80%): Applicable to most medicines on the positive list, except for exceptions provided for in the CNS statutes.
  • Preferential reimbursement rate (100%): For medicines that have a specific therapeutic indication, contain only one active ingredient, are irreplaceable or are of vital importance in the treatment of particularly serious or chronic conditions and are likely to result in an inappropriate contribution to the costs for the individual. All conditions must be met at the same time. By way of derogation, the 100% reimbursement rate may also apply to medicines containing up to three active ingredients, provided that at least one of them, when marketed alone, is reimbursed at the preferential rate and the others are reimbursed, alone, at least at the standard rate.

Registration on the positive list

To be included on the positive list, a medicine must:

  • Have a marketing authorisation and a retail price;
  • Be the subject of a formal application to the CNS by the authorisation holder using the dedicated form;
  • Meet the criteria defined by the Social Security Code (Articles 17 and 23).

Single-ingredient homeopathic medicines made from a plant, mineral or chemical source and sold as globules, granules, tablets or drops can also be added to the positive list. The decision to add a medicine to the list and its classification is made by the president of the CNS, after consulting the Social Security Medical Board.

Substitute medicine: definition and substitution policy

A substitute medicine has the same therapeutic effect as the original medicine, but is less expensive. It is produced by a different manufacturer, under a different name, and may contain different excipients (non-active ingredients) to give it its form or taste. However, its effectiveness, dosage and method of administration are identical to the original medicine. The substitution policy covers certain drugs for which pharmacies must offer lower-cost alternatives.

These drugs are also known as ‘generic drugs’.

Medication groups concerned

Currently, two groups of medications are subject to this policy:

  • Lipid-lowering drugs (statins)
  • Gastric acid secretion inhibitors (PPIs)

When a medicine from one of these groups is prescribed, the pharmacist compares its retail price with the reimbursement rate set by the CNS. If the price of the medicine exceeds this rate, the pharmacist offers a less expensive alternative from the same group while guaranteeing the effectiveness of the treatment.

Patient choice

The patient can:

  • Accept the substitute medicine, thereby helping to reduce costs without compromising their treatment.
  • Refuse the substitution: in this case, the patient will have to pay the difference between the reimbursement rate and the retail price of the prescribed medicine.

Other scenarios

In principle, the pharmacy dispenses the medicine prescribed by the doctor or requested by the patient. In the event of a stock shortage or unavailability, the pharmacist may offer another medicine to ensure continuity of care.

Coverage of medication

Coverage of medication by health insurance in Luxembourg is based on several specific criteria that must be met in order to guarantee partial or total reimbursement of treatment.

Prescription and Positive List

  • Reimbursable medications must be included on the ‘Positive List’ published by the CNS, which is available online and regularly updated.
  • Only medicines prescribed on prescription are eligible for coverage by health insurance; over-the-counter medicines are not reimbursed.

Conditions of validity of the prescription

  • In general, only one prescription is allowed per patient per consultation.
  • Unless otherwise stated, prescriptions are valid for a period of three months from the date of prescription.
  • If successive dispenses are indicated, they must be carried out within six months of the first dispense.
  • In the absence of specific instructions on the duration of treatment, only the smallest package size will be covered.

Reimbursement terms: Third-party payment

  • Direct billing allows patients to pay only the portion not covered by the CNS by presenting their social security card and prescription to the pharmacist.
  • The pharmacist keeps the original prescription or a certified copy and gives the patient a receipt detailing the amount reimbursed.
  • The specific reimbursement rate can be checked in the positive list and is specified on the reimbursement statement.

Frequently asked questions (FAQ)

What about homeopathic medicines?

They are covered if they appear on a specific list of homeopathic medicines that is approved by the CNS and updated periodically. The list of these homeopathic medicines can be consulted below.

Access to the list of homeopathic medicines

Focus on the forms

Focus on legislation

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