Prescriptions

[Grecian]

Apologies in advance is this appears to be a silly question.

This morning we visited our new doctor for the first time, and although we were told he could speak English, my wife conveyed her ailments to him, primarily in French, with not too much of a problem. He issued my wife with a prescription for the pills she requires to keep her going. On taking the prescription to the pharmacy, she noticed he had only given her a week's supply of one of her pills, as opposed to the month's supply he discussed in his surgery. At the pharmacy she was handed back her prescription after the pills had been dispensed, so is it permissible to present the same prescription again, and obtain another week's supply of tablets as laid out on the prescription, or once the prescription has been presented and dispensed, is that prescription then rendered invalid?

Any help gratefully received.

 

[Clair]

Call back at the surgery and explain you wanted it for 1 month.

A prescription can only be used once unless the doctor has marked it to be renewed x times (AR x fois).

[Benjamin]

I agree with Clair. However the pharmacy, just as they can in the UK, can overrule the doctor if they have any cause for concern as to the suitability of the items prescribed or where they feel two or more of the druge are not suitable to be used together. In practice I suspect that they wouldn't do so without speaking with the doctor concerned.

There is one other case which it might be worth knowing about. Earlier this year I had tendonitis (inflammation of a tendon) and the doc prescribed an anti-inflammatory cream. This ran out and I could still feel a slight twinge from the tendon. I took my original (now finished) prescription back to the pharmacy and they happily supplied me with another tube of cream, the cost of which was reimbursed via CPAM and our mutuelle. Obviously this wasn't a life threatening condition.  [:D]   It's always worth speaking to the Pharmacist.

[Âme]

I have a prescription with "traitment pour 6 mois" printed across the top... The pharmacist dispenses these items one month's supply at at time & date stamps the paper each time it is fulfilled. Could be that particular pill is controlled and only dispensed in small amounts. If the doc made an error the pharmacist will know (and the queue is shorter at the chemist, so I'd go there first!)

[Mimi]

On the subject of prescriptions, I have noticed that here in french pharmacies the items are not double checked by another person before being handed over, as they are in the UK.  Once I was given the wrong dosage of my usual medicine and another time the wrong drug altogether!  Bit scary really, luckily I noticed or I shudder to think what might have happened.  Recently at the same pharmacy I handed over a prescription for Betadine mousse (it was to shower with prior to an operation), the pharmacist gave me ordinary betadine (which as you may know stains the skin bright orange) and when I queried it she insisted it was the correct one.  Luckily I did not use it otherwise I would have looked like I'd been tango"d for a week!  Do you think they don't like me in this pharmacy? [:D]

[Grecian]

Thank you for your replies.

The drug in question is not a controlled drug, and was freely put on repeat prescription in the UK. At the moment we are not registered with the doctor, as we are still awating our attestations from CPAM, then hopefully our CV's. Would anybody know if it is still possible to have 'traitment pour 6 mois' written on the prescription from a doctor, without being registered with him?

We will be going back to the doctor, and try and get at least 1 month's supply of the pills sorted out in the interim.

 

[woolybanana]

Have a good look at the prescription paper and see if it says something like "renouvelable X fois" where X is a number. My doctor does that.

[NormanH]

Obviously Doctors in France tend not to give renewable prescriptions because that deprives them of their monthly consultation fee.

If I see my Doctor each month he earns €22.

If I simply take last month's prescription in marked 'Repeat' he makes nothing.

A simple example of the way that the system in France throws money down the drain.

[Ron Avery]

[quote user="NormanH"]Obviously Doctors in France tend not to give renewable prescriptions because that deprives them of their monthly consultation fee.
If I see my Doctor each month he earns €22.
If I simply take last month's prescription in marked 'Repeat' he makes nothing.
A simple example of the way that the system in France throws money down the drain.
[/quote]

How is it money down the drain if it goes from your pocket to his?  If he is giving you something for your high blood pressure/ fried potato on your scapula etc isn't it good that he checks your health every month instead of just dishing out pills willy nilly and earns a living whilst doing it?.

To answer Grecian's question, I doubt any GP will dish out a repeat prescription on a first visit,  they will do eventually, but not before you having signed up with a doctor and he can set up a regime to monitor your progress.  For all those who talk about what happens on the UK, this isn't the UK its France and just because you get prescriptions for 6 months in the UK don't expect the same here.

[Âme]

[quote user="Ron Avery"]

For all those who talk about what happens on the UK, this isn't the UK its France and just because you get prescriptions for 6 months in the UK don't expect the same here.

[/quote]

A good point.  Indeed, some drugs are categorised and prescribed differently, and some conditions treated with different drugs/therapies in the two countries.

During a recent consultation with my FR doctor, (we got into discussing the differences between the UK & FR systems) he said that he has latitude to prescribe for longer periods, citing as examples a patient travelling abroad for several months and a patient with an aversion to visiting the surgery.

'Fried potato on the scapula' is a new one on me and I thank you for it, Ron. [kiss] Made me laugh out loud.

[lorna]

I wasn't sure whether I should start a new thread for this question but it is all connected with the prescription process. In particular, the tiers payant card.

We visited our doctor for the first time last week. She asked for our carte vitales and copied the details into her pc. We didn't think to mention the tiers payant card. Somewhat belatedly, MOH is going to the pharmacy today with the prescription. I assume that he needs to show my carte vitale but what about the tiers payant card. How does that work? How do we get reimbursed?

[Ron Avery]

Never heard of a tiers payant card.  Do you mean the form you get from your mutuelle?

If so,  you should show your form to the pharmacist who will enter it on your records and in theory if your mutuelle has set it up properly,  you will then not have to pay anything for reimbursable items at the pharmacy.  Part of the cost is paid by CPAM the rest by your mutuelle and you don't get anything back.  You only get reimbursements from your mutuelle for money handed over like at the doctors or for X rays, tests as sometimes happens.  As its near the end of the year you may get another form from your mutuelle for 2009 and you should show that to the pharmacist when you get it so that your records are up to date and you continue not to have to pay for medicines.

EDIT

If your mutuelle has been set up properly you will be automatically reimbursed by CPAM and your mutuelle for your doctors visit less 1€, but note that you may not get the full amount back each time from CPAM as you have to pay a small tax on medicines dispensed and that is often deducted by CPAM from your doctor's reimbursement.

[lorna]

Thanks Ron, that is very helpful.

Yes, the tiers payant card was sent from the mutuelle. I think it is something to do with simplifying/expediting payments or reimbursements. I wasn't sure if we handed over money at the pharmacy and then got reimbursed or if showing the various cards meant we didn't have to pay ourselves. I have no idea how much the various medecines might cost. We don't keep a lot of money in our current account and move money over from the savings account when we need to.

The French seem to be very efficient with their banking. MOH paid for our heat pump installation with a cheque and the money was taken from our account the same day! 

[Sunday Driver]

Just some background on the way things work...

You produce your mutuelle card together with your carte vitale when you require any treatment. The first time you do it, the treatment provider transmits the details of your mutuelle to your caisse (ie, CPAM) and your account there is updated.

The method of reimbursing the treatment costs does vary, though.

If the doctor/clinic/pharmacy, etc have contracted to receive their money directly from your caisse, then you pay nothing up front. 

If they haven't contracted to receive their money this way (eg, they aren't prepared to wait or commit to the paperwork involved) then they take your money up front and inform your caisse, who then refund their share of the cost directly into your bank account.  The caisse will also automatically notify your mutuelle, who'll do the same for their share.

You'll probably find that your regular pharmacy falls into the first category and once your carte vitale and mutuelle details are in their computer, then they'll usually only ask for your carte vitale so as to identity your 'account' on their system.

 

 

[lorna]

Thanks SD. Also very helpful. Now we have a good idea of what to expect. [:)]

[mint]

Tiers payant is by far the easiet, Lorna.

Everything is taken care of, no money changes hands and you'll get a statement both from CPAM and your mutuelle in due course that will itemise the payments made on your behalf.

Some medical people (in my case the nurse, the dentist and the man who made my orthopaedic soles) gave me a feuille de soins (to claim back the money I had paid them) which I sent off to the CPAM and the money was repaid into our account by the CPAM and by the mutuelle.

Depends on what cover you have with the mutuelle, of course.  For example, they don't cover the orthopaedic stuff because I haven't paid for that level of cover.

The tiers payant method enables the CPAM and the mutuelle's computers to exchange information and therefore it saves you having to claim separately.

[lorna]

Merci!

[Chancer]

Sweet 17.

You dont remember by any chance what taux de remboursement you got against you orthopaedic insoles do you?

I only got 35% but may have made a mistake by going direct as the consultant is a friend.

[mint]

JR, just looked through my statements and I can confirm that I got 65%.  Nothing from the mutuelle, however, as we were apparently not covered for this type of treatment.  Different mutuelle this year so might be different.

BTW, another comment.  Although some people on the forum have been able to get remboursement for spectacles dispensed using a UK prescription, OH was turned down flat for that.  Even though he has glaucoma!

Perhaps, as with most things here in France, there are differences between different areas and I can only speak for Dept 17.  Perhaps you ought to compare with someone else from your dept?