First of all: the pharmacy has a general obligation to check whether the dispense is made under a GKV prescription. If the compound preparation described has a specific standard volume, the ingredients should be checked. The content of formulations should also be checked with an amount between the standard sizes:
- no answer: Medicinal products contain less than 300 mg of calcium ion per unit dose of vitamin D, and here delivery is at the expense of the patient
Compensation is possible if the medicinal product contains at least 300 mg of calcium ion per unit dose of vitamin D:
- In the absence of a diagnosis in the prescription, the pharmacy is under no obligation to check further and can issue an invoice for the statutory health insurance.
attention: If a diagnosis is presented, the pharmacy should check whether this meets the criteria for an OTC overview (Appendix 1 of the Medicines Directive):
- no answer: The criteria do not match – consult a doctor if necessary
- Recovery: Standards match
Non-standard package size
If the medication prescribed is not in a standard size, then the number of items is limited. If this is higher than the larger number (120 count), the prescribed medication is one of the jumbo packs. So the pharmacy cannot be billed at the expense of the GKV – the patients pay themselves.
OTC standards for calcium and vitamin D combination products
- Only at the same time as steroid therapy for diseases expected to require at least six months of steroid therapy at a dose of at least 7.5 mg prednisolone equivalent
- In the case of bisphosphonate treatment as specified in the relevant product information if absolutely necessary
- Behandlung manifest osteoarthritis