Monday, 13 October 2025
Across Poland, patients often leave pharmacies puzzled, wondering why their medicine, prescribed correctly and authorised electronically, carries no state discount. The doctor may have assured them that the prescription is valid and ready for collection, yet at the counter, they are told to pay the full price. The explanation lies not in hidden commercial interests or favouritism toward pharmaceutical companies but in the dense bureaucracy that governs the way Poland’s health system reimburses medicines.
When Poland introduced electronic prescriptions in 2020, the aim was to make healthcare faster, safer, and more transparent. Doctors no longer write paper slips; instead, they enter prescriptions into the national health database. Pharmacies can instantly access them using a patient’s identification number and a four-digit code. This digitalisation has reduced forgery and improved record-keeping, but it has also placed heavy administrative obligations on doctors and created new complications around reimbursement.
To grant a price reduction on a medicine, a doctor must comply with detailed national rules. Every discounted drug is tied to a specific illness, dosage, and medical condition that qualifies for public funding. The doctor must record the diagnosis, keep proof of the illness, and ensure that the treatment plan precisely matches the government’s official reimbursement notice. If even one element is missing or unclear, the National Health Fund can later demand repayment of the subsidy. Because of that risk, many doctors prefer to label prescriptions as fully paid. They do not profit from doing so; it is simply a safer bureaucratic choice.
Private practitioners face an additional hurdle. Although the law technically allows them to issue prescriptions with discounts, they can do so only if all medical documents are in order and if the prescription exactly matches the government’s reimbursement criteria. Since most private clinics operate outside the NFZ system, their software and administrative oversight often make applying refunds impractical or risky. As a result, patients seen privately—whether at Medicover, LuxMed, Enel-Med, or Damian—usually receive prescriptions marked “100% payment,” even for common chronic diseases.
Doctors working within the public system are not immune to this problem. To approve a discounted prescription, they must link the correct diagnostic codes, document previous treatments, and ensure that every line on the e-prescription conforms to the reimbursement list. If an audit later reveals an error, the financial penalty falls on the doctor or clinic. This strict accountability makes many public doctors equally cautious, opting to avoid discounts unless every requirement is met beyond doubt.
Medical associations and legal experts agree that the issue is one of compliance, not corruption. The reimbursement lists issued by the Ministry of Health are precise to the point of rigidity. They change several times a year, and their technical language leaves little room for interpretation. For busy doctors navigating shifting regulations and tight appointments, choosing the “full price” option can seem like the only safe route.
Pharmacists, meanwhile, have no ability to change a prescription’s payment status. Once the e-prescription is signed, the pricing category—whether full or discounted—is locked into the national database. Pharmacists can explain the reason for the charge but cannot override the doctor’s decision. Patients frustrated by the full price are therefore directed back to the prescribing clinic or to their NFZ family doctor for a reissued prescription.
For patients, the solution often lies in coordination. Specialist consultations can be done privately for speed or convenience, but long-term prescriptions are best confirmed by an NFZ-contracted general practitioner who can safely apply the relevant discount. Checking one’s digital health account at pacjent.gov.pl provides a quick way to see whether a prescription has been issued as reimbursed or not, and which medical conditions qualify for support under current rules. If a patient believes a refund was wrongly denied, they can ask their NFZ doctor to verify the diagnosis or contact their regional health fund office for clarification.
What began as a digital reform has evolved into a system where caution outweighs flexibility. The e-prescription platform has undeniably improved security and transparency, but it has also exposed the complexities of Poland’s reimbursement structure. The cost of a medicine may depend less on the illness itself than on the precision of the paperwork and the administrative setting in which the prescription was issued.
For doctors, marking a prescription as “100% payment” is rarely a reflection of indifference or bias. It is an act of self-protection within a regulatory framework that punishes even minor mistakes more severely than it rewards diligence. Until Poland simplifies its reimbursement process, both patients and physicians will continue to navigate a system that remains highly digital but still behaves, in many ways, like an old-fashioned paper bureaucracy.
