My Experience: Rapamycin in the Netherlands through Pharmacies

[Stijn]

I’m based in the Netherlands and wanted to share my journey of obtaining Rapamycin through local pharmacies, hoping it might shed some light on what you could expect:

Getting a Prescription:
Initial Consultation: It starts with a €25 fee for setting up a chat at EuDoctor.org. Make sure to select “Doctor consultation.” – Here’s all it took to get the prescription:

Prescription Delivery:
After the consultation, they email you the prescription directly:

Acquiring Rapamycin:
Two days back, I headed to the pharmacy to pick up sirolimus but found out it wasn’t in stock and had to be ordered. The price for 100x 1mg Rapamune (produced by Pfizer) was quoted at €469.88 (about $511).

When I went to collect it, the pharmacy staff, though friendly, inquired about my reasons for using it. I explained the basics: Rapamycin inhibits mTOR, focusing on complex 1 (c1) rather than complex 2 (c2), which is linked to immunosuppression in cases of long-term, high-dosage use. I reassured them that my prescribed dosage, 5mg weekly, wouldn’t significantly impact c2.

Their response was understanding, and they’ve now scheduled a discussion for me with their higher ups. They were quite apologetic about the inconvenience. And I understand, what I am doing is quite unusual.

For this meeting, I’ve prepared a document based on Why Take Rapamycin? (part 2), edited and enhanced with GPT4, adding details about pharmacology and safety measures.

Here’s the document for those interested:
Apotheek Rapamycine.pdf (511.8 KB)

I will update this after my chat with them in a few hours.

Update:
I had a conversation with the higher ups, they know that if they don’t give me it, someone else will, I explained that I have a blood testing company and that I will do very extensive panels, and that I will also test the Rapamycin contents in my blood, they understood, I gave them the document and they will do some additional research, I am expected to refill in 4-6 months, so they have enough time, the guy I spoke to was kind and understanding, they gave it to me. They were impressed with me and surprised someone at just 21 cares about this stuff, to be honest, I think he was also genuinely interested in it.

[Arhu]

You should say a doctor prescribed it. Try a different pharmacy. Btw was that screenshot the entire consultation? Wow, bare minimum does not even describe it, no history, no general screening anamnesis, didn’t ask about current prescriptions nor allergies

[Stijn]

They know, it’s okay, I am sure they will give the Rapamune to me.

Regarding the EUDoctor, yes that is all, I am surprised they still have their license, but I don’t mind.

[Stijn]

fyi, saying a doctor prescribed it doesn’t change anything, I also got some more questionable prescriptions through online doctors (stimulants) they do NOT like that.

[adssx]

Is it still reimbursed by the Dutch social security/insurance in this case?

[Stijn]

I think if your “huisarts” approves it, yes, I will explore that next time I buy.

[adssx]

Thanks. Found these useful pages on the EU website:

Presenting a prescription in another EU country

A prescription delivered by a doctor in one EU country is valid in all other EU countries. However, a medicine prescribed in one country might not be available or it may have another name.
If your doctor has given you an e-prescription you will usually need to make sure you ask for a paper copy if you plan to use the prescription in another EU country, as the e-prescription may not be available outside your home country.

(this is based on the Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare)

FAQs - Presenting a prescription in another EU country

YES - The rules on cross-border prescriptions also apply in Iceland, Liechtenstein and Norway.
NO - Switzerland is not covered by the agreement on recognition of cross-border prescriptions

=> What about the UK?

The EU patients’ rights directive states that medicines have to be dispensed in line with national rules. In Czechia prescriptions have to be dispensed within 14 days. Therefore, under Czech law, your prescription is no longer valid and the pharmacist does not have to dispense the medicine.

Not all countries support e-prescriptions, here’s the list: Electronic cross-border health services

The Netherlands not listed?!

Also, interesting to know:

Prescriptions abroad: expenses and reimbursements

You will most likely have to pay the full cost of a product dispensed on prescription at the pharmacy if: […] you have a prescription from another EU country (cross-border prescription)

[adssx]

@adssx

=> What about the UK?

Prescriptions issued in the EEA and Switzerland: guidance for pharmacists

From 1 January 2021, a prescription issued in an EEA member state (EU countries, Iceland, Liechtenstein and Norway) or Switzerland can be dispensed in the UK if the prescriber is from a profession recognised by this guidance that is legally entitled to issue a prescription of that kind in the country in which the prescription is issued.

[AnUser]

Yeah you don’t have to say anything. I am pretty sure the law is on your side. Ask for a rejection in writing of why they won’t give you your prescribed medication in the case they refuse and according to which law:

A prescription delivered by a doctor in one EU country is valid in all other EU countries.

[Stijn]

I know, I have no doubts I will get it. But I don’t think they are required to work with you, are they? Meaning, they did decline some of my other prescriptions, since I guess, they are private companies they don’t have to accept you as a customer. My stimulants were denied, 4 different pharmacies.

[AnUser]

I think they have to follow laws or regulations. It’d be weird if a pharmacy, or multiple pharmacies could reject giving you a life saving treatment, despite a doctor prescribing it to you (in the extreme scenario).

" I’m on holiday in Spain and I took my prescription, from my doctor in Belgium, to the pharmacy. However, the pharmacy refuses to dispense it, saying that they don’t have to recognise prescriptions from outside Spain. Is this true?"

" NO - If the prescription includes the required information, the pharmacy should dispense your prescription, provided the medicine is also available in Spain. In these circumstances, you can contact the country’s National Contact Point."

[Arhu]

Yes it is, at least for me even when I prescribe for myself

[Arhu]

@Stijn

My stimulants were denied

Which ones, are they covered under the opioid law?

[Stijn]

dexamfetamine, 5 mg, yes, I am going to try with bupropion (150mg XR) soon see if it does work, I don’t even want to use it, I am just curious if it will work.

Every pharmacy gave a different reason.

[adssx]

@Arhu

Yes it is, at least for me even when I prescribe for myself

Sorry, I meant: if you get a prescription from another EU country than the one you live in (such as EUDoctor, based in Croatia), can you still get reimbursed in your home country?

But then I read on the EU website that you cannot: My Experience: Rapamycin in the Netherlands through Pharmacies - #7 by adssx

[Stijn]

Updated the post, I got the Rapamycin

[adssx]

Congrats, you’re amazing! I’m considering trying EUDoctor for something benign (like telmisartan or acarbose) just to see if I can get it in the UK (theoretically yes, but in practice…).

[Stijn]

You can if your own doctor approves it, but just assume not

[adssx]

Ah you mean your local doctor can approve a foreign prescription? But in that case… why would you get a foreign prescription instead of going directly to your local doctor?!

[Stijn]

Exactly xD – in theory, not in practice