The electronic prescription in Romania: how it works, what you see on it, how to collect it

The electronic prescription — or SIPE (Sistem Informatic de Prescripție Electronică, the Electronic Prescription Information System) — has been operating in Romania since 2013 and is mandatory for any prescription reimbursed by CNAS (Casa Națională de Asigurări de Sănătate, the National Health Insurance House). In 2026, more than 95% of the prescriptions sent to pharmacies arrive through this system. Here is exactly what you see on it, how you collect it and what to do when something does not work.

What the electronic prescription is, in short

The SIPE system is operated by the National Health Insurance House (cnas.ro) and connects medical practices, pharmacies and CNAS into a single flow. The doctor fills in the prescription in an application — either SIUI (Sistemul Informatic Unic Integrat, the Unique Integrated Information System of health insurance) or an integrated practice software — and the prescription receives a unique 1D barcode (a numeric code of 14-16 digits) plus a 2D Datamatrix code that is read by the pharmacy's scanner.

The patient receives two printed A4 sheets (the official form approved by CNAS Order no. 674/252/2012): the red copy that goes to the pharmacy and the blue copy that stays with the patient. Both bear the same code — only one of them can be dispensed. If the prescription is purely digital (telemedicine after the pandemic), the patient receives the code by SMS or on the CNAS portal.

What you see on the printed form

A standard SIPE copy contains the following fields, in order from top to bottom:

• CNAS header — the logo, the address of the County Insurance House, the framework-contract number.
• The patient's CNP (Cod Numeric Personal, the personal numeric code) + surname + first name — automatically copied from the health card if it was used at the practice.
• Doctor's stamp code — the unique code of the prescribing doctor in SIUI.
• ICD-10 diagnosis — the diagnosis code (e.g. “I10 — essential arterial hypertension”). It is mandatory for reimbursement.
• The list of medicines — each row contains: the DCI (Denumirea Comună Internațională, the International Nonproprietary Name, e.g. “atorvastatin”), the pharmaceutical form (film-coated tablets), the strength (20 mg), the quantity (30 tablets), the dosage (“1 tablet in the evening”), the CIM code (Cod de Identificare a Medicamentului, the Medicine Identification Code — assigned by ANMDMR, the Romanian National Agency for Medicines and Medical Devices), the number of treatment days, the reimbursement sublist (A, B, C1, C2, C3, D), the reimbursement percentage (50%, 90%, 100%) and the CANAMED reference price (the national catalogue of maximum medicine prices).
• The barcode + Datamatrix at the bottom — used at the pharmacy for dispensing in SIPE.
• The doctor's electronic signature + the date of issue + the validity (usually 30 days for acute prescriptions, 90 days for chronic ones).

How you collect it from the pharmacy

Step 1: you present your health card (or your ID card + the European card / the certificate of insured status). The pharmacist inserts it into the reader. Step 2: you give them the A4 sheet or the SMS code — they scan the Datamatrix code and SIPE returns the prescription in the pharmacy's application. Step 3: the pharmacist sees their own stock and the prescribed quantity, proposes substitutions (another manufacturer for the same DCI — the generic substitution right), you confirm, and you sign with the card PIN or on the screen.

At the end you receive the fiscal receipt with three important columns: shelf price, CANAMED reference price and patient contribution. The difference between the reference price and what you pay is reimbursed directly by CNAS to the pharmacy — you do not see any settlement request, the system does it automatically.

Special situations — children, chronic patients, pensioners

• Children under 18 — the health card is not required. The CNP + the medical certificate or the birth certificate are used. Reimbursement is often 100% on sublist C2 (chronic childhood diseases).
• Pensioners with income below the minimum wage — they receive 90% reimbursement on sublist B (instead of the standard 50%) — the “pensioner with income below” code is attached automatically if you are in the CNAS database.
• Chronic patients — the prescription is valid for 90 days and can cover treatment for 30, 60 or 90 days (depending on the diagnosis and the annual MS-CNAS (Ministry of Health–CNAS) framework contract).

What you see in the CNAS portal for insured persons

On cnas.ro, the “Asigurat” (Insured) → “Servicii electronice” (Electronic services) → “Card de sănătate” (Health card) section shows you:

• the history of the prescriptions issued on your CNP (the last 12 months);
• the status of each: issued, partially dispensed, fully dispensed, cancelled;
• the pharmacy that dispensed it + the amount settled by CNAS;
• the prescribing doctor + the ICD-10 diagnosis.

Authentication is done with the CNP + a password (created online with a code received by SMS at the number declared at the County Insurance House) or with a qualified digital certificate if you have one. Many people never use the portal — but it is useful when you want to check that a prescription was indeed dispensed or when you have lost the printed sheet.

What to do when something does not work

1. The code cannot be read. Ask the doctor to reprint the prescription or to give you the 14-digit numeric code — the pharmacist can enter it manually in SIPE.
2. The card does not work. Call the County Insurance House (full list on cnas.ro) or present the certificate of insured status (printable online from the portal). Reimbursement is granted even without the physical card, if there is a certificate.
3. The pharmacy does not have all the medicines. You can dispense partially — you collect the rest within 30 days from another pharmacy with the same code. SIPE knows what the first pharmacy gave you and subtracts it from the total.
4. The diagnosis is missing from the prescription. Without the ICD-10 there is no reimbursement. You have to go back to the doctor — it cannot be added at the pharmacy.

How to read the fiscal receipt after dispensing

The fiscal receipt for a reimbursed prescription is more detailed than an ordinary one and must contain three essential columns that are worth checking straight away:

• Shelf price — the price at which the pharmacy sells the product (the pharmacy's actual retail price (PVA, preț cu amănuntul), below or at the maximum CANAMED retail price).
• Reference price — the CANAMED value used to calculate the reimbursement. It is the lowest price among all eligible manufacturers for that DCI.
• CNAS reimbursed — the amount that the insurance house settles directly with the pharmacy. Calculated as reference price × sublist percentage.
• Patient payment — the difference that you pay (shelf − reimbursed).

If you notice that the “patient payment” is higher than you expect, the possible causes are: the pharmacy sells above the reference price (you pay the difference), or the applied reimbursement percentage is wrong (check the prescription — was the sublist correct?). Talk to the pharmacist; if it persists, escalate to the County CNAS Insurance House through a complaint form.

Automatic renewal — chronic prescriptions

For patients with stabilized chronic diseases (controlled hypertension, controlled type 2 diabetes, hypothyroidism on a fixed dose), the family doctor can issue prescriptions with a 90-day validity that cover the treatment for the whole period. There are two practical schemes:

• Single collection — you take the entire 90-day stock at the first visit. Advantage: a single trip, you have stock for every day. Disadvantage: a larger quantity to carry, pay attention to storage (cool, dry).
• Monthly collection — you take 30 days each time, within the same SIPE code. The system automatically subtracts from the total. Useful if the pharmacy is nearby or if you want a smaller reserve at home.

At the end of the 90 days, you make a new appointment with the doctor for re-evaluation, a check of the parameters (blood pressure, blood glucose, TSH) and a new SIPE prescription. The procedure is simple — for stable chronic patients, the consultation with the family doctor is often short (5-10 min) and the prescription is issued immediately in SIUI.

Practical summary

The electronic prescription is the standard in Romania — any reimbursed prescription must go through SIPE. You, as a patient, have four things to do: 1) carry your health card with you or the certificate of insured status printed from the cnas.ro portal; 2) keep the blue copy as proof; 3) check on the fiscal receipt that the applied reimbursement percentage is the correct one (50/90/100% depending on the sublist A, B, C1, C2, C3, D); 4) for chronic conditions, plan the collection — single or monthly — depending on what is most convenient for you. The rest is handled by SIPE automatically, in a few seconds, at each Datamatrix code scan.