A Lithuanian pharmacy is a vaistinė, and the prescription that gets you into it does not exist on paper. Your doctor writes it into the national e-health system; you put your passport or ID card on any pharmacy counter in the country and the pharmacist finds it.
What confuses people is the bill. Lithuania reimburses medicines as a percentage of a base price, not of the price on the shelf, and the gap is a surcharge called the priemoka that the patient pays. Two people can leave with the same drug at the same strength and lawfully pay different amounts.
Table of Contents
- The electronic prescription
- Collecting it, and collecting for someone else
- The compensated list and the four levels
- The base price and the priemoka
- The basket, the over-75s and low incomes
- Over the counter, and outside the pharmacy
- Buying medicine online
- Bringing your own medicine in
- Frequently asked questions
The Electronic Prescription
The e. receptas is issued into the e-health system at esveikata.lt, the portal the healthcare guide describes, and it is the only form a prescription takes. Once written it is visible to every pharmacy in Lithuania, and to you in your own account.
Three separate timing rules govern it. The first dispensing must happen within 30 calendar days of the day it was written, or the doctor has to write another. One marked esant poreikiui — taken when symptoms occur — runs for 6 months instead. And since 1 January 2025 an adult already established on a medicine for a chronic condition can be given up to 12 months of treatment, with a pharmaceutical care consultation by the pharmacist at the 6-month mark deciding whether dispensing continues.
You need not take the whole prescription at once: medicines and medical aids can be bought in parts.
Collecting It, and Collecting for Someone Else
Bring a document, not a number
Only a passport or identity card opens the prescription: a recited personal code is not enough. Your asmens kodas is what the system matches on; the document proves it is yours.
Any pharmacy, not the nearest to the clinic
The prescription is national. Chain and town make no difference.
Someone else can go, but only on record
A representative must be named in your e-health account or hold a notarised power of attorney, and shows their own document. Handing a relative your card does not work.
Ask which version has the smallest surcharge
The pharmacist must show every manufacturer's version of the same active substance and offer the lowest priemoka first. Asking is the patient's one lever over the bill.
Day one for a new arrival, in order. Be covered by PSD; register with a primary care clinic and a family doctor; then get the Lithuanian prescription written. A repeat of your usual medicine is a Lithuanian doctor's decision, so if you take something daily book that appointment in your first fortnight and bring the packaging and your doctor's letter — the active substance transfers, not the brand.
The Compensated List and the Four Levels
Reimbursement applies only to the ministry's lists, and there are three: list A, diseases and the medicines that treat them; list B, medicines aimed at groups of people rather than diseases; list C, medical aids. The medicines lists are rebuilt twice a year, the aids list once.
For the first half of 2026 the list carries 2,212 preparations across 901 groups, 306 of them parallel imports — a cheaper second source of the same medicine, and why the fund expected the list to save about €5,500,000.
| Level | What it applies to | Who gets it |
|---|---|---|
| 100% of the base price | List A conditions marked at that level — cancer, tuberculosis, epilepsy, multiple sclerosis, clotting disorders, chronic hepatitis C, asthma, schizophrenia, post-transplant status and others | Every insured patient with the diagnosis |
| 90%, 80% or 50% of the base price | The other list A conditions, at the level the list sets for each | Every insured patient with the diagnosis |
| 50% of the base price | List B medicines | Old-age pensioners, disability pensioners, recipients of state aid pensions |
| 100% of the base price, either list | Any compensated medicine on list A or B | Children under 18, insured people with the heaviest disability |
The levels move. Fifteen everyday antibiotics — amoxicillin, co-amoxiclav, azithromycin, clarithromycin, doxycycline, metronidazole among them — went from list B to list A on 1 January 2024, from 50% for pensioners and children to 100% for everybody, costing the fund around €2,000,000 a year. A prescription written before a list changes is not invalidated: the new rate applies at the counter.
The Base Price and the Priemoka
A compensated medicine has two prices. The base price (bazinė kaina) is the portion the fund looks at, set administratively from the average of the lowest prices the medicine carries across a group of EU states. The retail price is what the pharmacy charges — the manufacturer's price for Lithuania plus the wholesale margin, the pharmacy's margin and 5% VAT, the reduced rate medicines attract. The manufacturer's Lithuanian price is the variable the patient never sees, and the only one that explains why two people's bills differ: 100%, 90%, 80% or 50% is set by diagnosis and applies to the base price alone.
The reimbursement percentage applies to the base price; the patient pays the rest of the retail price. That difference is the priemoka, and it exists even at 100% reimbursement, because 100% of the base price is not 100% of the shelf price.
Two limits stop this running away. The priemoka on a package is capped at €5.87, and where the compensated price is very small the cap falls to 20% of that price instead — a three-euro medicine cannot carry a five-euro surcharge.
Why your neighbour pays less for the same tablets
Because they were handed a different manufacturer's box. The pharmacist must display every version of the same active substance and offer the cheapest-surcharge one first, but a patient who names a brand, or says nothing, often walks out with a dearer box. Say the words: the one with the smallest priemoka. And check the substance rather than the name — a switched box with an unfamiliar brand is usually the same medicine, correctly dispensed.
The Basket, the Over-75s and Low Incomes
Three mechanisms cap what the surcharge system can do to you; the strongest applicable takes over.
The surcharge basket. Every insured person accumulates one automatically across the calendar year, filled by the priemokos paid on medicines carrying the lowest surcharge in their group. At €70.02 the state budget pays their surcharges on those medicines for the rest of the year. The figure resets annually — €59.04 in 2025 — and the running total is in your e-health account.
Age 75 and over. Since July 2020 the state budget has covered the priemokos on medicines and medical aids for everyone aged 75 or older — no basket, no application.
Low income in retirement or with a disability. Where a person of pensionable age, or a person with a disability, has pensions, state aid pensions, compensatory payments and annuities totalling less than €468 a month — the current year's minimum consumption needs figure — their surcharges are covered too.
None of it reaches anyone outside PSD: an uninsured patient pays the full retail price of everything, compensated list or not. And the basket only fills on the cheapest option — the second reason to ask for it.
Over the Counter, and Outside the Pharmacy
Non-prescription medicines are sold across the counter by a pharmacist who may advise on them, and since January 2019 a narrower list approved by the medicines control service is also sold in shops and filling stations: paracetamol and acetylsalicylic acid preparations, hydrogen peroxide, iodine and brilliant green among them.
A shop or a filling station
From the approved list only, and on terms:
- At the till, never from an open shelf
- Not to anyone under 16
- Staff may not advise or suggest an alternative
- Nothing on the compensated lists
A pharmacy
Everything else, with a pharmacist:
- The full non-prescription range, with advice
- Every prescription medicine
- Compensated medical aids on list C
- The surcharge comparison across makers
The prescription line differs across Europe and moves both ways, so check a preparation you rely on.
Which chain does not matter. Four account for most branches — Eurovaistinė, Gintarinė vaistinė, BENU and Camelia — all licensed on the same e-health system, all able to dispense any Lithuanian e-prescription, all bound to offer the lowest-surcharge version. Each chain's own branch finder is the only current source for opening hours; round-the-clock branches are few and concentrated in the big cities, so collect a repeat on the Friday. Out of hours, acute pain or infection means a hospital emergency department, or 112 if it is serious.
Buying Medicine Online
Non-prescription medicines may be sold online by any pharmacy licensed for distance selling — until February 2025 on its own website only, and since 18 February 2025 also through third-party e-commerce platforms and mobile applications, provided it notifies the medicines control service first.
Prescription medicines may not be sold on a commercial platform at all. They are ordered through the e-health system against your existing e-prescription, with a remote pharmacist consultation before the purchase is confirmed, and delivery runs to 2 working days in the cities and 4 in rural areas. Narcotics, psychotropics, extemporaneous preparations and anything needing special storage are excluded.
Every legitimate page offering medicines in the EU carries the EU common logo, and it is not a badge to trust on sight: clicking it must open the national register of pharmacies authorised for distance selling, published here by the medicines control service. A logo that leads nowhere is an illegal seller.
Bringing Your Own Medicine In
A prescription written in another EU or EEA state can be dispensed here where it is issued as a cross-border prescription: the e-prescription travels machine to machine between 10 EU and EEA states in both directions — Latvia, Estonia, Poland, Finland, Czechia, Croatia, Greece, Spain, Portugal and Cyprus among them — and you show a valid identity document. Narcotics and certain psychotropics are excluded, as are, until 3 January 2027, inhaled forms, powders for injection and infusion, and liquid and soft forms. A Lithuanian patient buying abroad takes the whole prescribed quantity, pays full price there and claims reimbursement from their territorial fund afterwards.
Medicine carried across the border or sent by post is governed by the medicines control service's quantity rules.
| How it arrives | How much you may bring | What you need |
|---|---|---|
| From another EU member state | A quantity for personal use | Nothing, except doping substances, limited to the prescription or certificate |
| From outside the EU, with a doctor's certificate | No more than the certificate states, for a course of up to 6 months | A certificate naming you, the medicine, its strength, dosage, duration and validity |
| From outside the EU, without one | Up to 10 packages at one crossing, once a calendar month | Nothing — but the limit is firm |
| Crossing often for work or study | Up to 40 packages a month, in consignments of 10 | Proof the work or study requires frequent crossings |
| By post | 10 packages per consignment, once a month, or the certificate's quantity | The certificate rules above |
Narcotic and psychotropic medicines sit outside all of this, under Lithuania's narcotics control legislation. Settle that before you travel, not at the border.
Frequently Asked Questions
How do prescriptions work in Lithuania?
Electronically. The doctor writes it into the e-health system at esveikata.lt; there is no paper version. Show a passport or identity card at any pharmacy in the country. The first dispensing must happen within 30 calendar days of the day it was written, or it lapses.
What is the priemoka and why do I pay it?
The surcharge left after the fund pays its share. Reimbursement is calculated on a base price — the average of the lowest prices the medicine carries across a group of EU countries — not on the retail price, which is the manufacturer's Lithuanian price plus wholesale and pharmacy margins plus 5% VAT. Diagnosis sets the percentage, 100, 90, 80 or 50, and it applies to the base price only.
Why does someone else pay less for the same medicine?
They were dispensed a different manufacturer's version. The base price and the percentage are identical; the manufacturer's Lithuanian price differs. The pharmacist must show every version of the same active substance and offer the lowest-surcharge one first, so asking is what changes your bill.
Is there a limit on what I can be charged?
Two. The surcharge on a package is capped at 5.87 euros, dropping to 20% of the compensated price where that price is very small. Separately an annual basket accumulates on lowest-surcharge medicines; at 70.02 euros the state pays your surcharges on them for the rest of the year. It was 59.04 euros in 2025.
Who pays no surcharge at all?
Everyone aged 75 and over, since July 2020, from the first package. And people of pensionable age or with a disability whose pensions, state aid pensions, compensatory payments and annuities total less than 468 euros a month — the year's minimum consumption needs figure.
Which medicines are reimbursed?
Only those on the ministry's lists. List A pairs diseases with medicines at 100, 90, 80 or 50 percent of the base price; list B gives 50 percent to old-age pensioners, disability pensioners and recipients of state aid pensions; list C covers medical aids. Children under 18 and insured people with the heaviest disability get 100 percent on either medicines list. The 2026 first-half list carries 2,212 preparations across 901 groups.
Can I get a prescription for a whole year?
For a chronic condition you are already established on, yes: since 1 January 2025 an adult can be given up to 12 months of treatment, with a pharmaceutical care consultation at the six-month mark. Medicines can be bought in parts throughout.
Can someone collect my medicine for me?
Only a representative named and confirmed in your e-health account, or holding a notarised power of attorney, showing their own identity document. Lending someone your ID card does not work: opening a prescription means opening a health record.
Can I buy medicines online in Lithuania?
Non-prescription medicines, from any pharmacy licensed for distance selling — and since 18 February 2025 through third-party platforms and apps where the pharmacy has notified the medicines control service. Prescription medicines may not be sold on a commercial platform: they go through the e-health system against your existing prescription, with a remote pharmacist consultation, delivered in two working days in cities and four in rural areas. Narcotics, psychotropics and extemporaneous preparations are excluded.
How do I know an online pharmacy is legal?
The EU common logo must appear on every page offering medicines, and clicking it must open the national register of pharmacies authorised for distance selling — published by the medicines control service and linked for every member state by the European Medicines Agency. A logo leading nowhere is a counterfeit.
Will my prescription from another EU country work here?
If it was issued as a cross-border prescription. The e-prescription travels between ten EU and EEA states both ways — Latvia, Estonia, Poland, Finland, Czechia, Croatia, Greece, Spain, Portugal and Cyprus among them — on a valid identity document. Narcotics and certain psychotropics are excluded, and until 3 January 2027 so are inhaled forms, powders for injection and infusion, and liquid and soft forms.
How much of my own medicine can I bring into Lithuania?
From an EU member state, a quantity for personal use. From outside the EU with a doctor's certificate, no more than it states, for up to six months. Without one, ten packages at a single crossing once a calendar month — forty a month in ten-package consignments if you can prove work or study requires frequent crossings. Post follows the same ten-package limit. Narcotics and psychotropics sit outside these rules.
Disclaimer
General guidance, not medical advice. Reimbursement levels, surcharge caps and the compensated lists change twice a year. Check your own medicine against the current price list with the National Health Insurance Fund or your pharmacist before budgeting on a figure here. In an emergency, call 112.