Continued prescription of ADHD medication in Austria

This information is mainly for people who have moved to Austria or are planning to do so and want to know how to get ADHD medication in Austria. The last paragraph may also be relevant for people moving within Austria.

Health care system

The health care systems in the EU have grown historically and, despite various harmonisations, are largely a matter for the individual states. In Austria, the Federal Constitution stipulates: "Social insurance is to be managed according to the principle of self-administration. [...] Social insurance is not subject to directives, but is subject to state supervision and control by the supervisory authority" (our translation from [1]). An essential part of social insurance are the health insurance funds (Social health insurance, SHI), which are under state supervision.

The outpatient sector: Two payment methods

In Austria, you are free to choose your doctor. There is no obligation to register with a GP, and there are no postcode restrictions. Unless you have an emergency or need to be admitted to hospital, you will not usually go to a hospital outpatient department.

When you go to see a doctor, however, you have to decide whether you want to see a doctor who is either a “Kassenarzt“/“Kassenärztin”, or a “Wahlarzt“/“Wahlärztin” ('Arzt' is the masculine form of the German word for doctor, 'Ärztin' is the feminine form, the plurals are 'Ärzte' and 'Ärztinnen'). This is how they differ:

Only the smaller part of the practising medical profession in this country has a contractual relationship with the health insurance funds. These doctors are called "Kassenärzte/-ärztinnen" (from the German "Krankenkasse", health insurance). They bill the SHI funds directly for the services they provide, the largest of which are ÖGK, BVA and SVS. You need a green smart card called an "e-Card" to access their services. The e-Card can also be used to obtain prescriptions, for which you currently pay a fixed fee of EUR 6.85 per medicine in the pharmacy (from 2023). You are bound to such a doctor only for the current billing period (usually a calendar quarter or month, depending on your insurance).

A doctor without a contract with the SHI or only with particular health insurance funds acts outside any contract as a “Wahlarzt”/”Wahlärztin" which translates approximately as “elective doctor". Services and prescriptions must be paid directly to the doctor or pharmacy, and the health insurance company fund usually reimburses you usually 80% of the fee paid to a contracted doctor (“Kassenarzt”). The "Wahlarzt" is allowed to charge you a higher fee than what the insurance company would pay directly to the doctor, so it is a good idea to ask what the fee will be and how much you can expect to get back from your Austrian insurance company. In Austria some private companies sell "supplementary health insurance", which may cover more or less of the excess. There is no reimbursement at all for private services provided by SHI doctors, because one could have made use of the SHI service.

The European Health Insurance Card (EHIC)

If you have such a card, you can receive treatment from a “Kassenarzt”/Kassenärztin”, but you must first complete various formalities. When making an appointment, please state that your appointment is to be billed via this card so that the formalities can be completed in good time beforehand.

e-Card, "authorisations" 

In 2005, a green chip card, the e-Card, replaced the health insurance certificate as proof of insurance in the area of SHI-accredited doctors. For some drugs, the prescription is subject to previous authorisation. This is the case for all ADHD medication except immediate release  methylphenidate tablets (Ritalin® and Medikinet® tablets). Since 2005, the authorisation process has been handled almost exclusively at the health insurance fund's offices via the electronic health network of the social insurance system (previously, the prescription always had to be taken to the health insurance fund and presented and stamped there). The details of the intended prescription are sent, with medical justification, to the social security counterpart, where the social security doctors approve most prescriptions or ask questions beforehand. Some prescriptions may not get approval or are approved only after more information has been submitted.

ADHD medications available in Austria

• Methylphenidate tablets and extended-release tablets (Ritalin®/Ritalin-LA®, Medikinet®/Medikinet retard® (equivalent to Medikinet adult® in Germany), Concerta® and others)
• Atomoxetine (capsules and liquid)
• Sustained-release lisdexamphetamine (Elvanse®, in some countries Vyvanse®)
• Amphetamine sulphate as a raw substance (immediate release), filled into capsules after a "magistraliter" prescription in the appropriate strength (only some pharmacies produce capsules)
• Guanfacine (Intuniv®)

Dexamphetamine in tablet form (Attentin® in D, CH) and Adderall® (USA) are NOT available.

Prescription of controlled substances

Prescriptions for any form of methylphenidate and amphetamine sulphate are narcotic prescriptions. They had to be, and in some cases still have to be, provided with a numbered drug vignette ("green sticker"). The electronic prescription with its security features is now kept equal to the vignette. Prescriptions for packaged preparations from the list of therapeutic products can be issued electronically since 1 July 2023. These prescriptions can be retrieved and dispensed with your e-card at any pharmacy within the country. Prescriptions for preparations to be prepared magistrally (e.g. capsules with amphetamine sulphate), however, cannot be prescribed electronically at present. They still have to be provided with a vignette and since the end of the pandemic-related permission to send faxes, they now have to be collected in the surgery and brought to the pharmacy.

I need a prescription for my current medication quickly …

As waiting times for specialist appointments are usually longer with SHI-accredited doctors, it is a good idea to take a good supply of your medication with you when you move. You may be able to get an appointment more quickly with specialists who do not have a contract with your health insurance fund (see above, "elective doctor"). It is becoming increasingly common for some GPs to write prescriptions for adult ADHD medication prescribed by specialists. Some may do this on request, even if you have not yet had your agreed initial local psychiatric appointment, and if you can show proof of previous prescriptions. However, at the latest after the specialist appointment, GPs will need a recent report from the specialist in the form of a doctor's letter. In any case, bring proof of your ADHD diagnosis and/or previous prescriptions (e.g. a copy of the prescription).