Paying Less for Prescription Medicines in Portugal
Researched and written with AI tools from official sources. How we make our guides
How the state shares the cost of SNS prescriptions, why your choice of brand changes the price, and extra help for low income pensioners and chronic illness.
Last verified: October 2026.
Who this is for
- You are registered with the national health service (SNS) and buy prescribed medicines at a pharmacy.
- You are a pensioner on a low household income and want to know if you pay less.
- You have a long-term condition and want to check whether it has its own, higher rate.
Not for you if: you need help with prescription codes, night pharmacies, or buying medicines at the counter. Read Using Pharmacies in Portugal instead.
Updated October 2026. New rules on how the state funds medicines took effect on 1 July 2026. The four payment rates did not change.
When an SNS doctor prescribes a medicine, the state pays part of its price. This is called comparticipação (state co-payment). The state pays 90%, 69%, 37%, or 15%, depending on the type of medicine. If a cheaper equivalent exists, the state's share is worked out on a reference price, so a pricier brand costs you the whole difference.
Low-income pensioners get a bigger share, up to 95%, if their household income is at or below €12,180 a year per person in 2026. Some long-term conditions have their own rates, up to 100%.
How the state's share works
Two things decide what you pay:
- A percentage of the price. Each medicine sits in one of four bands (escalões).
- A reference price. If generic or similar versions exist, the state's share is calculated on a reference price for the group, not on the price of the box you take.
Most surprises at the counter come from the second rule, not the first.
These rates apply to medicines prescribed to SNS users and dispensed by an ordinary pharmacy (farmácia).
The four bands
| Band | State pays | You pay |
|---|---|---|
| Escalão A | 90% | 10% |
| Escalão B | 69% | 31% |
| Escalão C | 37% | 63% |
| Escalão D | 15% | 85% |
The band depends on the medicine's therapeutic group, not on how ill you are or on your doctor's choice. Band A covers many medicines for serious long-term conditions. Band C includes many everyday medicines.
Band D is different. It is used mainly for some new medicines that the state funds for a transition period after assessment. If a medicine is at 15%, it is often because it is new.
Why the brand you choose changes the price
A homogeneous group (grupo homogéneo) is a set of medicines with the same active substance, dose, and way of taking it, where at least one generic or biosimilar is on sale. Each group has a reference price (preço de referência).
For medicines in a group, the state applies your band to the reference price, not to the price of the box you choose. If you pick a medicine priced above the reference price, you pay all of the extra yourself, on top of your normal share.
So a 90% rate does not mean you pay 10% of the price on the box. It means you pay 10% of the reference price, plus the whole gap between the reference price and the price of the medicine you chose.
What the pharmacy must do
- Stock cheap options. Every pharmacy must have at least three medicines with the same active substance, form, and dose, chosen from the five cheapest in each group.
- Tell you the cheapest. When dispensing, the pharmacist must tell you about the similar medicine with the lowest price.
- Give you the cheapest of those three, unless you choose otherwise.
You have a right to choose (direito de opção) any equivalent medicine, whatever its price. If you choose a more expensive one, you pay the difference. On an electronic prescription, you use a separate right-of-choice code (código de direito de opção) to do this.
If a medicine is not in stock, the pharmacy has up to 12 hours to try to get it for you.
Extra help for low-income pensioners
If you are a pensioner and your income is at or below the limit below, the state pays more.
| Band | Normal rate | Pensioner rate |
|---|---|---|
| A | 90% | 95% |
| B | 69% | 84% |
| C | 37% | 52% |
| D | 15% | 30% |
There is a second, bigger benefit. For any medicine priced at or below the fifth-lowest price in its group, the state pays 95%, whatever the band. INFARMED, the medicines regulator, updates the fifth-lowest prices every three months, at the same time as the reference prices. The three cheap options every pharmacy must stock come from these five lowest prices, so asking for the cheapest one can make a large difference.
The income limit in 2026
The test is not your pension alone. It is your household's total yearly income divided by the number of people in the household.
The limit is the higher of:
- 14 times the minimum monthly wage in force the year before (€870 in 2025), which gives €12,180; or
- 14 times the social support index (IAS) in force now (€537.13 in 2026), which gives €7,519.82.
So for 2026 the limit is €12,180 a year for each person in your household.
How to get the pensioner rate
You must prove your status with a document from the official services. The pensioner rate must then show on your prescription. If you think you qualify and your prescriptions do not reflect it, raise it with your health centre or the doctor who prescribes. The pharmacy applies what the prescription says.
Special rates for some conditions
Some conditions have their own, higher rates, set in separate rules. INFARMED publishes the list. As of October 2026 it has 34 entries. Each entry says whether you collect the medicines at an ordinary pharmacy or at a hospital pharmacy.
At an ordinary pharmacy, 100%: lupus, haemophilia, haemoglobinopathies, paramyloidosis, manic-depressive psychosis, and rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, and spondyloarthritis (medicines listed in the rules).
At an ordinary pharmacy, 90%: diabetes, psoriasis, inflammatory bowel disease, moderate to severe cancer pain, moderate to severe chronic non-cancer pain, infertility treatment, and ichthyosis.
At an ordinary pharmacy, other rates: pneumococcal vaccines at 69%, and Alzheimer's disease at 37%.
At a hospital pharmacy, 100%: among others, HIV, hepatitis C, multiple sclerosis, cystic fibrosis, amyotrophic lateral sclerosis, chronic kidney failure, transplant rejection prevention, acromegaly, and some antipsychotics.
A 100% scheme that only a hospital pharmacy can supply works very differently in daily life from a 90% scheme at your local pharmacy. Check the column before you plan your refills.
What the prescription must show. For a special rate, the prescription must name the rule that sets it. Each scheme can also limit which medical specialty may prescribe and where. Ask the doctor to include the reference. Without it, you pay the normal rate.
New in 2026. A new scheme for ichthyosis and epidermolysis bullosa takes effect on 20 December 2026. It replaces the earlier ichthyosis rules. Medicines for these conditions dispensed at an ordinary pharmacy will be paid at band A (90%). Other listed products dispensed by SNS health units will be free. A dermatologist in the SNS must prescribe them, and the prescription must mention the scheme.
Medicines that are cheaper at the hospital
Some medicines are funded at 100% only when an SNS hospital pharmacy dispenses them to outpatients. If you try to buy the same medicine at an ordinary pharmacy, you may pay much more, or the full price. This is not an error, and the pharmacy cannot change it.
If a hospital gives you a medicine free, ask where your refills will come from before you run out.
Medical devices and dressings
Medical devices and other health products, such as some dressings, have their own lower bands:
| Band | State pays |
|---|---|
| A | 75% |
| B | 35% |
| C | 15% |
The state funds a device only if there are public health reasons or proven savings and the assessment supports it. The same reference-price rule applies where a group has a reference price.
When funding can change
The state can withdraw or change funding for a medicine. Reasons include doubts about how well it works, a better alternative, new safety data, or a price more than 20% above funded non-generic alternatives. A medicine that becomes available without a prescription can also lose funding.
A funded product that is often short in supply loses its co-payment. If the rate on a medicine you take changes suddenly, ask the pharmacist whether its funding status has changed.
What this means for you
- Ask for the cheapest equivalent, not just the cheapest box. Your share is worked out on the group's reference price. Anything above it is all yours.
- If you are a low-income pensioner, check your rate. The pensioner rate, or 95% on the cheapest medicines, can save a lot over a year of repeat prescriptions.
- If you have a long-term condition, check INFARMED's list. Some conditions have 100% rates, but only if the prescription names the rule.
- Do not assume a hospital price follows you to a pharmacy. Ask before you need a refill.
- Expect devices to cost more than medicines. The device bands top out at 75%, not 90%.
- Private prescriptions can lose you a special rate. Many special schemes require an SNS doctor of a named specialty. A private prescription still gets the ordinary band, but often not the special rate. See Getting an SNS Número de Utente for getting registered.
This guide is general information, not medical or legal advice. Ask your pharmacist or doctor about your own medicines, and check the official source before you act.
Sources
This guide is written from official sources and, where relevant, organisations' own websites.
- Procuradoria-Geral Regional de Lisboa, Decreto-Lei n.º 118/2026, of 17 June (SiNATS), consolidated: https://www.pgdlisboa.pt/leis/lei_mostra_articulado.php?nid=4032&tabela=leis (article 35 bands, pensioner increases, 95% rule, income test, quarterly fifth-lowest price, band D; article 36 reference prices; articles 37 and 38 devices; article 41 special schemes; article 42 withdrawal of funding; article 63 entry into force on the first day of the month after publication), checked 2 October 2026
- INFARMED, Regimes excecionais de comparticipação: https://www.infarmed.pt/web/infarmed/regimes-excecionais-de-comparticipacao (34 schemes, rates, and whether dispensed at a community or hospital pharmacy; 100% funding of hospital-dispensed medicines for outpatients), checked 2 October 2026
- ACSS (Central Administration of the Health System), Normas relativas à dispensa de medicamentos e produtos de saúde (March 2024): https://www.acss.min-saude.pt/wp-content/uploads/2016/11/Normas_Dispensa_20240304_vf.pdf (three of the five cheapest in stock; duty to inform about the cheapest; right of choice and code; 12-hour supply rule; prescription must name the special scheme; pensioner rates of 95%, 84%, 52%, and 30%), checked 2 October 2026
- Diário da República, Portaria n.º 433-B/2026/1, of 21 September: https://files.diariodarepublica.pt/1s/2026/09/18302/0000200005.pdf (ichthyosis and epidermolysis bullosa scheme; band A at community pharmacies; free at SNS units; dermatologist prescription; replaces earlier rules; in force 90 days after publication), checked 2 October 2026
- DGERT, Evolution of the minimum monthly wage: https://www.dgert.gov.pt/evolucao-da-remuneracao-minima-mensal-garantida-rmmg (€870 in 2025 under Decreto-Lei n.º 112/2024; €920 in 2026 under Decreto-Lei n.º 139/2025), checked 2 October 2026
- Diário da República, Portaria n.º 480-A/2025/1, of 30 December: https://diariodarepublica.pt/dr/detalhe/portaria/480-a-2025-993056222 (IAS of €537.13 for 2026)
Last verified October 2026. Rules and fees change; check the official source before acting.
