Prior authorisation (visado) and restricted-use medicines

Key rules

• Visado: It is a check before funding, not a refusal of your medicine.
• Who decides: Your region's health inspection grants it, and INGESA does in Ceuta and Melilla.
• Report: A complete clinical report from your doctor is what keeps the request moving.
• Refusal: You can ask for written reasons, have the request resubmitted or appeal.

A visado is a step, not a refusal

A visado is a prior authorisation. The health inspectorate of your region checks your prescription before the public health system pays for the medicine. Your doctor is not saying no, and neither is the pharmacy. The check is a normal part of getting certain medicines.

Why your medicine needs one

Some medicines are only funded for specific uses. The visado makes sure the medicine is used for those uses and helps control spending. Examples include some growth hormones, certain erythropoietins, some anti-obesity or osteoporosis drugs, and certain biologics and high-cost drugs.

The Ministry of Health marks these medicines in its national medicines catalogue, the Nomenclátor. The list changes as drugs are added or removed, and regions can add their own control requirements. Ask your doctor or pharmacist whether your medicine is on it.

This applies to prescriptions paid for by the public health system. If you pay privately, there is no visado.

Who grants it

The medical or pharmaceutical inspection of your region's health service grants it. In Ceuta and Melilla, INGESA does it. If you are covered by MUFACE, ISFAS or MUGEJU (the civil-servant schemes), they have their own procedures, so ask them.

What you need

• The prescription.
• A clinical report from your doctor with your diagnosis and prior treatments.
• Your health card.

Your doctor may send the request electronically, or you may have to take it to the health centre or inspection office. Ask which applies to you. The steps in order are in the timeline below.

How long it takes

Many visados are resolved within a few days to two weeks, especially when sent electronically. An incomplete report is the most common cause of delay, along with inspection workload. If no decision comes in the set period, what silence means depends on the region. Ask your region's inspection office for its timing.

If it is refused or stuck

Ask the inspection for the reasons in writing. Then you have several options:

• Ask your specialist to resubmit with a fuller report, or to request a review.
• Ask your specialist about an alternative treatment the system covers.
• File an administrative appeal (recurso de alzada) with the regional health authority.
• Complain through your region's patient service or regional ombudsman.
• Pay for the medicine privately.

Time limits and procedures differ by region, so check the deadline for an appeal as soon as you get the refusal.

Timeline and deadlines

• Your doctor issues the prescription and the clinical report justifying it: before you ask for the visado

• The report and prescription go to the visado office of the health inspection: right after the doctor issues them

• The inspector checks the case and stamps or electronically validates the prescription: usually within a few days to two weeks

• Collect the medicine at the pharmacy or hospital pharmacy: once the prescription is validated

• Ask for the reasons in writing and have the report resubmitted or appeal: if no decision arrives or it is refused

Check the current turnaround with your regional health inspection office, as times vary by region.

Checklist

• Ask your doctor or pharmacist whether your medicine needs a visado, the prior authorisation from the health inspectorate.

• Bring your health card along with the prescription and report.

• Ask the inspection office of your region's health service how long the visado takes.

• Collect the validated prescription's medicine at the pharmacy or hospital pharmacy.

• If the visado is refused or stalled, ask for the written reasons and ask your specialist to resubmit or suggest a covered alternative.

What to watch out for

• An incomplete report can stall the visado: The inspector checks your case against the authorised conditions, so a report missing the diagnosis or prior treatments is a common cause of delay. Ask your specialist to include the diagnosis and prior treatments before the request goes in.

• The medicine may not be covered without a visado: A prescription for a medicine on the visado list cannot be dispensed with public funding until it is validated, and the list changes over time. Ask your doctor or pharmacist before you go to the pharmacy whether your medicine needs a visado.

• A refusal is not the end of the road: If a visado is refused or stalled, you can lose time waiting without knowing why. Ask the inspection office for the written reasons, then have your specialist resubmit with a fuller report or prescribe a covered alternative. You can also appeal or complain through the regional patient service.

Frequently asked questions

Who grants a visado if I live in Ceuta or Melilla?

In Ceuta and Melilla, the visado is granted by INGESA, the national health management body for those two cities. Elsewhere it is the medical or pharmaceutical inspection of your region's health service.

How long does a visado usually take to be granted?

Many visados are resolved within a few days to two weeks, especially when handled electronically. Delays usually come from an incomplete clinical report or a busy inspection office. If no decision arrives in time, what silence means depends on your region, so ask the inspection office.

What can I do if my visado is refused or stuck?

Ask the inspection office for the refusal reasons in writing, then your specialist can resubmit with a fuller clinical report or prescribe a covered alternative. You can also file an appeal (recurso de alzada) with the regional health authority, or complain through the regional patient service or ombudsman. You can also pay for the medicine privately.