Working research atlas30 marketsUpdated 24 August 2026

Selling GLP‑1s in Europe
is thirty different businesses

Whether you can own the pharmacy, prescribe to a stranger, put a box in the post, or say the drug’s name out loud changes completely at every border. This is the country‑by‑country working record: what the law says, who is already there, what it costs, and, kept deliberately visible, what we have not been able to establish.

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Four questions decide everything

Every country page answers the same six questions the same way, so the answers sit side by side. Four of them do most of the work.

Can you own it?12 of 30

Sweden, Norway, the Netherlands, Switzerland, Ireland, the UK, Portugal, Romania, Czechia, Slovakia, Lithuania and Malta let a company hold the licence outright. Germany, France, Spain, Denmark, Finland, Austria, Poland, Hungary, Slovenia, Cyprus and Luxembourg do not.

Can you post it?7 of 27

Prescription mail order is legal in Germany, Denmark, Estonia, Finland, Lithuania, the Netherlands and Sweden. Not, whatever every published list says, in Malta. Everywhere else the destination country closes the door.

Can you advertise?No

Nowhere. In the UK it is a criminal offence carrying two years. France fined Novo Nordisk 1.78m euros. Dutch and Swiss regulators have fined newspapers for covering the drugs.

Does margin survive?Barely

At UK list price, three of six Mounjaro doses are loss‑making at market retail. The fix is a manufacturer arrangement, and the manufacturers now control distribution.

Where to look first

Ranked by a weighted score across the six axes. Read the method before trusting the ordering, and the full matrix to sort it your own way.

shortlistSweden4.5On the structural axes that matter, the most open market in Europe: anyone can obtain a pharmacy licence, prescription mail order is legal and normal, and TLV rejected Wegovy from reimbursement in February 2026, leaving a fully cash-pay market that 2.5% of the population is already in.Portugal4.0The most commercially open market in southern Europe: companies can own up to four pharmacies outright, telehealth operators run a working e-prescription channel, and Portuguese consumers spent 55.2m euros on these drugs in the first quarter of 2026 alone. Reimbursement for obesity is still pending and now depends on a whole new evaluation system being built first.shortlistSwitzerland3.9Ownership is fully open, mail order works, and a genuine domestic operator now exists in ViaSlim, backed by Redcare’s licensed distribution. The catches are that Swissmedic polices advertising harder than any EU regulator including against journalism, which forces every operator to choose between naming the drug and staying safe; reimbursed prescribing is gated to specialists with patient-volume thresholds; and neither oral drug is authorised here. Romandie and Ticino have no native operator at all.shortlistDenmark3.9A large, sophisticated, fully cash-pay DTC market, and the one Nordic market with a genuinely domestic category leader rather than a pan-European one. You can never own the pharmacy end, because Denmark kept its pharmacist-only concession system under apotekerloven §15, and that turns out to be the moat: Aposund now runs in-person weighing at more than 170 physical pharmacy counters in partnership with Danmarks Apotekerforening, at 140 DKK per four weeks, a price no pure-digital entrant can match. Marketing is the hardest problem here, because Denmark bans video marketing of health services off your own site regardless of whether the drug is named.shortlistUnited Kingdom3.9The most developed private GLP-1 market in Europe and the easiest to set up in legally, a non-pharmacist can own the pharmacy outright, but advertising a prescription medicine to the public is a criminal offence, margins are negative at the doses patients titrate to without a manufacturer deal, and the incumbents have raised £45–150m each.shortlistNorway3.9Exceptional demand behind a closed door. Roughly NOK 2.6bn is spent out of pocket across 5.6m people, several times the Swedish figure per head, and the only reimbursement pathway is a narrow subgroup the Storting still has not funded. But inbound cross-border supply is flatly banned, more than 90 per cent of pharmacies sit in three chains, and DMP has now issued a stop order against a weight-loss telehealth operator. Our earlier score of 4.3 was too generous and has been marked down.Ireland3.8The best English-language EU beachhead: a limited company can own the pharmacy, remote prescribing is the working norm with no in-person mandate, and there is essentially no state cover for weight-management GLP-1s, but HPRA seizures of counterfeit product rose thirty-fold in a year and the regulator opened a social-media advertising push in May 2026.Lithuania3.5The most consequential correction on this site. Lithuania has permitted prescription mail order since 12 July 2022, with nineteen registered remote pharmacies, which means the widely cited list of seven EU states allowing Rx mail order is incomplete. Ownership is open, the market is small, and Dokteronline is not licensed here despite appearances.

All thirty markets

The arguments that cross borders

Where the same fact decides the shape of a business in eight countries at once.

The advertising wall

Every EU state bans advertising prescription medicines to the public. What differs is how far "advertising" reaches, and how hard anyone is looking.

7 sections

The Dutch route

Why every European cross-border structure runs through Venlo and Heerlen, and the three things that are wrong with the way people describe it.

5 sections

The pill changes the operation, not the law

Oral semaglutide deletes the cold chain, the largest cost and risk in online dispensing, and with it the fulfilment moat that protected incumbents.

5 sections

The economics are thinner than they look

A £300 monthly subscription that keeps £60 of it, for six months, at a customer acquisition cost nobody publishes.

6 sections

Who can own a pharmacy

The single structural fact that decides whether you can own the margin or only rent it, and it varies more across Europe than anything else in this atlas.

3 sections

Getting stock

The manufacturers have taken control of distribution, and that is now a bigger constraint on a new entrant than any regulator.

4 sections

The layer you can rent

Dispensing, prescribing, platform and certification are all buyable. Here is who actually sells them, and what is missing.

5 sections

Where to put the back office

Several markets are good places to employ clinicians and support staff and bad places to dispense. Do not confuse the two.

3 sections

What this is, and is not

A working record built to grow. Every country page carries the same schema, so any two markets are directly comparable and a thin page is visibly thin. All 30 of the 30 markets have now been researched from primary sources. Depth still varies, and the per-page open questions say where.

Every claim carries a source with a confidence tag: verified for a regulator, court, statute or filing, secondary for trade press or a law firm, unverified for a single commercial source or a headline we could not open. There are 391 sources logged. Where sources contradict each other that is recorded rather than resolved by picking a favourite.

And it keeps a running list of what we do not know: 19 questions, 4 of them genuinely blocking, plus the ones we have since closed, four of which turned out to correct a claim that this atlas, or everyone else, had wrong. That list is the research queue, and it is probably the most useful page here.

Open questions Evidence register Method