Belgium

Article 8 of the coordinated Loi du 10 mai 2015 places every officine under one or more pharmaciens-titulaires (§1). Where the authorisation holder is not the pharmacist, that is a non-pharmacist natural or legal person, §5 requires it to give the titulaire les moyens et l’équipement nécessaires and une autonomie suffisante, and forbids imposing anything that would prevent compliance with legal or deontological duties. §2 makes the titulaire personally liable in penal, civil and disciplinary terms.

The practical catch is §3: a pharmacist may be titulaire of only one pharmacy at a time. Outside capital is welcome; multi-site consolidation is not straightforward. No 2026 amendment to this article was found.

No statute bans telemedicine. The Ordre des médecins requires the physician to have sufficient pertinent and reliable information, and states that for a genuinely new or unknown patient with an acute-type request, recourse to telemedicine as a substitute for a classic consultation must be avoided. A prior established therapeutic relationship is expected.

That is materially more conservative than France after June 2025 and it does not fit cold acquisition. Separately, the temporary royal decree restricting Ozempic initiation to endocrinologists in multidisciplinary settings lapsed on 30 November 2025, and GPs could already prescribe Wegovy and Mounjaro directly throughout.

Two regulator-adjacent sources agree: only non-prescription medicines may be sold online in Belgium. Prescription medicines may be reserved online, with delivery and payment in person at the physical pharmacy. A Belgian pharmacy product page for Wegovy 0.25mg at 144.82 euros states it plainly. Consumer guidance says delivery of such drugs ordered from other countries into Belgium is prohibited, and customs seized 35 illegally imported Ozempic pens in a documented June 2025 case, with Sciensano finding counterfeit pens containing insulin rather than semaglutide.

The commercial consequence is visible: none of euroClinix, ZAVA, DoktorABC or Feeli lists Belgium among its served countries. euroClinix serves England, Sweden, Portugal, Germany, Denmark, Switzerland, Finland, France and Norway, and skips Belgium exactly as it skips Greece. No clearly compliant Belgian-domestic DTC platform was identified either.

On 3 to 4 June 2026 Minister Frank Vandenbroucke formally declined to reimburse Wegovy for obesity, citing potential cost exceeding half the total medicines budget, weight regain after stopping, unclear mortality and quality-of-life evidence, and the absence of an integrated multidisciplinary pathway in the request. Novo Nordisk publicly called the outcome inequitable. No evidence was found that the decision has been revisited.

Behind it sits a documented fraud problem. INAMI figures put fraudulent semaglutide billing at 21.5m euros between 2021 and 2024, driven by non-diabetics obtaining diabetes-coded prescriptions, forged scripts and doctor shopping, with INAMI semaglutide spend rising from 60.7m to 69.5m euros over eleven months as dose volume nearly doubled. Since 1 February 2026 mutuality pre-authorisation has been mandatory for GLP-1 diabetes reimbursement.

Novo Nordisk cut Wegovy prices by roughly 19 to 20% on higher doses in late April 2026. Current consumer prices: Ozempic 104.25 euros per four-dose pack regardless of strength; Wegovy 144.82 euros up to 1mg, 165.57 euros at 1.7mg, 189.48 euros at 2.4mg. Mounjaro ran 179 to 411 euros a month at the last available reading in October 2025.

On advertising, Test-Achats documented Novo-sponsored Meta and Google ads driving to obesity information sites, a newspaper piece substantially sourced from an undisclosed press release, and pharma-funded clinician training, and reported that AFMPS had still not acted despite being contacted two years earlier and again after France fined Novo and Lilly. Weak enforcement is a risk to plan around, not a strategy.