3

When a doctor writes a prescription for 1 per day with a quantity of 30 with 2 refills, I have never heard of anyone having a problem getting 90 days of the medication at once. That's 30 days for the original script plus 30 days for each refill. 30+30+30=90. Simple.

Suddenly, pharmacies are giving people a hard time about this, claiming that the doctor needs to explicitly write the script for 90 days in order to get a 90 day supply.

Has something changed in the laws or regulations modifying how this has always worked?

Details: USA; non-narcotic, non-addictive routine meds like levothyroxin sodium.

2

There are many factors that play a role in not allowing you to fill all the refills at once.

1- a typical insurance will pay for your medication and will not pay again until 2-3 days before you run out. (Insurance polices)

2- pharmacy systems do not allow the pharmacist to fill a medication on a patient profile more than once a day even if you do not use your insurance. (Company polices and systems)

3- to track your complience with your medication and ensure that you are taking your medication correctly. (Pharmacist decision)

4- refills exist to limit the number of tablets you can take in an amount of time. Otherwise, the doctor could have given you all pills at once. (Common sense!)

5- other insurance policies such as, insurance want you to go on mail order after your first 30 days supply, insurance will only pay for 30 days supply at a time, you have exceeded the maximum dose for the medication per 30 days supply (Insurance policies)

Sincerely, Pharmacist intern with 3 years of experience

  • 1
    Here on Health, we strongly encourage using references. They are the only way in which we can tell if information is reliable or not. If you are struggling to find good sources, check out, What are reliable sources? If you want to learn more about our site's stance on answers without references, check out, Should answers without references be immediately deleted?. Also, you do not reference which health care system (USA, Canadian, etc) you are addressing. – JohnP Feb 26 '16 at 22:20
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    I'd go with the mods on this - there must be some source of information about this, such as this one. Furthermore, the OP has given a specific medicine - levothyroxine sodium - a case where I disagree with your point No 3 - it's a medication taken chronically, patients mostly know how to use it and they don't visit their endocrinologist every 2 months, nor do they, in normal circumstances, do TSH and other analysis that often. – Lucky Feb 28 '16 at 13:08
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    @Lucky I have to agree with shnisaka here. My own insurance carrier, one of the major US companies, has various rules they apply as to when I can and can't refill prescriptions. I can't find those rules anywhere in my subscriber info or on their web site, and they're certainly not state law. For example, they won't refill a prescription until 2-3 days before the last one runs out, even if you're going to be traveling. For a business trip I had to call them to get an early refill, and even then they only authorized 5 days' worth to get me through the trip instead of the full 30 days. – Carey Gregory Feb 28 '16 at 21:24
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    @lucky deleted that point to make the answer more universal. In retail, pharmacist gets paid hourly and most of the time wants the best for his/her patients. If you fill a prescription and I notice that It is cheaper to give you 30 days than 90 days.. I would give you the 30 days.. it is a good customer service. – shnisaka Feb 28 '16 at 22:22
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    @Lucky There are many aspects of the American health care "system" that would be difficult for non-Americans to believe. Way off topic to discuss but trust me, it's broken in many ways. – Carey Gregory Feb 28 '16 at 23:15
1

90-day supplies are dominated by mail order pharmacies.

90 day scripts 2010 vs 2014

According to the PBMI’s 2014-2015 Prescription Drug Benefit Cost and Plan Design Report, 61% of employers allowed community pharmacies to fill 90-day prescriptions for maintenance medications.

Page 12 from http://reports.pbmi.com/report.php?id=10

This means that although the gap between retail and mail order is closing, there's still a restriction in being able to fill 90-day locally based on the employer's insurance policy.

  • Any reason for the -1. I edited my answer substantially, so please review again. – Sun Oct 18 '16 at 16:06
  • I don't see a reason for a downvote either. Good answer. +1 – Carey Gregory Oct 18 '16 at 18:47

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