3
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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.

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2 Answers 2

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2
votes

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 compliance 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

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  • 1
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    – JohnP
    Feb 26, 2016 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, 2016 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, 2016 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, 2016 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, 2016 at 23:15
1
vote

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.

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  • Any reason for the -1. I edited my answer substantially, so please review again.
    – Sun
    Oct 18, 2016 at 16:06
  • I don't see a reason for a downvote either. Good answer. +1
    – Carey Gregory ♦
    Oct 18, 2016 at 18:47

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