Last blog, I briefly mentioned a prescription service called auto refill. In this week’s blog, I am going to talk a little about this service. This way you, the patient, can make an informed decision when it is offered to you.

Many pharmacies offer the ability to put chronic medications on auto refill. This is a free service that is offered to help improve patient’s medication adherence by refilling their medications automatically without having to call the pharmacy to do so. The pharmacy’s software is programmed to generate the refill approximately 3 days before it is due, have the medication filled and be ready a day early so the patient can come in when the last fill of medication is finished. Many studies have been done that point to lack of patient compliance with their medications as a cause of treatment failure. As a result, the pharmacy profession’s answer to decrease this statistic is to entrust the refills to an automated process so that all the patient has to do is pick up the refill and continue taking their medication as prescribed. Sounds great for the patient, and on the surface appears to have the patient’s best interest in focus.

The flip side of this service doesn’t paint a good clinical picture or value the patient’s best financial interest. First, the “hazy” clinical picture: In healthcare, medications are often stopped, changed, or dosages adjusted. When the patient brings in a new medication order to start, the old one on auto refill is not stopped, either through omission or forgetfulness, and it gets filled and picked up by the unaware patient. The patient is unnecessarily exposed to a medication error. The same goes for when a dose is adjusted (up or down), the older prescribed dose gets filled and picked up, and now the patient is exposed to a medication error. These are daily occurrences in pharmacies which offer this service. In a profession where a zero error rate is the acceptable norm, these glaring system deficiencies are unacceptable.

In addition, auto refills are designed to increase the pharmacy’s bottom line, not the patient’s. When the medication fill is ready, the patient comes in to pick up the medication. It is made to be very easy and convenient for the patient. However, it is very rare that patients are as consistent as the automated system on the timeliness of their refills. In reality, patients miss doses throughout the month(s), and medication can easily accumulate if the patient keeps showing up every time a fill is ready for them to pick up. The pharmacy gets the sale, and the patient accumulates medication. And, if the physician stops the medication, the patient is out that prescription copayment.

Fortunately, most patients who have been exposed to this type of service have figured out that the auto refill service is not in their best interest. The above deficiencies are not worth the risk exposure. Good patients want to have control of their medications, and healthcare. They rely on pill boxes, calendars, and medication lists to help them keep track of their medications.

Always remember that you, the patient, must control your medication’s supply and refills. If you choose to delegate that task to your pharmacy, you will be increasing your risk of a medication error.

Until next week, be well.
Dion