You could say that medical advice and prescriptions are the salt and pepper of healthcare. Unfortunately, there will be times when you run out of prescriptions that you need to continue and you are worried about what needs to be done next. After this episode, you’ll be able to handle prescription refills, no sweat.
Let’s say you’re leaving the clinic with a treatment plan in mind and your doctor either gave you a physical prescription or sent an electronic one to your pharmacy. Now you fill the prescription either at the pharmacy or in the mail and you happily follow instructions for a while. Then you notice that you’re out of pills or whatever cream you’re using and you still have more treatment to follow through with. The first thing you should do here is to check if you have any refills. Usually on the paper or electronic prescription there should be a number that shows how many refills your doctor approved. Think of refills like this: your doctor whips up the play, meaning the treatment plan and drug, and then throws you the ball. As the receiver you’ll get the ball but you still have to catch it. The major concept here is that refills don’t just pop into existence, it’s your responsibility to get them—not enough providers are clear about that. In this situation, you can just reach out to the pharmacy and get your medication refilled without needing to call the clinic (unless of course you have treatment questions).
There are a few ways to get a refill, but in most cases you will need to give your prescription number. For example, on the pill bottle of a common medication like Metformin, there should be a label that will have your prescription number and approved refills along with other critical info like pharmacy contact details and your name. Since we live in the 21st century and have mini supercomputers in our pockets, using a pharmacy’s mobile app or website is helpful to get automatic refills as long as you know your prescription number. Even with modern technology like this you can still have issues with a pharmacy’s website and you may not be able to reach their team over the phone easily. Even when calling patients’ pharmacies from my clinic I’ve been on hold for over half an hour sometimes. In the worst case scenario, where you’re having problems getting a hold of the pharmacy, it’s best to go in person if possible—just bring your ID and other basic info so the pharmacist or pharmacy tech staff can find your record. Having a mail-order for your prescriptions is a great set up also, especially if there are meds you need to take consistently over time.
Even with all these great methods, you should know when to ask for a refill. Ideally you should contact your pharmacy if you think you’ll run out of medication in a week or two and you know a refill is needed because you got a treatment plan to finish. I say this because even though pharmacies can be pretty fast with refilling common meds, you might still have trouble waiting for re-ordered stock especially with today’s supply chain issues—it’s better to have a little bit of lead time and be proactive.
Numbers are an important theme here because most drugs are dispensed with a time limit or maximum quantity. For example, a tube of a common skin cream like Triamcinolone can be prescribed for 30 grams with two refills or the doctor can write up a 30-day supply with any refills allowed for that period. Although your provider is the one who decides the safe and effective amount of medication you need, it’s actually the health insurance plans who lay down the hard quantity and refill limits to keep a lid on the US’s already very high prescription drug costs. Health plans usually read over the latest clinical research and FDA guidance on each medication in the market to set those restrictions. The operations and content director at the GoodRx prescription indexing company goes into more detail about this in a separate article that I’ll link on my Substack post found at rushinagalla.substack.com. When it comes to these limits though, not everything fits together well like that jigsaw puzzle you spent a few long days trying to finish. The best medicine varies so much by the individual that your run-of-the-mill prescription length or amount may not make sense. That is why both patients and doctors are welcome to ask insurance plans to approve unusual amounts of medicine with a quantity limit exception. Your doctor’s office can file this and send any other pertinent clinical info the insurance needs to get this request done. One quick note before we get to the big picture. If a situation comes up where you lose a prescription or if you need a backup supply of meds for travel, you can reach out to your pharmacy to get an emergency refill (usually up to a 30-day supply depending on the medication). That being said, in some cases it might be easier to contact your doctor’s office directly and get a new prescription.
Speaking of new medications, you might be wondering what happens when you completely run out of refills. Thankfully, you’re not the end of the road. You’re now at the stage where you can ask for a prescription renewal. Just like how from very far away an emu looks like but isn’t actually an ostrich, a renewal is not the same thing as a refill even if it’s similar in principle. A renewal is a brand new round of medications and refills that get approved solely at your prescriber’s discretion. You can ask for a renewal when you visit or call your doctor but you can also have the pharmacy send that request on your behalf. Sometimes your provider can have strict rules on how he or she manages renewals; either you might need to see your doctor for a visit every time you need a renewal or if you were seen in the last 12 months your provider may just approve re-upped meds immediately. Doctors usually want to interact directly with patients for prescription review just to make sure medical history, lab work, and your other health details are current.
Now you’re up to speed on how to get refills and renewals done on time and on target. What might not happen in a timely manner though is your return to the doctor’s office and if the clinic even runs on schedule during any given day. In the next podcast, I’ll break down everything behind the scenes that clogs up the doctor’s calendar. Stay tuned and subscribe to Friendly Neighborhood Patient to get wise on healthcare. I’ll catch you at the next episode.
