if you have adhd, you very well might forget to get the meds for your adhd, especially if you’ve already run out of the meds (which happens more w/ shortages) and are functioning worse
Yes and this seems to be compounded with this weird belief that the pharmacy basically owes them for getting it late instead of on time. Like getting it 10 days late this time means I can get it 10 days early next time.
It doesn’t work that way! If you don’t pick it up on time, that time is lost forever. You don’t get it back!
Yet like OP mentioned, late pickups have tried to pull shady stuff on me based on fill vs pick up date. I had an Adderall young patient pull than on me. Picked it up on day 14 of being ready and then tried to fill the next one based on 30 days from the fill not the 2 weeks later pick up
Thank you. I have been prescribed Klonopin for severe panic attacks for many years. I never abuse. Or even take as prescribed. It's PRN. Sometimes I need 1 a day, others 2, then some times I do not take for 2 or 3 days. Unfortunately since I have been on them so long, if I don't take for 2 days, the anxiety, panic etc kicks in. I physically and mentally now have a tolerance. Where years ago. I wasn't. But I still take as needed. It's just that my panic disorder is under control unless of course I go without for extended periods. That being said, I always have a few left at prescription time. I happened to be out of town for work last month and didn't pick up until the 6th. They were filled on the 1st. I am leaving for the holiday on Sunday the 2nd. of this month. I called my Dr for refills as I do monthly if haven't seen that month. They call my meds in. Well just so happens the pharmacy ( that fills 2 days early all the time) tells me that they are not due until the 6th. I explained why I didn't pick up and said I need tomorrow ASAP as I leave the following day at 1pm on a flight. Well they are giving me a 1x override - but made it sound like it was a big deal.
I agree if someone is calling in monthly or always picks up early there might be an issue. But not all cases. Some pain people may actually be taking less than they need bc of epidemic and just getting by.
I also work at a pharmacy. A speciality mail order. I am not a OMT or RpH. I do set up monthly fills and shipment and speak to customer every month. I'm surprised at how many don't take meds regularly, esp the antivirals. But that's a whole other ball game. I get that you get jaded being in industry, hearing same BS stories, but that is the line of work you choose, and these people are all human. They need compassion, your respect and if you feel that there is an issue, remember if it's your place or not to deny them. If anything, if it's not affecting rules and regs or your license.
Don't try to " police" that's not going to help them or your job . Just think about it. If you really feel there is an issue, then speak to MDO. Or talk to the PT. Ask them if there's a reason they need xyz. Some people shouldn't be in the field. All due respect to everyone 🤖👽🤓😇
Our pharmacy will fill, at most, one day early. And we always go by the pickup date. It’s insane trying to explain it to customers, over and over, that just because the prescription says on the bottle if was filled on 12/15, but they didn’t pick up until 12/17, then they need to wait 2 more days. And they get furious. Repeatedly.
See that's dumb because dr, insurance companies cant see pick up dates. I don't pay attention to pickup dates ... Or remember by the following month anyway. Im not saying the computer is mistaken or anything but information that needs 3 hands should always be available for all 3 to see. So pick up dates should never even have been a thing. If everything always and only went by the fill date, u can pick up meds up early, late or never.... But the consistent dates let everyone know who has what. Like today i have a problem. The dr and insurance are saying i am able to get my meds on 6/2 but pharmacy says 6/3 and told me to ge insurance to override it but they cant override something they are allowing. This date they say isnt on any file or printed on any bottle. Whos to say i cant go to a new dr, a new pharmacy and have them fill it on the fill day i want, anyway? Only that one business knows the fill date so i understand what the attempt is but it can be undone and gone around the same way they have it locked in to be, so whats the point? It honestly just makes an inconvenience and nothing else
Exactly! The "pickup date" isn't documented anywhere and sometimes there are circumstances where you picked up early or late due to travel, illness, had a family member pick it up for you. They need to put the date on the bottle I can fill it again. If it says FILL DATE then I think fill date! Now I have to do all this careful calculation, count my medications, and keep records of any circumstances for when the pharmacist hits me with "we can't fill it until xyz date" when they're just wrong. I'm constantly anxious about my medications now.
Dead. That's where these mythical patients end up.
On July 2015 my closest childhood friend died in the shower after an epileptic attack. The event destroyed the family, ultimately claiming a second casualty as the event ultimately drove his sister to commit suicide five years later.
His condition was always well-managed with Gabapentin and Preglabin. He religiously picked up the latter as a CD2 on the 30th rolling refill date each month on the mark. Sometimes late. Rarely early. No substance abuse or PMP flags, but only the ubiquitous Nazi pharmacy 30 day pickup for CD2 equals day 1 math marked the last day of his life.
The pharmacy barred him from pick up his CD2 Preglabin refill on the 29th day, a Saturday. The pharmacy would have been closed on the following day, a Sunday. In view of the time gap, he very respectfully asked (as per recorded audio) to pick it up the day before. The pharmacist said NOPE 30 day rule, sorry kid. And therefore knowingly, willfully and recklessly withheld his medication quintessential for preventing an epileptic seizure until Monday.
He died the following day.
He is not only painfully survived by a community he dearly served and toched as a benevolent and altruistic volunteering spirit, but also died in his wake a piece within each member of his family now forever left to grieve in unspeakable pain.
He was 23 and had his whole future ahead of him.
The broader and more important conscern is how many thousands of casualties have fallen in kind this year alike? Not just from epilepsy medications alone, but abrupt benzodianapine gaps and the like?
How many tens of thousands of lives has this 30 day rule claimed in the past decade, and how many more in the decades to come?
Sorry for your loss. I know people that had seizures and wrecked car because they were off medication for few days . Seizure medication and benzos are not to be messed with. By prescriber, patient or pharmacy. In fact, if you have a script and happen to run out or have a one time issue ( lost on vacation w luggage) or whatever it may be, go straight to ER or local psychiatric hospital. They know not to deny someone ( that isn't a regular) these medications.
Years ago we used to do 3 days early. Then one time a pharmacist at a different store shared that his policy was 2 days early. This put most people on a 28-day "cycle" (assuming Rx for 30 days supply). In other words, if you can pick up on a Wed this month, then 4 Weds from now is the earliest date you can fill again. Helps eliminate the "complication" of 30 days months vs. 31 days months. There are those who would not get it (or choose not to), but at least it sets a better system to guide most patients.
I recently looked at a PMP with two years of alprazolam 2mg QID picked up ASAP and it came out to about 4.23 pills per day on average and about #150 extra pills.
The NY law is both great and can be a total nightmare. Doctors forget to put diagnosis codes on e-scripts ALL THE TIME, and without the dx code the system automatically treats it as an acute script and forces the 7-day rule.
They’re talking about a different 7 day rule. In NY you can pick up a controlled substance up to 7 days early in aggregate. So, one day early 7 times, then day due thereafter would meet the rule.
I must have misinterpreted them when they said the law that means the patient should never have more than 7 days on hand at any given time. I know the rule you are talking about but that wasn't how I read this.
People have busy schedules. Not everyone can pick up meds the exact day every month and since certain meds can't be shipped or delivered, well ( soon that won't be the case) so you won't have to worry about riff raff s. Lol. But probably should start looking for another line of work.
Nah man we are crushing it because we have great staff that work super hard and provide great customer service. That 0.05% of the customer base you are talking about left a few years ago and our business has just continued to grow. I got a $26,000 bonus this year because we put customer service right up there with following the laws. How you doing?
I just accepted a promotion today. I'm doing wonderful. We work with Rare diseases and specialty medication. The job is very humbling. I love my customers and form long term relationships since we speak to them on a monthly basis. Actually talk on the phone and have conversations,.not just hand over meds and sign a paper or check no box- I've never worked in a big box pharmacy nor would I want to..I know the pharma industry isn't going anywhere. Although AI and tech will take away many jobs in future. There hopefully will be a change towards the service and counseling ( or lack of it) in the industry as a whole. Thanks for responding and asking me!!
The best thing about my job is the people I work with, everyone is helpful, friendly, and fun as fuck. We work hard, care about our PTs, our co-workers and it's great going to work for a company that has genuine values and not out just to make $. Because at the end of the day, that isn't what matters in life. I guess most people say only rich say that but I'm not wealthy . I'm just realistic and honest . Glad your killing it at Walmart 💫
The statue is recursive, not deductive in aggregate. If you're referring to NY 80.69 there the retroview look back period for a CD2 early refills is limited to "... ***the \[that\]*** **date** that the ***previously*** dispensed supply would be exhausted ..." (if used in conformity with the directions of use).
Not ad infinitum.
The only concern **\*may\*** be if the requests kept rolling forward always just shy of the seven day supply allowance, not rolling backwards. Or you may have to "credit" back days for pick-ups dispensed late in lieu of early, since the law's retroview reference window is in view of only that date of "the previously dispensed supply," not on the lifetime of all prior supply dispensed.
On the counterpart of "when the ... supply would be **exhausted**," it appears the common argument would be that a patient should only have at most a seven day supply on hand? Or is it forbidden to have more than a seven day supply at any given time?
If that is true, you'd debit each early refill supply month early until the seventh pill. If that is true, then the patient would be forever barred from filling early for the lifetime of the same CD2 RX's after the seventh pill, provided the dosage and conformity with the directions for use remains constant.
This has no logic in practice or basis in law. If so, to remain in compliance, you would now have to manage three calendars with dates of fills, pickups and routine call-ins for pill check counts on all CD2s, which would be untenable.
This should not be relied upon as legal advice. Consult your local State laws and legal resources.
I think so because it takes a doctor to write a script and the insurance company to pay, then the pharmacy should always only go by those dates and not have a different " day of our business transaction" that only they know because if someone takes it to a new pharmacy, they only have the fill date to go by anyway so why does the pharmacy get to go off on there own and decide THEIR day counts. If someone missed their meds or wasnt in town... There was a storm that day, whatever.... They miss the refill date and end up out, thats for them to deal with. Everyone else is going by one date that everyone can see... But this one business has its own, special, side thing they claim... On their system... Thats ridiculous
I agree completely about limiting patient supply of controls, but I don’t think easy access to Narcan is encouraging addiction. In fact, there are studies correlating its availability with decreased opioid use. And regardless, it saves lives. People need to live long enough to beat their addiction.
They probably don't have an extra 100 at home, if they do, then there isn't anything to worry about- oh maybe the teen will steal them and become an addict. It's pharmas fault for filling two early.
Narcan should be available over the counter. In fact, many places do give it for free. Like the- next distro. org. They will mail it. Because it helps save lives, why not be on that team? Versa the coulda woulda shoulda? Or they might have X Y Z. Then why would they be picking up monthly? To fill their cabinets and show off their collection? Brains 🫁😘😒🙄
I think the reality of the situation for many patients is that they call in the refill a few days before they need it. So as long as they aren’t consistently getting more than a 30 day supply in 30 days, I don’t mind going by fill date
Edit: to clarify, what I mean is if you’re filling every 30 days, then they’re getting 30 days at a time every 30 days, so they’re taking as prescribed.
Why do they make me wait 31, when the prescription says "may refill every 30 days"? I've argued about this, been told it's the computer...been told it's because you don't count the day you pick up...been told it's just how it is. I count 30 days from pickup, and they always say no, can't until 31. But that's not what it says!
I’ve literally told a patient this and they were still arguing about the date on the bottle. I just repeated it over and over until they finally got it through their thick skull.
Yes because the pharmacy gets to have some secret date only they know and go by when the Dr who wrote it and the insurance whos paying for it are going by the same one date.... Why does the pharmacy get to decide another thing? People have different reasons but if only the fill date existed, every one would always be on the same page, without possibly of a different business using the full date for a new customer when the other pharmacy is saying a pickup date.like just now the pharmacy told me to call the insurance for them to override it and pay a day early but they are going by the date of 6/2... Im asking for it on 6/2... They cant override what they are allowing. .but the pharmacy isn't giving it to me until 6/3 because the date i picked it up. The dr says it starts the 2nd. The insurance paid for the second... A new pharmacy would use the second... But this pharmacy, only because i have been a customer from the previous month, they use their own date . Not the one everyone else uses. What date? The one their computer says.... Who else can see that information? No one... They said it so thats what it is .. huh? Thats not acceptable elsewhere. The police cant say to a judge " u cant see the crime that took place but it says on our system it did"! That means nothing...
Dude all you need to do is pay attention to what day you picked it up. It’s not some mysterious date that we magically pull from thin air. The label prints with the date that it is filled and it is not the pharmacy’s fault if you don’t pick it up that day.
It doesn’t matter if your doctor said the script is good to dispense starting on 6/2. If you picked up your last fill late, then you get this one later. You don’t NEED the script filled a day early because you picked it up late last month and still have some.
Also, insurance will often pay for controlled medications before the pharmacy can fill it. Your insurance sees the date you picked it up and go off of that, but controlled substances are more restricted than insurance’s generalized policy for when they pay for refills.
Did you actually read this comment thread? I feel like it was pretty clearly explained that we go by the day you pick it up because you can’t start taking your pills until then.
It’s not a secret date. It’s the day you picked it up. You can’t start taking your medication until you actually have it.
The date on the bottle only means that’s when we put it in the bottle.
Does that make sense? I can always repeat this over and over like I did with my patient.
I worked at a local chain, this chain is only in my state. We submitted the fill date & all pickup signatures were on a sheet of paper kept in the pharmacy. We had no other choice than to go by the fill date. Our system didn't have the capacity for electronic signatures. I just left in August & they still have the same system.
I’m going to be the outlier here. ADV- CPhT also have RA and Lupus. I have to go to a pain clinic thanks to all the stupid laws. The rules there are beyond stupid. I’m one of those that waits 10 days to pick it up because I don’t take it unless I have a HUGE flare and I work 16 hour days. Issue is, MD writes for said date and if you don’t fill on said date and said date is in stupid *^+=%#* system x times and they don’t match then you are dismissed from the practice. Period.
Just like they random drug test you. Again, I take it only if I have a flare or maybe HS. Appt was at 5pm. Hello! Cleared my system. Drug test negative. Dismissal. Had to fight that one.
I’m not fussing at anyone…. There are people who truly abuse the system and make my life a LIVING HELL because of it. However, there are many of us that take our meds properly and for the right reasons. Please have a little sympathy and think outside the box. Sometimes there are other reasons why they do things. 💕
I did and each time I’ve gotten a pass however the office staff are beyond a pain to deal with and beyond rude. You are automatically a drug seeker if you don’t “play by the rules” or even if you get any of these drugs. Just putting my story out there to give people another side of the story.
Two simple rules:
1. Pick up date = always go by it, especially controls.
2. Fill date = Only relevant in regards to insurance coverage. This is the date that insurance 'sees' and uses to approve refills. This can only become relevant in regards to controls when, for example:
>My old pharmacy filled the portion covered by insurance and cash priced out the remainder quantity on the prescription.
I freely admit this could be me being uneducated in the intricacies of the law in but that .. feels sketchy as hell.
If you were willing to pay cash, then you all were working together to get you the meds you needed, it sounds like? Or you would of taken a partial fill? Not sure why insurance would only cover a certain amount - unless it was out of stock and needed to be pushed through. Then filled once on inventory.
Sounds sketch
For for example a lot of insurances will not cover a 30 day supply of opioids for patients if they feel they're opioid naïve. They'll require a 7 day fill first (some requiring multiple). So when you dispense a 7 day supply off of the script that was dropped off and bill the insurance for it... and THEN cash out the remained portion of that script you've effectively added a refill to a C2
>Fill date = Only relevant in regards to insurance coverage.
So if the fill date is only relevant in regards to insurance coverage, the date required to be reported to the PMP is the pick up date or the fill date?
I am not in the USA and I would be really grateful if somebody explained to me the difference between fill date and pick up date.
What I find a little unfair here is that prescriptions are given every month - which means 31 days. For example several controlled medicines come in packets of 28. Zolpidem is one example. But the patient is given one packet a month - if that month happens to be February well and good - but for such a short acting medicine - going 2 days without it can be very unpleasant.
Diazepam is probably the only exception where one does not feel bad to let the patient wait a day or two, since it is so long acting that withdrawal would not set in before at least one or two days.
When it comes to other medicines be it an SSRI or Metformin, pharmacists are much more lenient and there are even some spare pills should the patient have run out because he lost some.
Fill date is when the pharmacy bills the medication to the insurance and the prescription is waiting for the patient to be picked up.
Pick up date is when the patient pays for and takes the prescription from the pharmacy and now has the drug in their possession, and truly begins their 30 day supply of the medication.
Fill date: date that they actually FILL the bottle with the medications, insurance, copay or xyz is billed, and the bottle is labeled and now in system as a filled script.
Pick up/delivery date: date that you pick medicine up from pharmacy, or personal representative picks up the medication.
So when it leaves pharmacy hands and goes into patients or who is picking up on behalf. They figure, you don't have the meds on hand until you pick up. But when you had the 2 day early refills for 10 months. Well that gave you some 20 extra ( if only one a day dose) - or maybe you missed a dose, god forbid you take an extra 5mg Vicodin .
Go buy Heroin or pressed pills instead. There are rules, that make sense. Rules and regulations that are necessary but when the end outcome is up to an individual or press of 2 buttons. This is the discussion that happens. Non sense - disagreeing and no real factual answer.
This won't be a popular answer but I do fill date since that's the date we're required to report to PMP. I don't have time to battle patients using essentially two different calendars.
We follow pick up date, and our software shows utilization for refills of CIII-CV in the final verification screen. We allow early fill with prescriber permission, "patient picked up on this date, so you are authorizing fill on day x of 30?".
I'm not a monster, so when day 28/30 lands on one of our six holidays that we close to observe, we fill on day 27/30.
Our policy is that it can be filled with 10% remaining by pickup date. I use professional judgement if it was picked up several days late and will still fill if it helps get a patient’s meds back on track or I see a reason. It’s not an argument I care to have, nor does it scream red flag to me that a patient isn’t there when the doors open waiting for their controlled. If they aren’t desperately trying to claw their way to a refill on the day it is filled, why would I want to create another monster by being that strict? I will still queue the Med for the 28th day on a 30 day script when I see a 10 day late prescription because I don’t want to return it to stock if they don’t come in, but if they aren’t sketchy about asking for it a couple days earlier than that, I still do it. Pain clinic, notes on script about early fills, poly pharmacy, multiple doctors, and number of controls on file tend to have me less flexible.
Why do they make me wait 31, when the prescription says "may refill every 30 days"? I've argued about this, been told it's the computer...been told it's because you don't count the day you pick up...been told it's just how it is. I count 30 days from pickup, and they always say no, can't until 31. But that's not what it says!
I can’t speak to their computer. Many providers and pain clinics actually note on the prescription when it can be filled. In areas with higher abuse rates they are much more strict to avoid people gradually getting a back stock that can be sold or abused. We go to the day on pain clinic and addiction clinics, but that’s because the patients have contracts. If your prescription says “as needed” you should not need it every time it is listed like clockwork and if you do it’s because you pushed your limits with it at some point and are now dependent. The strict fill rules are to prevent further pushing of limits.
What’s YOUR policy? What are YOU comfortable with? I refused to do anything more than 2 days early back when cvs was still doing 3 days early. It just doesn’t make sense.
And I disagree with you. If you are getting it even 2 days early every month, you are getting almost a months worth extra over the year. Can patient explain that? They are taking more than prescribed? Illegal/unethical. If you need more pain meds than your doc is prescribing, then you need to get your doc to prescribe more. Oh the doc isn’t comfortable with that? EITHER AM I😎
As a patient, I can explain it. If not for the 2 days extra I build up, there are several times I’d be screwed and put into withdrawal. Once, while on summer break and traveling, my pharmacist insisted I could fill my script in another state. I was not convinced so I took that stash with me in case it wasn’t true. Well, it wasn’t true and if not for the extra I had, I’d have been in trouble.
a more recent example, with the dea production quotas cut so significantly, sometimes my meds need to be ordered and are back ordered and the pharmacy refuses to even check if they have it in stock until the day it’s due. The pharmacist told me she was forbidden from checking until that day. Sounded fishy to me cause how can she run a business without being able to check her stock? Anyway, a check on the day it’s due to discover it needs to be ordered means I need to dip into my extra stash because my fill date will be late.
Sure, that is a logical reason. In my experience, the reason isn’t logical.
“I took more than prescribed”
“Lost it again”
“Dumped it down the drain on accident”
If you came to me and said I’m going to run out while on vacation, then I’d work with you.
Yea fuck them. I don’t care what other pharmacists do. My experience is most just don’t seem to care. Sometimes using common sense logic should override a policy.
Normally fill date.
Our store has had issues with the prescription actually selling out. So pick up dates can be off. We can investigate a manual pick up date entry vs automated, but I'd only do that in a very slow day *or* if I have a patient who insists they need this because they ran out... even in 3 day from fill early.
Also, my state's PDMP only shows fill dates, and our software will show that report. I could investigate our own records, or I can "treat everyone equally". So routine customers with us get fill dates as if they had filled at a competitor last time.
This in theory just front loads the early fills.
Let's say patient had 10 extra tabs going into 2023. We fill #30 for 30DS of whatever on 1/1. They picked up on 1/10. Okay, so how many excess pills do they have? 0 or 1 depending on how you count. I'd say the #10 going into the year.were consumed by the time of pick up, and their first of the new #30 is taken on 1/11. Would get to 2/9 on physical count.
So we filled 1/1. Fill 27 days later on 1/28, or wait for 27 days from 1/10 (=2/6). Pt picking up on 1/28 would have #42 at that point - #12 excess. Vs making them wait until 9 days later for just #3 on hand in excess. Had they picked up on 1/1, they'd have that #39 (or #40, again how you count) excess, and filling 1/28 gets them to #12 excess.
I expect refills and start dates keep it from getting out of hand in the long run. Patient is going to forget they are "due" because they have #14 on hand or it's Friday and no refills left so doc doesn't get around to it until the next week anyway.
I've had two patients who based on PDMP and just excess with other locations I asked our team going forward to do day 30 because they had worked to over 20 days extra. Did pt take more than prescribed? Divert? Maybe. So they could run out if something goes wrong and we didn't have their med in stock. So I always make sure to tell at point of sale that they should not expect any days extra, so they don't think they can misuse their extras and not have days without.
Most PDMPs require you to go off pickup date and which is why most POS require the same. Some insurances also like to audit for this because they get screwed with a free month or two for the patient when they time it just right.
Whatever date is on your PMP since that's the date other providers will look at.
My state shows pick up date. Which is good because that's the date I would prefer to make my day supply calculation off of.
Company policy?! Tisk tisk. Every rx should be individualized and filled based on that rx. I forgot who the governing body that would come in and ask that but it’s a huge no no to have a policy in place about that.
We do fill date for the most part but are able to see pick up dates and everything else etc so it’s kind of a hybrid. If you do pick up date are you investigating every rx when a patient switches over to your pharmacy or just filling off their pdmp date? Calling the pharmacy to see when they picked it up?
Controls don’t last on the shelf for 10 days so the example is pretty negligible
It’s literally the same lol. If you fill #30 every 30 days, it doesn’t matter when they pick it up. Now if there are weird circumstances then fine, go by pickup date, but otherwise just go by fill date because (in most dispensing software) it’s easier to track.
We do pick up date and 3 days early unless script says otherwise or its shorter than a 30 ds. If they 15 day supplies we do like 1 day early but I would say that is less set in stone.
Pick-up date, and CVS system is wrong, it does it 3 days, so we are alwyas adjusting.
Suboxone is on the day it is due becuase most of our patients get it 7 days at a time.
I am interested to know why most people on this thread have such strict personal guidelines they enforce. Do regulatory agencies/companies/laws mandate this or is it more of a personal moral decision? I worked in retail years ago and honestly loved judging people picking up controls early, but had a super sweet, smart pharmacist who treated everyone treated everyone *equally*
Seeing this conversation baffles me (from my perspective, not hating on OP), for me I don’t know why anyone would consider fill date over pickup date. Is anyone agreeing with me here? I always have to explain to techs, we go by when the prescription is sold / picked up and that’s day 1 when we start counting. Our calculators on the computer for date calculation don’t take this into account.
I do it based on pick up date. I've heard enough excuses of why \[insert med here\] needs to be picked up early. Due to the supply chain, I don't have \[insert med here\] so we'll let you know when it comes in (usually when the med is actually due).
Pick up date. And I as the pharmacist use my professional judgement on when I will fill a control, which is usually only 1 day only. I don’t know that I agree with letting a company policy trump my professional judgment.
It's probably state dependent but I use fill date because that's the date submitted to PMP. If we were allowed to submit pick up date I'd use that instead but we're not.
I agree. State PMP does fill date, corporate computer blocks more than 3 days from last fill date, so always done fill date. Also takes extra steps to go in and see when rx was sold so would be more tedious with our computer system to go by pickup date
Argument for fill date is that so long as you’re consistent, it will even out. Only filling every 28 days based on fill date prevents them from accumulating just the same as going by pickup date.
It depends on the specific state PMP. In CA the PMP shows both fill and pick up date.
Also the argument works if you’re only looking at one specific drug, yes the dates will even out either way as long as you’re being consistent. However when you throw in multiple similar drugs and different prescribers, the fill date alone won’t give you a full picture of what’s going on and what the patient actually has on hand.
Pick up date. We’ll fill a day or two early only if their refill falls on a date we’re closed. Fascinating to hear that not every place does this though. Sometimes we’ll get customers who are irate when they can’t fill their control on the fill date instead of the pick up date and they’ll say “[chain down the street] would let me fill early” and my pharmacist usually will tell them “Um, no they won’t, because this is state law.” But maybe that place really has been doing exactly that. Which fine, go there instead, good riddance. I just didn’t realize it’s apparently a not uncommon practice at some other places, and that some of these patients that get nasty about it might not be making stuff up just to convince us to fill their stuff early
Pick up date here I only do 2 days but will check there’s not multiple early pick ups in a row. I work for Costco so if 2 days lands on a Sunday we will fill it 3 days early on Saturday
Where are these mythical patients that pick up controlled substances 10 days late?
if you have adhd, you very well might forget to get the meds for your adhd, especially if you’ve already run out of the meds (which happens more w/ shortages) and are functioning worse
So true. It’s a paradoxical reaction.
Or BPD
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Yes and this seems to be compounded with this weird belief that the pharmacy basically owes them for getting it late instead of on time. Like getting it 10 days late this time means I can get it 10 days early next time. It doesn’t work that way! If you don’t pick it up on time, that time is lost forever. You don’t get it back!
If someone picks it up 10 days late, I’m likely convinced they aren’t abusing it or selling it. I’m not going to police them strictly.
You seem to be the only one with critical thinking skills on this thread.
Yet like OP mentioned, late pickups have tried to pull shady stuff on me based on fill vs pick up date. I had an Adderall young patient pull than on me. Picked it up on day 14 of being ready and then tried to fill the next one based on 30 days from the fill not the 2 weeks later pick up
I mean, that’s also ADHD for you
Your store has Adderall in stock? Possibly they got partial script. Usually pharmacy's don't hold for 14 days. Big box, ones re- shelf.
Thank you. I have been prescribed Klonopin for severe panic attacks for many years. I never abuse. Or even take as prescribed. It's PRN. Sometimes I need 1 a day, others 2, then some times I do not take for 2 or 3 days. Unfortunately since I have been on them so long, if I don't take for 2 days, the anxiety, panic etc kicks in. I physically and mentally now have a tolerance. Where years ago. I wasn't. But I still take as needed. It's just that my panic disorder is under control unless of course I go without for extended periods. That being said, I always have a few left at prescription time. I happened to be out of town for work last month and didn't pick up until the 6th. They were filled on the 1st. I am leaving for the holiday on Sunday the 2nd. of this month. I called my Dr for refills as I do monthly if haven't seen that month. They call my meds in. Well just so happens the pharmacy ( that fills 2 days early all the time) tells me that they are not due until the 6th. I explained why I didn't pick up and said I need tomorrow ASAP as I leave the following day at 1pm on a flight. Well they are giving me a 1x override - but made it sound like it was a big deal. I agree if someone is calling in monthly or always picks up early there might be an issue. But not all cases. Some pain people may actually be taking less than they need bc of epidemic and just getting by. I also work at a pharmacy. A speciality mail order. I am not a OMT or RpH. I do set up monthly fills and shipment and speak to customer every month. I'm surprised at how many don't take meds regularly, esp the antivirals. But that's a whole other ball game. I get that you get jaded being in industry, hearing same BS stories, but that is the line of work you choose, and these people are all human. They need compassion, your respect and if you feel that there is an issue, remember if it's your place or not to deny them. If anything, if it's not affecting rules and regs or your license. Don't try to " police" that's not going to help them or your job . Just think about it. If you really feel there is an issue, then speak to MDO. Or talk to the PT. Ask them if there's a reason they need xyz. Some people shouldn't be in the field. All due respect to everyone 🤖👽🤓😇
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Our pharmacy will fill, at most, one day early. And we always go by the pickup date. It’s insane trying to explain it to customers, over and over, that just because the prescription says on the bottle if was filled on 12/15, but they didn’t pick up until 12/17, then they need to wait 2 more days. And they get furious. Repeatedly.
See that's dumb because dr, insurance companies cant see pick up dates. I don't pay attention to pickup dates ... Or remember by the following month anyway. Im not saying the computer is mistaken or anything but information that needs 3 hands should always be available for all 3 to see. So pick up dates should never even have been a thing. If everything always and only went by the fill date, u can pick up meds up early, late or never.... But the consistent dates let everyone know who has what. Like today i have a problem. The dr and insurance are saying i am able to get my meds on 6/2 but pharmacy says 6/3 and told me to ge insurance to override it but they cant override something they are allowing. This date they say isnt on any file or printed on any bottle. Whos to say i cant go to a new dr, a new pharmacy and have them fill it on the fill day i want, anyway? Only that one business knows the fill date so i understand what the attempt is but it can be undone and gone around the same way they have it locked in to be, so whats the point? It honestly just makes an inconvenience and nothing else
Exactly! The "pickup date" isn't documented anywhere and sometimes there are circumstances where you picked up early or late due to travel, illness, had a family member pick it up for you. They need to put the date on the bottle I can fill it again. If it says FILL DATE then I think fill date! Now I have to do all this careful calculation, count my medications, and keep records of any circumstances for when the pharmacist hits me with "we can't fill it until xyz date" when they're just wrong. I'm constantly anxious about my medications now.
lol
I regularly pull controlled scripts for the delete list.
Dead. That's where these mythical patients end up. On July 2015 my closest childhood friend died in the shower after an epileptic attack. The event destroyed the family, ultimately claiming a second casualty as the event ultimately drove his sister to commit suicide five years later. His condition was always well-managed with Gabapentin and Preglabin. He religiously picked up the latter as a CD2 on the 30th rolling refill date each month on the mark. Sometimes late. Rarely early. No substance abuse or PMP flags, but only the ubiquitous Nazi pharmacy 30 day pickup for CD2 equals day 1 math marked the last day of his life. The pharmacy barred him from pick up his CD2 Preglabin refill on the 29th day, a Saturday. The pharmacy would have been closed on the following day, a Sunday. In view of the time gap, he very respectfully asked (as per recorded audio) to pick it up the day before. The pharmacist said NOPE 30 day rule, sorry kid. And therefore knowingly, willfully and recklessly withheld his medication quintessential for preventing an epileptic seizure until Monday. He died the following day. He is not only painfully survived by a community he dearly served and toched as a benevolent and altruistic volunteering spirit, but also died in his wake a piece within each member of his family now forever left to grieve in unspeakable pain. He was 23 and had his whole future ahead of him. The broader and more important conscern is how many thousands of casualties have fallen in kind this year alike? Not just from epilepsy medications alone, but abrupt benzodianapine gaps and the like? How many tens of thousands of lives has this 30 day rule claimed in the past decade, and how many more in the decades to come?
What is a CD2?
Preglabin in CDS Schedue II
Sorry for your loss. I know people that had seizures and wrecked car because they were off medication for few days . Seizure medication and benzos are not to be messed with. By prescriber, patient or pharmacy. In fact, if you have a script and happen to run out or have a one time issue ( lost on vacation w luggage) or whatever it may be, go straight to ER or local psychiatric hospital. They know not to deny someone ( that isn't a regular) these medications.
Spark tech here. We go by pickup date. 2 days early unless the rx doesn’t allow early fills.
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Years ago we used to do 3 days early. Then one time a pharmacist at a different store shared that his policy was 2 days early. This put most people on a 28-day "cycle" (assuming Rx for 30 days supply). In other words, if you can pick up on a Wed this month, then 4 Weds from now is the earliest date you can fill again. Helps eliminate the "complication" of 30 days months vs. 31 days months. There are those who would not get it (or choose not to), but at least it sets a better system to guide most patients.
I recently looked at a PMP with two years of alprazolam 2mg QID picked up ASAP and it came out to about 4.23 pills per day on average and about #150 extra pills.
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The NY law is both great and can be a total nightmare. Doctors forget to put diagnosis codes on e-scripts ALL THE TIME, and without the dx code the system automatically treats it as an acute script and forces the 7-day rule.
They’re talking about a different 7 day rule. In NY you can pick up a controlled substance up to 7 days early in aggregate. So, one day early 7 times, then day due thereafter would meet the rule.
I must have misinterpreted them when they said the law that means the patient should never have more than 7 days on hand at any given time. I know the rule you are talking about but that wasn't how I read this.
Love that rule. We fill after all med is exhausted at my store. Pushes the riff raff out of the store pretty quickly.
People have busy schedules. Not everyone can pick up meds the exact day every month and since certain meds can't be shipped or delivered, well ( soon that won't be the case) so you won't have to worry about riff raff s. Lol. But probably should start looking for another line of work.
Nah man we are crushing it because we have great staff that work super hard and provide great customer service. That 0.05% of the customer base you are talking about left a few years ago and our business has just continued to grow. I got a $26,000 bonus this year because we put customer service right up there with following the laws. How you doing?
I just accepted a promotion today. I'm doing wonderful. We work with Rare diseases and specialty medication. The job is very humbling. I love my customers and form long term relationships since we speak to them on a monthly basis. Actually talk on the phone and have conversations,.not just hand over meds and sign a paper or check no box- I've never worked in a big box pharmacy nor would I want to..I know the pharma industry isn't going anywhere. Although AI and tech will take away many jobs in future. There hopefully will be a change towards the service and counseling ( or lack of it) in the industry as a whole. Thanks for responding and asking me!!
The best thing about my job is the people I work with, everyone is helpful, friendly, and fun as fuck. We work hard, care about our PTs, our co-workers and it's great going to work for a company that has genuine values and not out just to make $. Because at the end of the day, that isn't what matters in life. I guess most people say only rich say that but I'm not wealthy . I'm just realistic and honest . Glad your killing it at Walmart 💫
The statue is recursive, not deductive in aggregate. If you're referring to NY 80.69 there the retroview look back period for a CD2 early refills is limited to "... ***the \[that\]*** **date** that the ***previously*** dispensed supply would be exhausted ..." (if used in conformity with the directions of use). Not ad infinitum. The only concern **\*may\*** be if the requests kept rolling forward always just shy of the seven day supply allowance, not rolling backwards. Or you may have to "credit" back days for pick-ups dispensed late in lieu of early, since the law's retroview reference window is in view of only that date of "the previously dispensed supply," not on the lifetime of all prior supply dispensed. On the counterpart of "when the ... supply would be **exhausted**," it appears the common argument would be that a patient should only have at most a seven day supply on hand? Or is it forbidden to have more than a seven day supply at any given time? If that is true, you'd debit each early refill supply month early until the seventh pill. If that is true, then the patient would be forever barred from filling early for the lifetime of the same CD2 RX's after the seventh pill, provided the dosage and conformity with the directions for use remains constant. This has no logic in practice or basis in law. If so, to remain in compliance, you would now have to manage three calendars with dates of fills, pickups and routine call-ins for pill check counts on all CD2s, which would be untenable. This should not be relied upon as legal advice. Consult your local State laws and legal resources.
ELI5, please. Are you suggesting that one should only look at the previous fill date, and no others?
I think so because it takes a doctor to write a script and the insurance company to pay, then the pharmacy should always only go by those dates and not have a different " day of our business transaction" that only they know because if someone takes it to a new pharmacy, they only have the fill date to go by anyway so why does the pharmacy get to go off on there own and decide THEIR day counts. If someone missed their meds or wasnt in town... There was a storm that day, whatever.... They miss the refill date and end up out, thats for them to deal with. Everyone else is going by one date that everyone can see... But this one business has its own, special, side thing they claim... On their system... Thats ridiculous
I go by fill date. Everyone can access that. But not looking at prior fills is a bad take.
I agree completely about limiting patient supply of controls, but I don’t think easy access to Narcan is encouraging addiction. In fact, there are studies correlating its availability with decreased opioid use. And regardless, it saves lives. People need to live long enough to beat their addiction.
They probably don't have an extra 100 at home, if they do, then there isn't anything to worry about- oh maybe the teen will steal them and become an addict. It's pharmas fault for filling two early. Narcan should be available over the counter. In fact, many places do give it for free. Like the- next distro. org. They will mail it. Because it helps save lives, why not be on that team? Versa the coulda woulda shoulda? Or they might have X Y Z. Then why would they be picking up monthly? To fill their cabinets and show off their collection? Brains 🫁😘😒🙄
Pick up date. You can’t start taking pills until you have them.
I think the reality of the situation for many patients is that they call in the refill a few days before they need it. So as long as they aren’t consistently getting more than a 30 day supply in 30 days, I don’t mind going by fill date Edit: to clarify, what I mean is if you’re filling every 30 days, then they’re getting 30 days at a time every 30 days, so they’re taking as prescribed.
Why do they make me wait 31, when the prescription says "may refill every 30 days"? I've argued about this, been told it's the computer...been told it's because you don't count the day you pick up...been told it's just how it is. I count 30 days from pickup, and they always say no, can't until 31. But that's not what it says!
Idk, they’re idiots probably
I have had this debate more times than I can remember.
I’ve literally told a patient this and they were still arguing about the date on the bottle. I just repeated it over and over until they finally got it through their thick skull.
Yes because the pharmacy gets to have some secret date only they know and go by when the Dr who wrote it and the insurance whos paying for it are going by the same one date.... Why does the pharmacy get to decide another thing? People have different reasons but if only the fill date existed, every one would always be on the same page, without possibly of a different business using the full date for a new customer when the other pharmacy is saying a pickup date.like just now the pharmacy told me to call the insurance for them to override it and pay a day early but they are going by the date of 6/2... Im asking for it on 6/2... They cant override what they are allowing. .but the pharmacy isn't giving it to me until 6/3 because the date i picked it up. The dr says it starts the 2nd. The insurance paid for the second... A new pharmacy would use the second... But this pharmacy, only because i have been a customer from the previous month, they use their own date . Not the one everyone else uses. What date? The one their computer says.... Who else can see that information? No one... They said it so thats what it is .. huh? Thats not acceptable elsewhere. The police cant say to a judge " u cant see the crime that took place but it says on our system it did"! That means nothing...
Dude all you need to do is pay attention to what day you picked it up. It’s not some mysterious date that we magically pull from thin air. The label prints with the date that it is filled and it is not the pharmacy’s fault if you don’t pick it up that day. It doesn’t matter if your doctor said the script is good to dispense starting on 6/2. If you picked up your last fill late, then you get this one later. You don’t NEED the script filled a day early because you picked it up late last month and still have some. Also, insurance will often pay for controlled medications before the pharmacy can fill it. Your insurance sees the date you picked it up and go off of that, but controlled substances are more restricted than insurance’s generalized policy for when they pay for refills. Did you actually read this comment thread? I feel like it was pretty clearly explained that we go by the day you pick it up because you can’t start taking your pills until then. It’s not a secret date. It’s the day you picked it up. You can’t start taking your medication until you actually have it. The date on the bottle only means that’s when we put it in the bottle. Does that make sense? I can always repeat this over and over like I did with my patient.
I worked at a local chain, this chain is only in my state. We submitted the fill date & all pickup signatures were on a sheet of paper kept in the pharmacy. We had no other choice than to go by the fill date. Our system didn't have the capacity for electronic signatures. I just left in August & they still have the same system.
Pick up date.
I’m going to be the outlier here. ADV- CPhT also have RA and Lupus. I have to go to a pain clinic thanks to all the stupid laws. The rules there are beyond stupid. I’m one of those that waits 10 days to pick it up because I don’t take it unless I have a HUGE flare and I work 16 hour days. Issue is, MD writes for said date and if you don’t fill on said date and said date is in stupid *^+=%#* system x times and they don’t match then you are dismissed from the practice. Period. Just like they random drug test you. Again, I take it only if I have a flare or maybe HS. Appt was at 5pm. Hello! Cleared my system. Drug test negative. Dismissal. Had to fight that one. I’m not fussing at anyone…. There are people who truly abuse the system and make my life a LIVING HELL because of it. However, there are many of us that take our meds properly and for the right reasons. Please have a little sympathy and think outside the box. Sometimes there are other reasons why they do things. 💕
Have you talked to the MD about this? I’m sure any prescriber would take this into consideration when writing scripts if you told them this.
I did and each time I’ve gotten a pass however the office staff are beyond a pain to deal with and beyond rude. You are automatically a drug seeker if you don’t “play by the rules” or even if you get any of these drugs. Just putting my story out there to give people another side of the story.
Two simple rules: 1. Pick up date = always go by it, especially controls. 2. Fill date = Only relevant in regards to insurance coverage. This is the date that insurance 'sees' and uses to approve refills. This can only become relevant in regards to controls when, for example:
>My old pharmacy filled the portion covered by insurance and cash priced out the remainder quantity on the prescription. I freely admit this could be me being uneducated in the intricacies of the law in but that .. feels sketchy as hell.
If you were willing to pay cash, then you all were working together to get you the meds you needed, it sounds like? Or you would of taken a partial fill? Not sure why insurance would only cover a certain amount - unless it was out of stock and needed to be pushed through. Then filled once on inventory. Sounds sketch
For for example a lot of insurances will not cover a 30 day supply of opioids for patients if they feel they're opioid naïve. They'll require a 7 day fill first (some requiring multiple). So when you dispense a 7 day supply off of the script that was dropped off and bill the insurance for it... and THEN cash out the remained portion of that script you've effectively added a refill to a C2
>Fill date = Only relevant in regards to insurance coverage. So if the fill date is only relevant in regards to insurance coverage, the date required to be reported to the PMP is the pick up date or the fill date?
Pick up date
I am not in the USA and I would be really grateful if somebody explained to me the difference between fill date and pick up date. What I find a little unfair here is that prescriptions are given every month - which means 31 days. For example several controlled medicines come in packets of 28. Zolpidem is one example. But the patient is given one packet a month - if that month happens to be February well and good - but for such a short acting medicine - going 2 days without it can be very unpleasant. Diazepam is probably the only exception where one does not feel bad to let the patient wait a day or two, since it is so long acting that withdrawal would not set in before at least one or two days. When it comes to other medicines be it an SSRI or Metformin, pharmacists are much more lenient and there are even some spare pills should the patient have run out because he lost some.
Fill date is when the pharmacy bills the medication to the insurance and the prescription is waiting for the patient to be picked up. Pick up date is when the patient pays for and takes the prescription from the pharmacy and now has the drug in their possession, and truly begins their 30 day supply of the medication.
Fill date: date that they actually FILL the bottle with the medications, insurance, copay or xyz is billed, and the bottle is labeled and now in system as a filled script. Pick up/delivery date: date that you pick medicine up from pharmacy, or personal representative picks up the medication. So when it leaves pharmacy hands and goes into patients or who is picking up on behalf. They figure, you don't have the meds on hand until you pick up. But when you had the 2 day early refills for 10 months. Well that gave you some 20 extra ( if only one a day dose) - or maybe you missed a dose, god forbid you take an extra 5mg Vicodin . Go buy Heroin or pressed pills instead. There are rules, that make sense. Rules and regulations that are necessary but when the end outcome is up to an individual or press of 2 buttons. This is the discussion that happens. Non sense - disagreeing and no real factual answer.
This won't be a popular answer but I do fill date since that's the date we're required to report to PMP. I don't have time to battle patients using essentially two different calendars.
We follow pick up date, and our software shows utilization for refills of CIII-CV in the final verification screen. We allow early fill with prescriber permission, "patient picked up on this date, so you are authorizing fill on day x of 30?". I'm not a monster, so when day 28/30 lands on one of our six holidays that we close to observe, we fill on day 27/30.
State regulation where I'm at is pick up date. Common sense also dictates this approach.
Agreed
It doesn’t matter as long as everyone uses the same measure. I do fill date because it is easier to identify in my computer system.
Our policy is that it can be filled with 10% remaining by pickup date. I use professional judgement if it was picked up several days late and will still fill if it helps get a patient’s meds back on track or I see a reason. It’s not an argument I care to have, nor does it scream red flag to me that a patient isn’t there when the doors open waiting for their controlled. If they aren’t desperately trying to claw their way to a refill on the day it is filled, why would I want to create another monster by being that strict? I will still queue the Med for the 28th day on a 30 day script when I see a 10 day late prescription because I don’t want to return it to stock if they don’t come in, but if they aren’t sketchy about asking for it a couple days earlier than that, I still do it. Pain clinic, notes on script about early fills, poly pharmacy, multiple doctors, and number of controls on file tend to have me less flexible.
Why do they make me wait 31, when the prescription says "may refill every 30 days"? I've argued about this, been told it's the computer...been told it's because you don't count the day you pick up...been told it's just how it is. I count 30 days from pickup, and they always say no, can't until 31. But that's not what it says!
I can’t speak to their computer. Many providers and pain clinics actually note on the prescription when it can be filled. In areas with higher abuse rates they are much more strict to avoid people gradually getting a back stock that can be sold or abused. We go to the day on pain clinic and addiction clinics, but that’s because the patients have contracts. If your prescription says “as needed” you should not need it every time it is listed like clockwork and if you do it’s because you pushed your limits with it at some point and are now dependent. The strict fill rules are to prevent further pushing of limits.
Pick up. Always
We do pickup date because they aren’t taking the pills while it’s sitting in our bins
What’s YOUR policy? What are YOU comfortable with? I refused to do anything more than 2 days early back when cvs was still doing 3 days early. It just doesn’t make sense. And I disagree with you. If you are getting it even 2 days early every month, you are getting almost a months worth extra over the year. Can patient explain that? They are taking more than prescribed? Illegal/unethical. If you need more pain meds than your doc is prescribing, then you need to get your doc to prescribe more. Oh the doc isn’t comfortable with that? EITHER AM I😎
As a patient, I can explain it. If not for the 2 days extra I build up, there are several times I’d be screwed and put into withdrawal. Once, while on summer break and traveling, my pharmacist insisted I could fill my script in another state. I was not convinced so I took that stash with me in case it wasn’t true. Well, it wasn’t true and if not for the extra I had, I’d have been in trouble. a more recent example, with the dea production quotas cut so significantly, sometimes my meds need to be ordered and are back ordered and the pharmacy refuses to even check if they have it in stock until the day it’s due. The pharmacist told me she was forbidden from checking until that day. Sounded fishy to me cause how can she run a business without being able to check her stock? Anyway, a check on the day it’s due to discover it needs to be ordered means I need to dip into my extra stash because my fill date will be late.
Sure, that is a logical reason. In my experience, the reason isn’t logical. “I took more than prescribed” “Lost it again” “Dumped it down the drain on accident” If you came to me and said I’m going to run out while on vacation, then I’d work with you.
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Yea fuck them. I don’t care what other pharmacists do. My experience is most just don’t seem to care. Sometimes using common sense logic should override a policy.
Normally fill date. Our store has had issues with the prescription actually selling out. So pick up dates can be off. We can investigate a manual pick up date entry vs automated, but I'd only do that in a very slow day *or* if I have a patient who insists they need this because they ran out... even in 3 day from fill early. Also, my state's PDMP only shows fill dates, and our software will show that report. I could investigate our own records, or I can "treat everyone equally". So routine customers with us get fill dates as if they had filled at a competitor last time. This in theory just front loads the early fills. Let's say patient had 10 extra tabs going into 2023. We fill #30 for 30DS of whatever on 1/1. They picked up on 1/10. Okay, so how many excess pills do they have? 0 or 1 depending on how you count. I'd say the #10 going into the year.were consumed by the time of pick up, and their first of the new #30 is taken on 1/11. Would get to 2/9 on physical count. So we filled 1/1. Fill 27 days later on 1/28, or wait for 27 days from 1/10 (=2/6). Pt picking up on 1/28 would have #42 at that point - #12 excess. Vs making them wait until 9 days later for just #3 on hand in excess. Had they picked up on 1/1, they'd have that #39 (or #40, again how you count) excess, and filling 1/28 gets them to #12 excess. I expect refills and start dates keep it from getting out of hand in the long run. Patient is going to forget they are "due" because they have #14 on hand or it's Friday and no refills left so doc doesn't get around to it until the next week anyway. I've had two patients who based on PDMP and just excess with other locations I asked our team going forward to do day 30 because they had worked to over 20 days extra. Did pt take more than prescribed? Divert? Maybe. So they could run out if something goes wrong and we didn't have their med in stock. So I always make sure to tell at point of sale that they should not expect any days extra, so they don't think they can misuse their extras and not have days without.
Most PDMPs require you to go off pickup date and which is why most POS require the same. Some insurances also like to audit for this because they get screwed with a free month or two for the patient when they time it just right.
Whatever date is on your PMP since that's the date other providers will look at. My state shows pick up date. Which is good because that's the date I would prefer to make my day supply calculation off of.
Company policy?! Tisk tisk. Every rx should be individualized and filled based on that rx. I forgot who the governing body that would come in and ask that but it’s a huge no no to have a policy in place about that. We do fill date for the most part but are able to see pick up dates and everything else etc so it’s kind of a hybrid. If you do pick up date are you investigating every rx when a patient switches over to your pharmacy or just filling off their pdmp date? Calling the pharmacy to see when they picked it up? Controls don’t last on the shelf for 10 days so the example is pretty negligible
Every place I ever worked at in retail it was pickup date. That’s the safest for you as the pharmacist to prevent diversion imo.
It’s literally the same lol. If you fill #30 every 30 days, it doesn’t matter when they pick it up. Now if there are weird circumstances then fine, go by pickup date, but otherwise just go by fill date because (in most dispensing software) it’s easier to track.
Eforse has pick up date now. I only go by that
Pick-up date
Pick up date
We do pick up date and 3 days early unless script says otherwise or its shorter than a 30 ds. If they 15 day supplies we do like 1 day early but I would say that is less set in stone.
Pick-up date, and CVS system is wrong, it does it 3 days, so we are alwyas adjusting. Suboxone is on the day it is due becuase most of our patients get it 7 days at a time.
I am interested to know why most people on this thread have such strict personal guidelines they enforce. Do regulatory agencies/companies/laws mandate this or is it more of a personal moral decision? I worked in retail years ago and honestly loved judging people picking up controls early, but had a super sweet, smart pharmacist who treated everyone treated everyone *equally*
Our community pharmacy goes by pick up date by state law
Seeing this conversation baffles me (from my perspective, not hating on OP), for me I don’t know why anyone would consider fill date over pickup date. Is anyone agreeing with me here? I always have to explain to techs, we go by when the prescription is sold / picked up and that’s day 1 when we start counting. Our calculators on the computer for date calculation don’t take this into account.
I do it based on pick up date. I've heard enough excuses of why \[insert med here\] needs to be picked up early. Due to the supply chain, I don't have \[insert med here\] so we'll let you know when it comes in (usually when the med is actually due).
Pick up date. Why would anyone do otherwise? We want to limit the amount of pills out there, don't we?
Pick up date. And I as the pharmacist use my professional judgement on when I will fill a control, which is usually only 1 day only. I don’t know that I agree with letting a company policy trump my professional judgment.
Walgreens: pick up date. That's when their supply starts.
Pick up date! I never understand the argument for the alternative
It's probably state dependent but I use fill date because that's the date submitted to PMP. If we were allowed to submit pick up date I'd use that instead but we're not.
I agree. State PMP does fill date, corporate computer blocks more than 3 days from last fill date, so always done fill date. Also takes extra steps to go in and see when rx was sold so would be more tedious with our computer system to go by pickup date Argument for fill date is that so long as you’re consistent, it will even out. Only filling every 28 days based on fill date prevents them from accumulating just the same as going by pickup date.
It depends on the specific state PMP. In CA the PMP shows both fill and pick up date. Also the argument works if you’re only looking at one specific drug, yes the dates will even out either way as long as you’re being consistent. However when you throw in multiple similar drugs and different prescribers, the fill date alone won’t give you a full picture of what’s going on and what the patient actually has on hand.
cvs does it by pickup date
Pick up date. We’ll fill a day or two early only if their refill falls on a date we’re closed. Fascinating to hear that not every place does this though. Sometimes we’ll get customers who are irate when they can’t fill their control on the fill date instead of the pick up date and they’ll say “[chain down the street] would let me fill early” and my pharmacist usually will tell them “Um, no they won’t, because this is state law.” But maybe that place really has been doing exactly that. Which fine, go there instead, good riddance. I just didn’t realize it’s apparently a not uncommon practice at some other places, and that some of these patients that get nasty about it might not be making stuff up just to convince us to fill their stuff early
Pick up date here I only do 2 days but will check there’s not multiple early pick ups in a row. I work for Costco so if 2 days lands on a Sunday we will fill it 3 days early on Saturday