![]() Although further consideration regarding approaches to reduce oversupply is needed, it is not likely that placing barriers on the involvement of pharmacists in the prescription refill process will reduce the problem of medication oversupply.Īs with all research, our study has several limitations. ![]() However, our findings support a hypothesis that automatic refill programs help to reduce, not exacerbate, the problem of prescription drug oversupply. We found high rates of oversupply in both cohorts-18% in the 30-day supply refill cohort and 19% in the control cohort-while among those receiving a 90-day supply, the proportions were 26.6% for the refill cohort and 27.8% for the control cohort. 6,12 Our findings support this hypothesis. These authors suggested that putting the pharmacist in control of the refill process would reduce the tendency of the patient to stockpile medication, thus reducing oversupply. Interestingly, this was an outcome expected by commentators in Europe who conducted reviews and studies of similar refill programs. 11 We found that members enrolled in this automatic refill program were less likely to receive more than a year’s supply of medication and had less oversupply than did members of the matched control group. 10 Some policy makers have expressed concern regarding the impact of medication wastage on limited healthcare budgets. In the United States, there is particular concern with oversupply contributing to increased regimen complexity, opiate abuse, antibiotic resistance, and environmental toxicity. Improved medication adherence was obtained without an increase in medication oversupply. In our evaluation of the CVS automated refill program for retail patients, we found that the members enrolled in the refill program had significantly improved medication adherence compared with a matched cohort of members not enrolled in the program across 11 therapeutic classes prescribed for the management of chronic disease. All differences were directionally similar and statistically significant, except for 90-day fill patients on calcium-channel blockers or SNRIs.Īutomatic medication refill programs provide a simple solution to address a component of the medication nonadherence problem by making medication refills more convenient for patients. Across all therapeutic classes, the refill cohort filled later than the control cohort, resulting in less oversupply. In the 90-day analysis, the oversupplied automatic refill cohort patients filled 7.19 days early, while the control group patients filled 9.38 days early ( P <.001) ( Table 3). In the 30-day user analysis, oversupplied patients in the refill cohort refilled 3.32 days early, while the control group patients filled 5.82 days early ( P <.001). In the 90-day analyses, we found a similar relationship, with 26.6% of the refill cohort receiving more than 365 days of supply compared with 27.8% of the control cohort ( P <.001). In the 30-day analyses, 17.9% of the refill cohort patients received more than a 365-day supply compared with 18.6% of the control cohort patients ( P <.001). Results: Overall, patients receiving 30-day supplies of medication in the automatic refill program had an MPR that was 3 points higher than those not in the refill program among those receiving 90-day fills and in the refill program, the MPR was 1.4 points higher ( P 100%). ![]() The results are reported across 11 therapeutic classes. Measures included medication possession ratio (MPR) and average days excess at the time of refill. The intervention was the automatic prescription refill program. Participants included patients on medication for chronic conditions those receiving a 30-day supply (n = 153,964) and a 90-day supply (n = 100,394) were analyzed separately. Methods: The setting of the study was a pharmacy benefit manager administering benefits for patients of retail pharmacies. Study Design: Retrospective propensity score matched cohort study with multivariable generalized linear modeling. We evaluated the impact of an automatic refill program on patterns of medication use. A concern is the potential for prescription drug wastage and unnecessary healthcare spending. Objectives: Automatic prescription refill programs are a popular means of improving medication adherence.
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