![]() ![]() And at the time of the “third fill,” he’ll have 73 excess pills from the two prescriptions previously dispensed! Note that at the time of the “second fill,” your employee will have 36 unused pills on hand from the previous prescription (90-54). ![]() Or looking at a calendar: When your employee obtains his first prescription with two refills available, rather than receiving his “fills” on January 1 st, April 1 st and a few days before July 1 st, he’d receive them on January 1 st, February 23 rd and April 18 th. That would mean that your PBM would dispense “fills” every 54 days (90 x 60%). Or looking at a calendar: If your employee obtained his “first fill” on January 1 st, given that certain months have slightly fewer or more than 30 days, your employee would need to receive his next “fill” on April 1 st, his next “fills” a few days before July 1 st and October 1 st, and again on December 25 th.īut suppose your PBM’s standard practice is to dispense each “fill” after 60% of the previous “fill” has likely been used. #DISCOVERY PRO PBM CONTACT NUMBER PLUS#If your employee is purchasing a 90 day supply of a maintenance medication from a mail order pharmacy, to obtain a year’s supply your employee needs to receive 4 prescriptions a year, plus 5 days from a fifth prescription (90 x 4 = 360 + 5 = 365). #DISCOVERY PRO PBM CONTACT NUMBER HOW TO#Here’s how to fully understand the “dispensing date creep” problem: As a result of this “dispensing date creep,” many plan beneficiaries receive far more drugs than they actually need. Then, ignoring the excessive number of pills that the beneficiaries already have in hand, the PBMs dispense the “third fill” too early as well. Moreover, many PBMs dispense a “second fill” to plan beneficiaries long before the beneficiaries have run out of pills from the initially dispensed prescription. ![]() As a result, many of your plan beneficiaries are probably getting refills when they don’t want or need them. Many PBM pharmacies automatically refill prescriptions without the beneficiary asking for the refill. “I can’t fathom what I’m supposed to do with all these pills!” “Pills – pills – and more pills,” they’ll likely exclaim. Thus, if your health plan is trying to contain its costs, you need to investigate your PBMs’ refill practices and end all excessive dispensing by your PBM’s refill pill mill.Īsk any of your employees, and you’ll probably learn many are swimming in unused pills that need never have been dispensed. Unbeknownst to health plans, many PBMs are dispensing through their subsidiary pharmacies far more pills than needed, at great cost to the health plans. ![]()
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