According to the 2018 Generic Drug Access & Savings report, roughly eight percent of prescriptions for generic drugs, and 21 percent of prescriptions for brand-name drugs are abandoned at the pharmacy.  That is to say, prescriptions are received by the pharmacy, filled, but never picked up.

Research sponsored by CVSHealth delved into reasons why patients abandon prescriptions, and found a direct link both to higher co-pays, and whether a prescription was received electronically or was handwritten and brought to the pharmacy by the patient.  Specifically, the research found patients with co-pays of $50 were nearly four times more likely to abandon a prescription at the pharmacy than patients with $10 out-of-pocket costs.

And with regard to electronic versus handwritten scripts, the research found e-prescriptions were 65 percent more likely to be abandoned.  Researchers speculated that since patients must proactively bring a handwritten prescription to the pharmacy, they are more invested in receiving their medication, whereas electronic prescriptions require no action on the patient’s behalf.

Whatever the reason, prescription abandonment is a serious issue, and a contributing factor to the national crisis of medication non-adherence.

But for pharmacies, abandoned prescriptions pose an added threat to inventory management, and the ability to accurately forecast demand for certain medications.  This is because when a prescription is filled, the amount of medicine dispensed is deducted from the store’s inventory.  The pharmacy system will thus indicate a reduced level of inventory, and may trigger an automatic reorder, if the level reaches a pre-determined  point.  In fact though, an alarming number of prescriptions may be sitting in the will call bin, in a sort of “inventory limbo” -- no longer reflected in the store’s inventory, and unlikely to be picked up by the patient.

Technology can play an important role in helping pharmacies manage inventory-related fallout from abandoned prescriptions.  New system capabilities have come to market in recent years that identify prescriptions left in the will-call box, and seamlessly manage the reversal of the disbursement process.  Not every technology system is equipped with this capability, so a manager must shop around to find an adequate solution.  Key features to look for include:

• Avoiding abandonment – patient outreach.  The best way to manage prescription abandonment is to encourage patients to pick up their medications.  Research has shown that texts, emails and phone calls can have a significant impact in improving pickups.  Research by Walgreens, for example, found patients who received reminder calls had a 23 percent greater adherence rate, while JAMA Internal Medicine reported that mobile text messaging approximately doubles the odds of medication adherence. Pharmacists can use their technology system to schedule refill and pickup reminders, including alerts that a prescription is about to be cancelled.  This is a relatively easy tool for a pharmacist to implement, but can have a noticeable impact in reducing rates of abandonment.
• Claim Reversal.  Once a prescription is identified as abandoned, the claim submitted to the third-party payer must be reversed.  Many technology systems enable this capability, and can avoid staff members from having to manually initiate the reversal process.
• Patient History Updates.  An efficient technology system will seamlessly update a patient’s records, to indicate that prescribed medications were never filled.
• Inventory Sync.  Medications that have not left the pharmacy’s closed distribution system, ( i.e. have not left the pharmacy’s will-call bin, or been opened or used in any part) are eligible to be returned to inventory and resold.  While pharmacy staff must be sure to follow state and federal laws with regard to drug storage, inventory records must also be updated to reflect real-time medication levels.
• Automatic Ordering Adjustment.  Since most automatic ordering systems are directly linked to store inventory levels, it essential that a technology system continually sync the two processes, so orders are submitted based on accurate, real-time inventory levels.
  

Pharmacists understand that abandoned prescriptions pose a serious risk to medication adherence and patient health.  By relying on their technology system to manage the “business aspects” of prescription abandonment, pharmacists have more time to focus on helping patients understand the importance of filling their prescriptions, and following their medication protocols.