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Thursday, September 19, 2013

One Month Supply

Doctors don't like math. It's okay, they're not really that great at it anyway. Their e-scribing software usually does the hard work, but for those who like the old ink-and-paper method, they still have to use their brains a little.
That's where we as pharmacists come in. Historically, it has pretty much always been our job to be the math gurus. We need to double-check the doctors' calculations; on dosing, quantities, and day supplies, etc. It is a surprisingly not-so-infrequent occurrence that the supply and directions do not match (take 1 tablet 2 times a day for 10 days--dispense 14 tablets). Do we call? Nope. We get to exercise Professional Judgement. By the powers vested in me by the State License under which I practice, I can make that change all on my own. Do we double-check antibiotic dosing for children? Yep. The maximum amount of acetaminophen per day? Sure do. Let's not even get in to the amount of calculations my brethren in the hospital world have to do.

Doctors frequently take the easy way out and write to dispense a "One Month Supply".
As Pharmacists, we always take that to mean 30 days. (For once a day dosing we'd dispense 30 tablets. For twice a day, 60 tablets, and so forth...)
But why do we always pick 30 days?
Is it because it works out to an even 360 tablets in a year?

As a Cynical Pharmacist, I obviously see things differently. The next time the doctor actually writes "month supply" or "1 month" or something similar, I am going to say "February". That's the month supply I am going to use. February. (Side question: How many months have 28 days?  All of them have 28 days, the rest all have 30 days, and 7 of them have 31...But I digress...)

What's really funny is, if we use the 28-day method, patients can fill prescriptions 13 times which equates to a 364 day supply. It is actually a better way to fill. However, as with all things new, two groups would not go for it:
1. Doctors. They'd never be able to figure out how to prescribe 1 month plus 12 refills.
2. Patients: They'd never be able to figure out how we gave them 13 months of medication in a 12 month period. AND they'd complain about the extra one copay per year and extra trips to the pharmacy.

Besides, what else is good about February? It should be the new standard month...

1 comment:

  1. You didn't mention how the insurance computers would completely fall apart with this perfectly reasonable logic. :)