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Here’s that Rx refill you didn’t order

By Laura Etherton
Health Care Policy Analyst

Is your pharmacy refilling your prescription without your knowledge or approval, and billing your insurance company for the cost?

If so, it’s the latest example of waste we shouldn't tolerate in our health care system.

As David Lazarus of the Los Angeles Times has reported, The U.S. Justice Department, the Department of Health and Human Services, and state pharmacy regulators in California and New Jersey are investigating whether actions by CVS Caremark amount to fraud.

Now, it appears this practice may be more widespread. In Lazarus’ latest Los Angeles Times column on the issue, he reports that patients are complaining the same practice is taking place at Target, Rite Aid and Walgreens pharmacies.

We all know health care costs more than it should. The high cost of prescription drugs drive many consumers to shop around to find the best deal, leading to fierce competition between pharmacies. 

Given that, from the pharmacy’s perspective, enrolling consumers in automatic-refill programs is a smart way to build repeat business. And to be fair, these programs can be good for consumers too, especially for patients on critical maintenance drugs who are apt to miss doses between refills. Helping patients adhere to prescribed medication can help keep them healthy and out of the hospital.

But the win-win falls apart if pharmacies are enrolling customers in these automatic-refill programs without their approval. Doing so could needlessly drive up claims costs for Medicare and private insurance, and could end up driving up premiums and out-of-pocket costs.

If your pharmacy has refilled your prescription without your approval, you can contact your state’s Board of Pharmacy to file a complaint. You can find a list of Boards of Pharmacy and their contact information at the website of the National Association of Boards of Pharmacy.

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