May 15, 2011 
I signed up for an auto-refill program recently. It quickly made me realize how stockpiling happens. (Stockpiling is where a patient ends up with a large supply of their medication over time…typically due to refilling too soon.)
Imagine the following:
- I get a 90-day supply of a medication.
- At day 75, I get a refill of the medication. (I have 105 days left at this point.)
- 75 days later, I get my next refill. (I now have 120 days left at this point.)
- 75 days later, I get my next refill. (I now have 135 days left at this point.)
The problem here is what I would call “static refill logic”. The auto-refill program is triggered to fill the drug 75 days after it was last filled.
What is needed is “dynamic refill logic” which calculated days supply on hand. This isn’t easy, but it makes a lot of sense. The risk (if I’m a mail pharmacy) is that without this, I get gaps-in-care and/or create a short-term retention issue.
Imagine the following:
- You ask me to refill, but I have 30 days on hand so I say no.
- Now I forget to refill on time and I have a choice – (a) skip my medication for a few days or (b) go back to retail. Neither is ideal for the mail pharmacy.
BUT, all of this could have been fixed if the logic was dynamic and they called to confirm my refill when I had just a few weeks left (i.e., enough to be thinking about refilling but also enough to have time to get it shipped to me).
Enabling Healthy Decisions 
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