Pharmacists Forced To Throw Out $30K In Auto-Refilled Prescriptions

What happens when your mail-order prescriptions keep on coming, automatically refilling month after month? If you pass away, your family might just find a cache worth $30,000 in unopened, expired meds, and give it to a local pharmacist to deal with, as happened recently in New York.

The part owner of a Cohoes pharmacy (who also happens to be the town’s mayor) is upset over the unused prescriptions that a local resident had stockpiled in his home. He’ll have to send the meds and supplies off to be incinerated.

“Look at this waste. It’s unbelievable,” he told the Times Union, adding that he’d never seen anything like it for 25 years as a pharmacist.

The deceased man’s family dropped off dozens of bottles of pills, insulin, boxes of diabetic test strips and other supplies to treat diabetes, hypertension, kidney disease and allergies.

The man had used mail-order pharmaceutical companies with automatic refill programs, and had such a low or nonexistent co-pay that he didn’t bother to stop the shipments. Since he was a public servant, that cost was being taken out of taxpayers’ dollars.

“The solution to this kind of problem is complicated, but it’s becoming more prevalent than we ever imagined,” said the pharmacist, mentioning another recent case of a woman passing away with thousands of dollars worth of drugs in her home. Those have to be destroyed by law.

The pharmacy ships the unused prescriptions at its own expense, to be incinerated in Texas, in an effort to be friendly to the environment. Usually they see a few bottles dropped off at a time. The pharmacist adds that it’s their mission to stop fraud, waste and abuse, which makes incidents like this recent one upsetting.

“This isn’t fraud,” he said. “But it is waste and it’s definitely abuse for taxpayers who paid for it.”

Issue behind $30G in unused drugs [Times Union]

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  1. Hoss says:

    “It’s a big problem with pharmacy operations that do automatic shipping. Once they’ve got your prescription, they just keep shipping and shipping on auto-refill and you can’t stop it. It’s like a robot gone wild.”

    BIG problem, and you can’t stop it — yah, right. Got any dog in this game Mr Pharmacist?

    • StarKillerX says:

      Well I think what he’s saying is that there currently isn’t any way to have then stop automatically when someone passes away and instead it requires either someone to let the mail order pharmacy know the patient passed away or wait for the script itself to expire.

      And he would be right.

      • Hoss says:

        Shutting off credit cards help, and forwarding mail to the executor — that helps too. They can’t be the big problem he says it is

        • StarKillerX says:

          True, but again both of those actions require that a family member of the deceased take action, which in this case didn’t appear to happen, which is what the pharmacist appears to be refering to, at least that’s the way I read it.

        • Firethorn says:

          In this case shutting the credit card wouldn’t have helped – apparently the deceased’s copay was effectively zero.

          I dislike it due to the waste, but who wants already issued meds?

          Personal: I once had to turn in 120 days worth of anti-malarial drugs. I was all scheduled to go to Djibouti, and got the meds the day before they changed what country I was going to – to a non-malaria infested country. I turned them back in, and yup, to be destroyed. A bit irked at the waste. Still, while I know I didn’t mess with/mistreat the pills, I know there are people who would, so why take the risk?

    • PHRoG says:

      Think you misunderstood the article. The mail ordered prescriptions were not filled by this pharmacy. The family brought them in to this pharmacy to be properly disposed of. So the pharmacist here is complaining about the waste from these mail order auto refill systems.

    • kc2idf says:

      “Got any dog in this game Mr Pharmacist?”

      Sure.

      His pharmacy must, at his pharmacy’s cost, pay for the destruction of these wasted supplies sent by a different pharmacy.

      His pharmacy, like any other, would rather have had the business themselves than had someone else have it. But they didn’t, so it doesn’t matter.

      Now, please go read the article.

      TLDR: Go read the article.

  2. Herbz says:

    Damn those ungrateful dead people. Don’t they know they should stop their prescriptions after they die?

    • StarKillerX says:

      While notifying the pharmacy after the death of a loved one wouldn’t be anyone’s first priority the pictures with the story leads me to believe these were dozens of deliveries over at least a few months which leads me to believe that the family didn’t care about it because it wasn’t costing them anything, despite the 10′s of thousands of dollars worth of items due to their inaction.

      I dealt with this when my father passed away, about a month after he died with got a large box containing his next batch of refills so I called the pharmacy right away and informed them that he was dead to avoid wasting any further resources.

    • YouDidWhatNow? says:

      Yeah. Definitely prefer grateful dead.

  3. Costner says:

    Perhaps auto-refill programs should be outlawed for this very reason. It isn’t like the company shipping these drugs or supplies is going to get a timely notice that the recipient has died, so even best case scenario there will be at least a month or two of shipments that aren’t needed.

    • Hoss says:

      People do pick up dead people’s mail — they close credit card accounts — and prescriptions, they expire, usually after a year.

    • crispyduck13 says:

      Outlawed? How about simply fixing the (apparent) problem of having prescriptions refilled automatically for years. I’ve never had a prescription written out for more than one year’s worth of a medication, and you need a valid prescription to use an autofill service.

      “”It’s a big problem with pharmacy operations that do automatic shipping. Once they’ve got your prescription, they just keep shipping and shipping on auto-refill and you can’t stop it.

      “It’s a big problem with pharmacy operations that do automatic shipping. Once they’ve got your prescription, they just keep shipping and shipping on auto-refill and you can’t stop it.

      Read more: http://www.timesunion.com/local/article/Issue-behind-30G-in-unused-drugs-3411017.php#ixzz1paW51afT“It’s a big problem with pharmacy operations that do automatic shipping. Once they’ve got your prescription, they just keep shipping and shipping on auto-refill and you can’t stop it.

      “Once they’ve got your prescription, they just keep shipping and shipping on auto-refill and you can’t stop it”

      The real question is was this servicer issuing drugs based on an outdated script? The shipments should stop when the script time table expires or the quantity is satisfied.

      • crispyduck13 says:

        Um, ok. Comments are getting a little squirrely today.

      • ORPat says:

        Ours automatically goes to the DR for a new perscription

      • Not Given says:

        They can only refill for a year. You can also put your prescriptions on auto renew and they fax the doctor to renew the prescription. If you’re dead, hopefully the doctor will turn them down.

        • Costner says:

          Well let’s say Mr. Smith gets a prescription on January 1st for some random med. He signs up for auto refills, and he dies on January 5th. His widow and/or his estate receives these automatical refills all year until either the insurance company notifies the company, the company figures it out on their own, the widow or the family alerts the company, or the prescription expires after a year… whichever comes first.

          I’m guessing if the family doesn’t know about the auto-refill program they aren’t about to call anyone to cancel, and we all know how efficient programs like Medicare can be… so chances are there will be anywhere from 2 to 11 unnecessary shipments sent to the address on file.

          Surely there has to be a better way. Is it too much to ask for someone to click “yes” in an email or push “1″ to respond to a robocall indicating that they SHOULD still get the refill on a monthly basis? I don’t think that is burdensome – but maybe I’m a heartless bastard. I guess I have no idea how much of a hassle it is to deal with montly prescriptions since I’ve never had any.

    • Cerne says:

      Yah that’s we need another law. And this would be a great one too. People paying more for drugs, missing medication doses and lots of other fun things.

  4. Cat says:

    Something similar happened to me with mail-order brides.
    They. just. keep. coming.
    Automatically, month after month.

  5. KenZ33 says:

    Of course, you can probably guessed which industry sponsored the law requiring that “unused” pharmaceuticals need to be destroyed.

    • wickedpixel says:

      would you want to take “used” medication?

    • Nigerian prince looking for business partner says:

      Regardless of the law, I’d imagine that pharmacy insurance underwriters wouldn’t be too keen on reselling returned medications.

    • GuyGuidoEyesSteveDave‚Ñ¢ says:

      Can you return alcohol in your state?

    • coffeeculture says:

      yeah, i mean…that insulin could have been sitting out at room temperature for a few months before being stuck back in the fridge. once it leaves a pharmacy, the pharmacist can’t verify its integrity or storage.

      Not so important for tablets, WAY important for stuff you inject into your body. The point of our dispensing laws are that the pharmacist doing the final check can account for the drug from manufacturer to distributor to his/her site.

  6. caradrake says:

    If the prescriptions are still in the company-shipped envelopes, and the contents inside are still sealed – why do they need to be destroyed? Wouldn’t they be able to be returned to the company and sold to someone else?

    Is the risk of tampering really that high that 30K worth of meds needs to get destroyed?

    • Cat says:

      One word for ya, from TFA:

      “expired”

      • voogru says:

        Bottled water has expiration dates on it too.

        • KungFuGrip says:

          Bottled Water has expiration dates because the cheap plastics used in the bottle break down over time and contaminate the water within.

          • StarKillerX says:

            Wrong!

            The truth is that bottled water has an expiration date due to NJ law requiring that all food products sold in the state display an expiration date of two years or less from the date of manufacture.

            Also PET bottles are porous and over time can pick up tastes and smells from their surroundings. These pores also allow gas out, which is why many companies put more carbonation in PET bottles in their product put into PET bottles then in glass ones or cans such that even with the continual “leakage” the product will stay adequately carbonated for a longer period of time.

            • KungFuGrip says:

              While the practice began with the NJ law, my statement is still valid. Plastics ages and makes bottled water toxic:

              http://www.ehow.com/about_5087733_bottled-water-expire.html

              Expiration Dates
              While the FDA does not require expiration dates to be printed on bottled water, some manufacturers voluntary mark their containers with a two-year expiration date. Most agree that this practice originated with a 1987 law required by the state of New Jersey to put an expiration date on all food products (including water); however, in 2004, New Jersey changed the law to simply mark the bottle with the date produced.

              Potential Contaminants
              In recent years, a host of studies have found high levels of toxicity in a variety of different plastics, especially recycle numbers 3, 6 and 7. While bottled water is usually manufactured as recycle number 1, which is generally considered less toxic, leeching can occur especially as plastic ages. A 2008 study conducted by the Environmental Working Group found more than 38 chemical pollutants in the 10 most popular bottled water brands, raising questions about both the water’s origins and the plastic it’s housed in over time.

      • Firethorn says:

        Yeah, that’s a good one for not using it. Though it makes me wonder – most medications don’t expire for at least a year, and they found lots and lots of it, yet the man ‘died recently’. I wonder if part of the problem was that he wasn’t taking his meds and/or stopping the prescriptions if there was a reason he wasn’t taking them?

        • GOInsanity says:

          “The man had used mail-order pharmaceutical companies with automatic refill programs, and had such a low or nonexistent co-pay that he didn’t bother to stop the shipments.”

          The man stopped taking the meds while he was alive and just kept piling them up. I guess after he died, the family cleaned the place out and hit the mother load.

        • GuyGuidoEyesSteveDave‚Ñ¢ says:

          I have been known to skip doses, and after a few months, I will at least have a one month buffer because of that. Many meds will tell you to skip the dose and take your next scheduled one.

    • voogru says:

      That reduces profit margins for the drug companies.

      We can’t have that.

    • Nigerian prince looking for business partner says:

      I’m guessing it has to do with an unknown handling conditions. A package could still be sealed but it may have sat in the back of a parked car for a week, just baking away in the sun.

    • StarKillerX says:

      Yes the risks are that high, and it’s not just tampering but also you have no clue how they were stored (not an issue with some drugs but it is with many more then you would expect.)

      Also if the risk were lower I can’t imagine a pharmacist being willing accept the liability, especially when the insurance has already paid for the medicine.

      Along those lines, what I find interesting that it appears that the insurance continued to pay, for several months after the death of their client, also I have to wonder why they had so much flonase, since from what I can find online about dosage it appears that each bottle is a 30 day supply.

    • Bunnies Attack! says:

      Its tampering but its also storage. Did they get wet? Water can leak through the seams of a plastic container without breaking the seal if the container isn’t waterproof. Was it left out in the sun? The cold? Its hard to tell from looking at it and many medications can be damaged from extreme heat/cold so its safer just to dispose of it.

  7. Paul in SF says:

    Around here you can donate unopened prescriptions to free clinics and such.

    • LMA says:

      When I’ve taken an expensive medicine that I get too much of or have to discontinue because of side effects, I cut my name off the label and give it to my prescribing doctor so he can pass it along to any lower-income/uninsured patients he might have.

  8. Wawa says:

    Aside from the obvious pharmacy derp, what about the root cause….

    By that, I mean his health insurance paying for all these meds. Shouldn’t his coverage ended upon his death?

    • cheri0627 says:

      We found stuff like this after my FiL passed away. It wasn’t necessarily prescriptions that were filled after he died automatically, but him getting prescriptions filled every month for things he wasn’t using all that much of or wasn’t using anymore. He just kept getting them filled “just in case” or those diabetic testing supplies he got from some automatic mail order place. He got about 3x the amount he needed in the first few months, and then adjusted his supply after that, but still had tons of extra from the beginning. We had bags full of unopened testing supplies and even two unopened meters, in case one died or something.

    • catastrophegirl chooses not to fly says:

      i was wondering the same thing about the insurance ending.
      although i do have what i call my “8 thousand dollar closet” – diabetic supplies aren’t cheap and due to past issues with my pharmacy delaying shipments, my doctor overprescribes. if i ever lose my insurance i’d be good for about 6 months in backstock. of course i use the FIFO method to ensure nothing expires. the stuff in the back of the closet is good through the end of 2013.
      http://www.flickr.com/photos/catastrophegirl/4159545564/

  9. Cat says:

    Can someone explain why all my prescriptions have a date after which I must get a new scrip, or is this just something my doctor does to keep me coming back every year?

    Just seems odd to me for a doctor to write a prescription with perpetual refills.

    • StarKillerX says:

      I don’t know the specifics but the number of refills and/or how often you need to renew the script varies by the class of drugs involved and I believe some allow up to enough refills for a one year supply.

      And if this is the case I think insulin and Flonase, two of the drugs mentioned, would likely fall into that catagory as they aren’t really what someone migh use for recreational purposes.

      • catastrophegirl chooses not to fly says:

        actually some types of insulin can be obtained over the counter, no scrip needed.

  10. mysty says:

    Every prescription I have received expired after a year or all refills are completed, whichever is first. I don’t understand how these could keep being shipped year after year. Am I missing something?

    • GuyGuidoEyesSteveDave‚Ñ¢ says:

      If you tend to skip doses, you may have a month or two left over at the end of the year. When you see your doctor, you get another year’s worth(because who likes to admit to their doctor that they skip doses?), and the problem compounds over years. I know I have about a years worth of Wellbutrin floating around my house, because I sometimes skip a dose or two, but my Dr. prescribes when I see her regularly, and I don’t admit I sometimes forget to take them.

  11. IphtashuFitz says:

    Simple fix: Require the customer to re-apply every year. It can be as simple as sending out a letter with a prepaid postcard to send back. Don’t get the postcard back in the mail in a reasonable amount of time then make two or three attempts to contact the customer by phone. Don’t have any luck there then cancel the auto-renewal.

    • joako says:

      But they make money billing the insurance. So as long as they follow the minimum standards set by the insurance carrier and the law, why would they spend money to make less money?

  12. lovemypets00 - You'll need to forgive me, my social filter has cracked. says:

    “In the patient’s mind, the pile of drugs and medical supplies that piled up were thought to be “free.””

    That’s because all the commercials on TV have convinced people if they need a scooter chair, diabetic supplies, catheters, cell phones, or any number of things, they can just call a number, and if they qualify, it’s “Free”. No, it’s not! Someone pays for these things. Just because you can receive something at “no cost to you”, it doesn’t mean you should just keep getting it ’cause you can. Someone, somewhere is paying for it.

    I blame the dead guy for having this mentality. And didn’t his family notice this giant stockpile of stuff sitting on a counter somewhere in his house when they visited him? If they visited him?

    • theduckay says:

      “Just because you can receive something at “no cost to you”, it doesn’t mean you should just keep getting it ’cause you can.”

      Why not? Its not my problem if they’re offering their product at no cost to me and someone else is paying for it, or however they’re subsidizing the costs. If they say you qualify for whatever it is and can get it for free, then that’s awesome. Why would I pay for something I could get for free?

      • JuzMe says:

        Hmm, another “We, the entitled,….”

      • lovemypets00 - You'll need to forgive me, my social filter has cracked. says:

        It’s one thing to be truly needy, and qualify for assistance with medical supplies, and then actually use said supplies. It’s quite another thing to qualify for assistance with medical supplies, get them, and not use them and let them pile up in your house until they’re expired.

        I hope you can see the difference.

  13. evilpete says:

    The truly sad part is a majority of those drugs were still good, the one year expiration is a act of congress and has nothing to do with the real expiration of the drugs which can be several years or decades.

    • GuyGuidoEyesSteveDave‚Ñ¢ says:

      They might have been “within code”, but if you store a frozen dinner on your counter for 3-4 days, is it still as good as one in the freezer, both made on the same day?

  14. evilluckycharms says:

    Why can’t they donate them??? I hear stuff about donating expired scrips to third world clinics all the time. I would much rather them go to free clinics here in the US, but if the gov’t hands are too busy in the pockets of big pharma, the least we could do is get them to developing nations so they’re not completely wasted!

    • GuyGuidoEyesSteveDave‚Ñ¢ says:

      “America is sending you medicines they would not even give their citizens. This is how they think of you, less than human, less than they.”

      Yeah, no way this could be spun in a bad way. Donating something that is not being used is way different than giving possibly life saving medications to another country without even knowing how it was stored.

    • mbz32190 says:

      Just like why most stores won’t donate food that is “out of date” or stuff that was “already cooked”….liability and lawsuits. Seems like its easier to throw stuff out than to get waivers and things signed saying it is okay to donate (if those kinds of things even hold up in a court, I don’t know). You should have seen the waste I encountered when I worked at a “upscale” grocery store I’ll refer to as W-mans.

  15. maxamus2 says:

    Imagine all those records and CDs he has from Columbia House as well!

  16. MickeyMoo says:

    Step 1: Outlaw those sketchy late night “talking glucose meter” “new improved catheter” and whatever it is that Wilford Brimley is shilling. “Your Scooter Store” while we’re at it

    Step 2: Single payer.

  17. eezy-peezy says:

    the mail order pharmacy we use requires you to sign and return a piece of paper for each shipment, saying that you got it, and requesting the next shipment. With a warning that if you DON’T send it back, you may be charged.
    I suspect Medicare requires verification. Something is not right with this story, unless he was getting the supplies and not using them, before he died.

  18. Debbie says:

    My local CVS keeps refilling prescriptions after you tell them to stop. Then they call and hope you’ll come in and pay for it.

  19. libwitch says:

    I love how all the fault in the article is being heaped on the deceased guy. Pharms and supply companies love to sign you up for these helpful auto refill programs and then make it hell for you to get off of them. And why should they make it easy? They will just keep billing your insurance company,who will pay them regardless if you have used the stuff or not.

    I have two that I have been fighting with for two years to try to stop auto refills with, and neither one can prove I ever approved a program -except for the fact that I started using them to begin with.

  20. Jedana says:

    Mr Jedana is on home hemodialysis, and every month we have to order his dialysis supplies (gloves, needles, dialysate, etc). we go through a good amount of supplies, usually 4-8 10cc syringes a day for example, and 3 boxes of dialysate. He does a treatment 6 days a week.

    Every month, I tell the people sending us the dialysate to NOT SEND ANY THIS MONTH because I have over 150 boxes of it in my garage. And every other week, I get a delivery of at least 15 boxes (but usually between 30-45 boxes).

    It’s ridiculous. At least I finally got the other company (that does the needles/gloves/etc) to stop just sending us the entire allowable order and to let me pick and choose what is needed. I swear I have enough 2×2 gauze pads to cover 3 or 4 mummies.

  21. psikic says:

    Local veterinary clinics in my area accept unopened expired prescriptions of many supplies, including antibiotics. It turns out that much of what is prescribed to animals is the same as the human drug, and the expired drugs can be used by local humane societies and shelters to treat their animals.

  22. pika2000 says:

    Ironically, most pharmacy managements people want people to sign up for auto-fill. Why?
    1. There’s usually a fine-print that if you sign-up for auto-fill, it’s slipped in some agreement in related to marketing, eg. spam.
    2. Retail pharmacies use auto-fill so they can cut the hours of their local stores. Yeah, they want to REDUCE jobs.