# Pharmacist only gives 28 days worth of tablets



## Krew Bot (27 May 2008)

Every six months I go to my doctor to get a prescription renewed and she writes me a prescription for six months worth of tablets. When I go to the pharmacist to have the prescription made up I am only given 28 days worth of tablets, which does not equal to a months supply. The shortest month this year had 29 days.

After 12 visits to the pharmacy I will only have enough tablets to see me through 11 months of the year. Ultimately this means I will have to buy 13 'monthly' prescriptions each year.

Is there anything that can be done about this?


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## selfbuildkk (27 May 2008)

try a different pharmacist?


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## eileen alana (28 May 2008)

I think the OP is complaining because she is being charged the drug fee every month when she has to go to the pharmacy. Why can't he/she be given the whole six months drug supply at once and it would save a fortune in charges. I often thought about that myself.


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## Brianne (28 May 2008)

Sometimes it depends on the tablets, eg some antidepressants or sedatives, maybe they have a policy about not giving out several months supply. 
However if the tablets are neither of the above, I think you should ask for the six months supply where possible. The only thing is that some tablets are packaged as 28 packs which never made sense to me but if the doctor has written down clearly a months or six months supply , you should ask the pharmacist why you are being left short by the one, two or three days. 
A lot of the time , it means breaking open a new pack for the pharmacist and maybe thats not feasible.


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## sam h (28 May 2008)

It's a really good question which does affect those who do not have a medical card . I used to get scripts filled for an elderly relative & noticed they only gave the 28 days but as they had a medical card & had to go for regular checkup, it didn't really matter.  But anyone who is paying the doctor for visit and their monthly prescription fee will get caught out by the extra month.  I've never had any script for more than about a month, so not really a problem, but I can definitely see where you are coming from.



> The shortest month this year had 29 days.


Actually it's 28.2422 days....but who's counting


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## extopia (28 May 2008)

Why not go to the pharmacist every 28 days, rather than once a month?


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## sparkeee (28 May 2008)

its to do with profits,90 euro every month to the pharmacist rather than 90 euro every six months.


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## comanche (28 May 2008)

Krew Bot said:


> Every six months I go to my doctor to get a prescription renewed and she writes me a prescription for six months worth of tablets. When I go to the pharmacist to have the prescription made up I am only given 28 days worth of tablets, which does not equal to a months supply. The shortest month this year had 29 days.
> 
> After 12 visits to the pharmacy I will only have enough tablets to see me through 11 months of the year. Ultimately this means I will have to buy 13 'monthly' prescriptions each year.
> 
> Is there anything that can be done about this?



ask the pharmacist!


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## rob30 (28 May 2008)

There is a very logical reason for giving 28 tablets.
If a patient gets a prescription for 30 tablets on a thursday, they will run out on a Sunday, and have a problem getting a new supply.
With a 4 week prescription cycle, that will not happen. 
It also reduces the amount of "extra XXXXXXXXXXXXXXXXXXXX" nursing and care homes have lying around, and the potential for error. It also lets them semiautomate reordering ( eg. ward 1 on the week 1, ward 2 week 2, on a tuesday. 
Also, the NHS has pushed for a 28 day cycle, meaning that pill manufacturers are putting 28, not 30, tablets in a blister packet.
I cannot envisage the manufacturers supplying special packs for the small irish market.


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## Mel (28 May 2008)

I have a prescription for a chronic condition and fill it in one of 2 pharmacies, depending on which is more convenient. There are 28 XXXXXXXXXXXXXXXXXXXX in the standard pack, but both pharmacies always add extra XXXXXXXXXXXXXXXXXXXX cut from another blister pack. 
They give out 1 month's worth unless I ask for the entire prescription to be filled and there is never a problem getting 6 months together. It's much more convenient than remembering to go to the pharmacy every couple of weeks. 
I seem to remember that there is a dispensing fee to be paid each time you fill a prescription also, I think that's reduced by collecting all together, but I'm open to correction on that.


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## BOXtheFOX (28 May 2008)

I found that a relative of mine was having her tablets rationed by her husband as she approached her three monthly visit to her doctor in order to make them last. He didn't want to disturb the doctor or himself by doing something about it. Unfortunately just before she died her three monthly visit coincided with Christmas and her visit was put back by an extra few days until after Christmas. She died on Christmas day.  I often wonder to this day had the rationing of tablets something to do with her death.


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## eileen alana (28 May 2008)

How awfully sad, It is a fact that some people are struggling to pay the monthly charge on perscribed medications and the limit for the drug payment scheme is going up all the time.

Mel - Are you sure you can pick up 6 months supply at once?


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## MrMan (28 May 2008)

> Mel - Are you sure you can pick up 6 months supply at once?



i have done this and it was the pharmacist that made me aware that I could do it, but I presume it depends on the drug in question. Regarding the months supply I get 28 +cut offs from another pack to make up the difference.


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## eileen alana (28 May 2008)

Thanks for that, its interesting to know.


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## ubiquitous (28 May 2008)

This practice is a major problem for patients on long-term medication for ongoing conditions. For some patients, for example those with psychiatric conditions, can have serious (and sometimes horrific) consequences, as it serves a temptation for the patient to do without their medication for a few days.


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## giardiniera (28 May 2008)

i had the same problem and the tablets were 76 euro so i was only allowed buy one packet a month (drugs refund rules). Since i got the first packet at the start of the month they would move say i bought the second packet in the next month. No one ever thought to give me a few extra tablets to prevent it happening.


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## Mel (28 May 2008)

eileen alana said:


> How awfully sad, It is a fact that some people are struggling to pay the monthly charge on perscribed medications and the limit for the drug payment scheme is going up all the time.
> 
> Mel - Are you sure you can pick up 6 months supply at once?


 
I'm positive because I do it when I remember to ask - but you have to ask when handing in the script. 
My script wouldn't have a risk of overdose associated with it, someone mentioned that above, so there might be rules around some drugs. 
My prescription is also relatively cheap and even 6 months supply barely takes me near one month's DPS limit so it doesn't affect that.


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## rmelly (28 May 2008)

rob30 said:


> There is a very logical reason for giving 28 tablets.
> If a patient gets a prescription for 30 tablets on a thursday, they will run out on a Sunday, and have a problem getting a new supply.


 
Sounds like you work in a related position, and that all makes sense but the above isn't foolproof as it doesn't take account of bank holidays?


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## purpeller (28 May 2008)

As I understand the Drug Payment Scheme, on a repeat prescription, you can only get one fill of it per month as part of the €90.  EG, I know in the past, if I wanted to buy a second month's worth of something, I had to pay for it and it was not included in the €90.  Also, it was medication that was required for every single day and I was always given a full pack and then a couple of loose ones to make up the 30 days.  Usually bought in Boots or McCabes.  I have no affiliations with these businesses.


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## Graham_07 (28 May 2008)

sparkeee said:


> its to do with profits,90 euro every month to the pharmacist rather than 90 euro every six months.


 
Not so. The pharmacist is paid the full price for the drugs by the HSE under the Drugs Payment Scheme less whatever contribution the customer makes, regardless of whether this is one months worth or more.


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## gnubbit (28 May 2008)

First check what your Dr has written on the prescription.  Sometimes the prescription has 28/30 tablets written on it (based on the pack size).  In this case, the pharmacist must give the specified quantity.  If the Dr puts  1/12 or a month, then the pharmacist can give an original pack containing 28 or 30 tablets.  Or they may give sufficient tablets to cover the month which may involve cutting into a new blister pack.  This practice is unheard of in most other countries and is not considered good practice but Irish patients expect it. 

Generally the pharmacist will try to give the same quantity of all monthly medications, e.g. if one comes in a pack of 30, then any in a 28 pack will have 2 added.

On the Drug Refund scheme, you pay for the number of tablets you get.  You can save money by getting all 6 months in one go as you pay only one dispensing fee.  It's probably not a good idea unless you are well-established on the medicine as if it doesn't suit you, then you've wasted money on medicine you can't use (and no, you shouldn't sell it on to friend )

On the Drug Payment Scheme, the cost of the drug is subsidised by the government so the patient only pays €90 max.  (I'm deliberately not mentioning the current dispute as it's off-topic).  This allows for a month, again, it depends how it's worded on the prescription but in practice, the pharmacist will make up any shortfall - the patient will not have to pay extra.  

If anyone is unhappy with their current arrangement, a quick chat with the pharmacist should sort it out.


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## comanche (28 May 2008)

ubiquitous said:


> This practice is a major problem for patients on long-term medication for ongoing conditions. For some patients, for example those with psychiatric conditions, can have serious (and sometimes horrific) consequences, as it serves a temptation for the patient to do without their medication for a few days.



On the flip side it helps to prevent interactions between drugs. Take the common scenario where people are on many different medicines and one of the prescriptions is changed by the doctor, the pharmacists has more of a chance of picking up possible interactions earlier if the patient is in for their drugs every 28 days instead of every 6 months. 

Remember that doctors know very little about drugs, only what they see in their books or what the drugs rep tells them! Its the pharmacists that are the experts.

Am sure that a pharmacist would love to dispense all the drugs for 6 months in one go as its less overhead for them (paperwork etc), but am sure that they are following best practise by dispensing long running prescriptions monthly.

So if in doubt ask the pharmacist!


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## Conor_28 (28 May 2008)

I’m an pharmacist so here goes:

To the original poster (Krewbot),
It depends on the drug you’re getting. Let’s say, for example, it’s a contraceptive pill or HRT. This is always taken in 28-day cycles, so the pharmacist couldn’t actually give you 30 or 31 tablets even if you asked for it.
For most other types of drugs, pharmacists would usually give 30-day supplies to avoid the 28-30 day issue. Most likely is you’re going in, he’s looking at his computer screen and just giving you what you always got in the past, so just ask him/her next time for an extra two tablets and it shouldn’t be a problem.

There is generally no problem with getting more than one month's supply at a time. If the medicine is inexpensive this is maybe the easiest way to do it (unless you then lose all your medicine, which happens). Please note that for some types of drugs, e.g. sedatives, painkillers, the pharmacist will not give more than one month supply.


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## bigdee77 (28 May 2008)

You should get at least 30 tablets when prescribed a months supply


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## Conor_28 (28 May 2008)

ubiquitous said:


> This practice is a major problem for patients on long-term medication for ongoing conditions. For some patients, for example those with psychiatric conditions, can have serious (and sometimes horrific) consequences, as it serves a temptation for the patient to do without their medication for a few days.


 
Just in response to this as well, most psychiatric clinics write prescriptions for weekly/two-week/four-week lots, because they are held on the same day every week. So, if a patient got 30 days of tablets but was going to the clinic every 28 days, then he would be building up supplies of potentially harmful meds. (And there is no difference in profitability for the pharmacist)


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## eileen alana (28 May 2008)

Conor 28 - Thank you for clarifying the issues raised and welcome to AAM.


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## mathepac (28 May 2008)

Interesting thread.

I am being treated for a primary illness and secondary related conditions with 4 daily tablets. 1 of these drugs is packaged in 14 day blister-packs, another is in 28 day blister packs and yet another is packaged in 7 day blister packs. Each of these drugs has the day named on each blister, which is very handy as an aide memoire.

However, the main drug I take is packaged in a 30-day blister pack and the pharmacist cuts two tablets from the package when dispensing this drug
 for me.

Last month, when I got my prescription home, I discovered that I had been given a collection of "cut-offs" from 30-day blister packs of this latter drug, which made it a bit of a nightmare each morning tracking whether I had taken the tablet or not, although I am someone who would regard himself as being reasonably organised and  "compos mentis".

My doctor renews my prescription every five months and writes up my prescriptions for monthly dispensing, but the pharmacist and drug companies seem fixated on 28 day cycles.

Unlike OP, the costs of my drugs are covered on my long-term illness card, but we still seem to have primary health-care givers, GP's, working at odds with product dispensers and their suppliers.


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## lukegriffen (28 May 2008)

You have to pay (up to) €90 for each month's prescription, based on usage, not purchase patterns.   If you get 2 months worth of medicine in 1 go, then you should pay 2 lots, so up to €180.
If the chemist isn't charging you twice, then good for you.
If people were able to order multiple months in 1 go, and pay just €90,  the costs would soar for the government. 

Before when i was going travelling, I wanted to purchase 6 months of drugs, but the chemist said I had to get authorisation from the Health Board.  They gave me just 3 months, and then faxed the authorisation for this to my chemist.  Only then would the chemist dispatch multiple amounts to me.
But it probably depends on the type of medication you're on.


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## tall chapy (4 Jun 2008)

It funny, the direct opposite happened me.... If I purchase the tablets under the Drug Purchase scheme I get an amount for that month usually 30 days supply. This is to stop me hetting a month(s) supply for free.If I purchase it privately I will only get a 28 days supply. The main reason for this was eluded to by giardiniera. If I have a repeating monthy perscription and I purchase my tablets on the 1st of the month under the DPS for arguments sake for €90, then 28 days later on the 29th I can get them for free. To stop this, they usually give you at least 30 days supply. 
I have been on the scheme for 15 years and have never thought to ask if I can have my 6 month supply up front & only pay for 1 months supply... 
It sickens me (excuse the pun) that the limit for the drugs goes up each year. Nobody wants to be dependant on a permanant drug supply for the rest of their lives, yet the government just wants to squezze every drop of blood out of us (excuse the pun again). Thank god I am in remission, though I still need to take the tablets. 
One other bug bear about it is the that the perscription only has a life span of 6 months. My consultant wanted me to come back in 9 months time to see him again. I said I would be willing, if he was willing to post date by 6 months another perscription. I explained that his first perscription would expire in 6 months and the only way that I could get a perscription was for my local GP to charge me €60 for my visit and the perscription. He did not post date my perscription & he called me back in 6 months. I will have my perscription filled tomorrow & sods law they will give me 28 days supply. This will probably happen as I opted out of the scheme as such so that I could claim some back it tax with out any complications..
PS : I find Pharmacists usually very helpful.


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## Complainer (4 Jun 2008)

tall chapy said:


> I opted out of the scheme as such so that I could claim some back it tax with out any complications..


Can you expand on this approach?


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## Ris (4 Jun 2008)

Conor_28 said:


> There is generally no problem with getting more than one month's supply at a time. If the medicine is inexpensive this is maybe the easiest way to do it (unless you then lose all your medicine, which happens). Please note that for some types of drugs, e.g. sedatives, painkillers, the pharmacist will not give more than one month supply.


 
Conor I am very interested in this as I have a chronic long term illness and have to pay my Pharmacy the maximum payment each month for my prescriptions even though I have a six monthly prescription from the hospital. Do you mean to say that there are pharmacies who would give me six months supply and only charge me one months fee, i.e. €90?

Sorry I know this has gone off topic a bit but I would be very interested if I could save any money towards my ongoing medical costs.

As for the OP, talk to your Pharmacist about their practice of only giving you 28 days. My pharmacist always adds in two extra tablets for any medication I have that comes in 28 day blister packs. I am on 15 different tablets per day and quite a substantial number of them come in 28 day packs.


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## gnubbit (4 Jun 2008)

Ris said:


> Conor I am very interested in this as I have a chronic long term illness and have to pay my Pharmacy the maximum payment each month for my prescriptions even though I have a six monthly prescription from the hospital. Do you mean to say that there are pharmacies who would give me six months supply and only charge me one months fee, i.e. €90?
> 
> .



Hi,

No unfortunately on that scheme you can't get more than a month's supply for your €90.  The pharmacist wouldn't be able to claim back the cost.  If someone's monthly medicines come to less than €90, it can be worth getting the full 6 months dispensed at once to save on theh dispensing fee.

Don't forget you can claim tax relief on the charges. 

Also, depending on what your illness is, you might be eligible for the Long Term Illness scheme.  It's quite restrictive though and I'd imagine your pharmacist would already have suggested it if you were eligible but no harm asking.

I know it's a lot of money but it's better than having to pay the full cost - I nearly fainted when I heard how much some drugs cost!


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## Ris (4 Jun 2008)

gnubbit said:


> Hi,
> 
> No unfortunately on that scheme you can't get more than a month's supply for your €90. The pharmacist wouldn't be able to claim back the cost. If someone's monthly medicines come to less than €90, it can be worth getting the full 6 months dispensed at once to save on theh dispensing fee.
> 
> ...


 
Thanks for clearing that up gnubbit. I thought it might be too good to be true! Ive never claimed tax relief on the charges. I will investigate that. Unfortunately my illness doesnt come under the Long Term Illness Scheme even though its a chronic long term incurable illness - go figure! I have been in touch with the powers that be but so far no luck! I will keep trying though!

Thanks again


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## gnubbit (4 Jun 2008)

Ris said:


> Thanks for clearing that up gnubbit. I thought it might be too good to be true! Ive never claimed tax relief on the charges. I will investigate that. Unfortunately my illness doesnt come under the Long Term Illness Scheme even though its a chronic long term incurable illness - go figure! I have been in touch with the powers that be but so far no luck! I will keep trying though!
> 
> Thanks again



You're very welcome.

You can claim tax relief on your expenses for the last 4 years so that's something at least.

I agree, it seems very arbitrary what counts for the LTI scheme and what doesn't - good for you for fighting it!


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