Lost refills: where does an independent pharmacy lose them?
An independent pharmacy loses refills in four places. Some prescriptions never get filled. Some get filled but never get picked up. Some refills come in late. And some refill calls never get answered.
Here is how big each one is.
Prescriptions that never get filled. In a study of about 196,000 e-prescriptions, 22% were never filled. For new medications, it was 28%. That means more than 1 in 4 new prescriptions never turned into a sale.
Prescriptions nobody picks up. In a study of more than 10 million prescriptions, about 3 in every 100 filled prescriptions were never picked up. Your team counted them, bagged them, and later put them back on the shelf.
Refills that come in late. In a study of 18 community pharmacies, only about 7 or 8 in 10 refills for diabetes, blood pressure and cholesterol drugs came in on time. Every late refill is a month with fewer fills.
Refill calls nobody answers. No study counts the refill calls pharmacies miss after hours. But you have seen it. It is the voicemail box on Monday morning.
Each leak is small on its own. Together, they are a big share of the refills your pharmacy should be filling. So the next question is why patients drift away in the first place.
Prescription abandonment: why do patients stop refilling?
Patients stop refilling for two big reasons: the cost, and forgetting. Cost is the one you can measure.
In IQVIA's 2019 data, about 44% of new prescriptions that cost the patient more than $125 were left at the pharmacy. Above $500, it was more than 60%. Most prescriptions cost far less than that, but the pattern holds at lower prices, too.
In the 10-million-prescription study, patients were 3.4 to 4.7 times more likely to leave a prescription behind when their copay was over $40. New patients were 2.7 times more likely to leave one than patients who had taken the drug before.
So the patient most likely to slip away is new to the drug and has a high copay. That patient needs a call from you most.
The other reason is plain forgetting. A patient runs out on a Tuesday, means to call, and does not. Nobody reminds them. That is the leak a phone call closes.
Refill reminder calls: do they bring refills back?
Yes. A phone call to a patient whose refill is late brings a real share of them back.
In a study of 735,218 patients, Walgreens pharmacists called patients who were 3 days late on a refill. The share of patients who refilled within two weeks went up 22.8%. That is about 6 more patients out of every 100 who got a call.
The call worked because it came at the right time: right after the refill was due, before the patient got used to going without it.
The catch is time. Making those calls by hand takes your team away from the counter, so most pharmacies only make them when it is slow. We cover how to automate them in 3 Automations Every Independent Pharmacy Should Have Running.
Medication synchronization: does one pickup day help?
Yes. Medication synchronization puts all of a patient's refills on one pickup day each month, and patients who use it stay on their medications more.
In large US studies, patients on synchronization took their medications 3 to 5 percentage points more of the time than patients who were not on it. In a Medicare study, the gain was three times bigger for patients who had been missing the most refills.
That matters for your pharmacy, because the patients who miss the most refills are the ones you are losing.
One independent pharmacy measured what it meant for business. After it started a synchronization program, its monthly prescription volume rose 4.8% in the first six months. That is one pharmacy, so your result will be different. But it shows the gain is not just on paper.
Synchronization works best when someone calls each patient before their pickup day to confirm what they need. That brings us back to the phone.
After-hours refill calls: what happens when you are closed?
When your pharmacy is closed, a refill call usually goes to voicemail. The patient has to remember to call back, and some never do.
No study measures this for pharmacies yet. But doctors' offices show how often after-hours calls fall through. When Kentucky's Medicaid program had callers phone primary care offices at night and on weekends, only about half reached a live person or got a callback within 30 minutes. The most common miss was being told to leave a message.
When patients cannot reach anyone, they find another way. In a national CDC survey, 12% of adults said they went to the emergency room because their doctor's office was not open. For a refill, another way might mean a different pharmacy, or going without.
That is the gap the VOXO Pharmacy AI Agent fills. It answers refill calls at night and on weekends, takes the request, and puts it into your PMS, so it is waiting for your team when you open. Below, we show what that did for one pharmacy's weekend refills.
Prescription capture rate: how can you tell what you are losing?
You can see most of your leaks this week without any new software. Here are three checks.
Count your return-to-stock bin. At the end of the week, count the prescriptions you are putting back on the shelf. Each one is a patient who did not pick up.
Pull your late-refill list. Most PMS software can list patients who are past due on a maintenance drug. Count how many are more than a few days late.
Count your missed calls. Look at how many calls went to voicemail or hung up after hours and during your busiest hours.
Write the three numbers down. They are your starting point. Check them again in a month to see if what you changed is working.
How VOXO is helping independent pharmacies capture refills
VOXO helps independent pharmacies capture refills in three ways. It answers refill calls day or night. It calls patients when their prescription is ready. And it calls patients when a refill is due.
Every refill call answered. The VOXO Pharmacy AI Agent answers refill calls at any hour and puts the requests directly into your PMS. Nobody on your team has to type them in. Since we launched it, the Agent has handled more than 1.39 million calls for independent pharmacies and sent more than 367,000 refill requests into their pharmacy systems.
Weekend refills that used to go to voicemail. One independent pharmacy using VOXO captured 150 to 200 more weekend refills a month, from calls that used to go to voicemail. Nobody had to be on the phone.
Pickup reminders. When your team marks a prescription ready in your PMS, VOXO calls the patient on its own to tell them it is ready. The patient presses 1 to confirm. Fewer prescriptions sit in the bin until they go back on the shelf.
Refill reminders. VOXO calls patients whose refill is due. The patient presses 1, and the refill lands in your queue. Today, your team uploads the list of patients due, which takes a few minutes in the morning.
Put together, the patient gets a reminder, refills with one button, and gets a call when it is ready. Your team never has to pick up the phone for any of it.
Clinical questions always go to your pharmacist. If a patient asks about dosing, side effects, drug interactions or anything that sounds like medical advice, the Agent sends the call to a licensed pharmacist. That is built into the Agent, and it cannot be turned off.
The bottom line
Your pharmacy loses refills in four places: before the fill, at the counter, between refills, and on the phone.
The pharmacies winning them back do three things. They call patients when a refill is late. They put refills on one pickup day. And they answer every refill call, even after hours.
Start by counting what you are losing. Then fix the biggest leak first.
How VOXO helps you capture more refills
VOXO answers every refill call, puts the request into your PMS, and calls patients when their refill is due and when it is ready to pick up. Your team gets the time back for the patients at the counter.
Book a 30-minute demo and we will show you how many refill calls your pharmacy is missing.
Frequently asked questions
What is prescription abandonment?
Prescription abandonment is when a pharmacy fills a prescription and the patient never picks it up. The pharmacy then puts the drug back in stock. In a study of more than 10 million prescriptions at a large US retail chain in 2008, 3.27% of filled prescriptions were abandoned, and 1.77% went back to stock without the patient filling the drug anywhere else within 30 days.
How many prescriptions are never filled?
About 22%. In a US study of 195,930 e-prescriptions published in 2010, 78% were filled and 22% were not. For prescriptions for new medications, 28% were never filled.
Do refill reminder calls work?
Yes. In a randomized study of 735,218 patients published in 2017, Walgreens pharmacists called patients who were 3 days late on a refill. The share who refilled within 14 days rose 22.8%, about 6 percentage points.
Does medication synchronization work at an independent pharmacy?
Yes. One independent community pharmacy in West Virginia saw its monthly prescription volume rise 4.8% in the six months after it started a synchronization program. Larger US studies found patients on synchronization took their medications 3 to 5 percentage points more of the time than patients who were not, with bigger gains for patients who had been missing the most refills.
Can a pharmacy take refill requests after hours?
Yes. An AI phone agent can answer refill calls at any hour and put the request into the pharmacy's management system. VOXO's Pharmacy AI Agent does this for independent pharmacies and has sent more than 367,000 refill requests into their pharmacy systems.
Does an AI phone agent answer clinical questions for the pharmacy?
No. VOXO's Pharmacy AI Agent handles routine calls, like refill requests, whether a prescription is ready, pickup and delivery, and store hours. Questions about dosing, drug interactions, side effects, or anything that sounds like medical advice go to a licensed pharmacist every time, and that cannot be turned off.
