How do you handle rx returns

[PharmD RPh]

Just wondering what the consensus is on rx returns in the sense that a customer just wants to return it after they leave the store for no apparent reason? For example, someone buys some lipitor calls you up the next day and says I changed my mind and want a refund.

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[npage148]

If there are no mistakes on our end, once it leaves the store I will never take back a return. It is there's for good. State and fed laws dictate this

 

[All4MyDaughter]

If there are no mistakes on our end, once it leaves the store I will never take back a return. It is there's for good. State and fed laws dictate this

This was policy at both chains where I've worked plus our outpatient VA operation.

 

[MrsAppleseed]

If there are no mistakes on our end, once it leaves the store I will never take back a return. It is there's for good. State and fed laws dictate this

Co-signed.

 

[PharmD RPh]

It justs seems likely lately it's becoming more of an issue at my store. Had one guy buy tussionex, call up 5 days later saying it's too expensive. He proceeds to bring it back to the store throwing a fit. What about the case where the dr writes for a wrong strength? Do you blame the dr and ask the patient to seek compensation from their dr?

 

[Old Timer]

If there are no mistakes on our end, once it leaves the store I will never take back a return. It is there's for good. State and fed laws dictate this

Oh really? I would like to see the statutes. I'm pretty sure there is no federal regulations and I know there are no state regulations in PA. Please DO NOT conflate the taking back part and the reselling part. There is absolutely no law that prohibits returns or what would we do with recalled medication? What happens with a dispensing error? What happens if the doctor makes an error? What if you gave the brand, but they want the generic? What if you have a defective inhaler or a batch of pills that are crushed?

Now that you have the medication back is where the problem comes in. Most states prohibit the reselling of these items. You are free to refund them and take a loss, just not free to resell them.

I looked on line and searched the Code of Federal Regulations. The best thing I could find is his article from Drug Topics.

Can prescription drugs be taken back from patients?

Unless you have a citation to backup what you say, I would say this is just another case of pharmacists inventing rules and regulations that do not exist.

 

[Hibiclens]

Oh really? I would like to see the statutes. I'm pretty sure there is no federal regulations and I know there are no state regulations in PA. Please DO NOT conflate the taking back part and the reselling part. There is absolutely no law that prohibits returns or what would we do with recalled medication? What happens with a dispensing error? What happens if the doctor makes an error? What if you gave the brand, but they want the generic? What if you have a defective inhaler or a batch of pills that are crushed?

Now that you have the medication back is where the problem comes in. Most states prohibit the reselling of these items. You are free to refund them and take a loss, just not free to resell them.

I looked on line and searched the Code of Federal Regulations. The best thing I could find is his article from Drug Topics.

Can prescription drugs be taken back from patients?

Unless you have a citation to backup what you say, I would say this is just another case of pharmacists inventing rules and regulations that do not exist.

2nd Time Old Timer 😀

http://forums.studentdoctor.net/showpost.php?p=10277251&postcount=31

 

[Old Timer]

2nd Time Old Timer 😀

http://forums.studentdoctor.net/showpost.php?p=10277251&postcount=31

That covers Georgia, you do not explain if that precludes pharmacies from taking back class one recalls. What that means is you are not completely quoting Georgia Law as there has to be other parts of the regulations that handle some of the scenarios I outlined. Additionally, it does NOTHING to show a federal violation. As for state regulations, I spoke about Pennsylvania. So it's not the second time.

At that time I asked you as an expert on the law in the ******ed state of Georgia to show me the rest of the state regulations. You didn't dot then so I'll ask for it again.

 

[Hibiclens]

That covers Georgia, you do not explain if that precludes pharmacies from taking back class one recalls. What that means is you are not completely quoting Georgia Law as there has to be other parts of the regulations that handle some of the scenarios I outlined. Additionally, it does NOTHING to show a federal violation. As for state regulations, I spoke about Pennsylvania. So it's not the second time.

At that time I asked you as an expert on the law in the ******ed state of Georgia to show me the rest of the state regulations. You didn't dot then so I'll ask for it again.

Was npage speaking just about PA...I must have missed that. It's illegal in Georgia, it is that simple. No further explanation required.

Granted, it is pretty much unenforcable, but hey, you wanted to see a statute.

 

[Old Timer]

Was npage speaking just about PA...I must have missed that. It's illegal in Georgia, it is that simple. No further explanation required.

Granted, it is pretty much unenforcable, but hey, you wanted to see a statute.

Most everyone says it's against Federal law. And so far you are the only one who has posted a state law. You still have not explained Class I recalls. You have not explained physician errors. Are they also prohibited. So if a patient has dangerous medication from a class one recall they have to keep it in the ******ed state of Georgia?

I also pointed out in my response in the previous thread that the language really deals with reselling. You fail to point out that it's not iron clad as you are allowed to take back medication in TRSOG (The ******ed Sate of Georgia) from a nursing home....

 

[Ackj]

That law was very poorly written. It pretty much says "well, they could've tampered with it, so we don't want it back." They make the assumption that if they take it back, they're just going to end up dispensing it again, which is definitely illegal. However, that's a pretty poor assumption to make, since you can definitely take it back and throw it to medturn or something similar.

 

[npage148]

Now that you have the medication back is where the problem comes in. Most states prohibit the reselling of these items. You are free to refund them and take a loss, just not free to resell.

With non-controls if we can't resell it why take them back if we did nothing wrong? So we can take the couple 100$ hit? Great business practices. I'll invent rules all day if I want based on my interpretation of the laws. With controls, we can't destroy or dispense them so we are stuck with them.

There is absolutely no law that prohibits returns or what would we do with recalled medication?

Recalls are done on corporate level at my job, I don't take the meds back

What happens with a dispensing error?

Refer to my disclaimer

What happens if the doctor makes an error?

The patient is free to get their money back from the doctor. We did nothing wrong and should not be punished for their incompitance

What if you gave the brand, but they want the generic?

In NY the patient has no say in this situation so it doesn't happen

What if you have a defective inhaler or a batch of pills that are crushed?

We take it back (NOT RETURNED) and the manufacture replaces it. I don't know how you practice but I make it a habit to not send out crushed pills. Don't you verify what's in the bottle?

If you have any other questions regarding pharmacy practice or if you want statute #s you should ask your lawyer buddies, just make sure they don't try to bill you later. They are slimy like that.

 

[PharmD RPh]

In my state you can do returns and accept a loss, but it is illegal to redispense it after it's left the pharmacy. Would you want me giving you a med that some random stranger took home and decided to return? I'm with the majority on returns. If we dispensed correctly why should we eat the cost of some of these expensive meds? If we return it that's essentially what we are doing. However if a mistake was made on our part, i.e. Dispensed incorrectly, tech refilled wrong med, etc. Then I have no problem eating the cost. If Dr makes mistake on their rx, why should the pharmacy literally pay for the dr mistake? Would the dr offer to pay for a mistake I made?

 

[Old Timer]

With non-controls if we can't resell it why take them back if we did nothing wrong? So we can take the couple 100$ hit? Great business practices. I'll invent rules all day if I want based on my interpretation of the laws. With controls, we can't destroy or dispense them so we are stuck with them.

You still have not shown me a federal statute that backs up your claim federal prohibits the return of the medication. You can't interpret something that does not exist. Controls are governed by DEA regulations and even that is going to chnmage as the number of children killed by undisposed controlled medications is growing. As long as you admit you are making it up as you go along, it's fine with me, it proves my point.

Recalls are done on corporate level at my job, I don't take the meds back

Class 1 recalls are done at the corporate level? What do the patients do, mail the stuff to corporate?

We take it back (NOT RETURNED) and the manufacture replaces it. I don't know how you practice but I make it a habit to not send out crushed pills. Don't you verify what's in the bottle?

So they can return defective things and get a replacement and it only counts as a return if you give a refund? If they give it back to you, they returned it and by your logic this is an illegal act. I don't look at the pills when I dispense bottles of 30 in a unit of use package. That is what unit of use packages are all about. Do You remember the Paxil debacle? The pills would just split in half even if they were dispensed whole.

If you have any other questions regarding pharmacy practice or if you want statute #s you should ask your lawyer buddies, just make sure they don't try to bill you later. They are slimy like that.

It's up to the person who makes the claim to back it up with documentation. If I say the moon is made of green cheese, it;s up to me to back it up with factual proof. If you say something is against the law, it's up to you to site the law that proves your point. And not all lawyers are slimy any more than all pharmacists know pharmacy law.

 

[Sparda29]

It's not against the law to take it back and refund it, but it's against the law to resell it. It's easier to just tell the customer that it's illegal for you to refund them as opposed to telling the customer you don't want to take it back because if you do, then you are gonna take a loss.

 

[Old Timer]

In my state you can do returns and accept a loss, but it is illegal to redispense it after it's left the pharmacy. Would you want me giving you a med that some random stranger took home and decided to return? I'm with the majority on returns. If we dispensed correctly why should we eat the cost of some of these expensive meds? If we return it that's essentially what we are doing. However if a mistake was made on our part, i.e. Dispensed incorrectly, tech refilled wrong med, etc. Then I have no problem eating the cost. If Dr makes mistake on their rx, why should the pharmacy literally pay for the dr mistake? Would the dr offer to pay for a mistake I made?

When you decide to return something and take a loss a lot of factors come into play. I know an independent community pharmacist who wouldn't take back something and the patient left and came to my pharmacy along with his $15,000.00 of yearly prescription spending. Would you eat a $100.00 to keep $15,000.00 a year in sales, the answer is yes.

There is a clear difference between refunding and re-selling. The former is permitted in many situations while the latter is prohibited by state and federal regulations. It's a matter of professional judgement and I prefer pharmacists exercise said judgement rather than hide behind imaginary laws in order to avoid a difficult conversation. They would rather say "I can't" instead of "I won't". I tell people all of the time that I won't take back medication because I can't re-sell it. I ask them if they want medication that was at somebody else's house for a week. They always say no.

 

[PharmD RPh]

When you decide to return something and take a loss a lot of factors come into play. I know an independent community pharmacist who wouldn't take back something and the patient left and came to my pharmacy along with his $15,000.00 of yearly prescription spending. Would you eat a $100.00 to keep $15,000.00 a year in sales, the answer is yes.

There is a clear difference between refunding and re-selling. The former is permitted in many situations while the latter is prohibited by state and federal regulations. It's a matter of professional judgement and I prefer pharmacists exercise said judgement rather than hide behind imaginary laws in order to avoid a difficult conversation. They would rather say "I can't" instead of "I won't". I tell people all of the time that I won't take back medication because I can't re-sell it. I ask them if they want medication that was at somebody else's house for a week. They always say no.

I see your point and would do the same in that situation but also make a point to let them know that I won't be able to do this again in the future. I just think we sometimes empower the public with their irrational demands. They have the attitude that whether right or wrong they get what they want. They think if they complain enough or call corporate then they might get a gift card or we'll cave in to their demands.

 

[Old Timer]

I see your point and would do the same in that situation but also make a point to let them know that I won't be able to do this again in the future. I just think we sometimes empower the public with their irrational demands. They have the attitude that whether right or wrong they get what they want. They think if they complain enough or call corporate then they might get a gift card or we'll cave in to their demands.

My philosophy in dealing with corporate is: If my boss is going to override me then I it's better to take it back up front. They are more likely to to try to go over your head again.

 

[firework]

the law says, if the store is not at fault, the item is not defected, the customer have the right to be refunded only if the item is in a "re-sellable" condition.

 

[Old Timer]

the law says, if the store is not at fault, the item is not defected, the customer have the right to be refunded only if the item is in a "re-sellable" condition.

The law? What law? I ask again for a citation. There might be a law in your state, but there is NO federal law that prohibits the return of any non controlled medication.

 

[firework]

what are you trying to say here?

If you are asking if the federal law rules against taking back dispensed medicines and refund the patients, maybe there is no such law. So what? There are a lot of things not in the federal law, but we are doing business in a free market here, some rights are protected in a more basic term. You can't buy a tomato and let it rot in the back of your car then return it for full refund, can you? Is there a law specific about this? Maybe not. Can the store choose to refund and take the loss? Yes, it can. Does the store have right to refuse refund? Yes, it does.

Okay, maybe you are right pharmacists shouldn't say "we can't take your medicine back because it's against law" if there is no such law, but we can say "you are against law to force us refund something we can't resell because of your fault". What's the difference?

The law? What law? I ask again for a citation. There might be a law in your state, but there is NO federal law that prohibits the return of any non controlled medication.

 

[Old Timer]

the law says, if the store is not at fault, the item is not defected, the customer have the right to be refunded only if the item is in a "re-sellable" condition.

what are you trying to say here?
If you are asking if the federal law rules against taking back dispensed medicines and refund the patients, maybe there is no such law. So what? There are a lot of things not in the federal law, but we are doing business in a free market here, some rights are protected in a more basic term. You can't buy a tomato and let it rot in the back of your car then return it for full refund, can you? Is there a law specific about this? Maybe not. Can the store choose to refund and take the loss? Yes, it can. Does the store have right to refuse refund? Yes, it does.

Okay, maybe you are right pharmacists shouldn't say "we can't take your medicine back because it's against law" if there is no such law, but we can say "you are against law to force us refund something we can't resell because of your fault". What's the difference?

Make your mind up. Either there is a law or there isn't a law. There are valid customer service reasons why you would refund a prescription a prescription from a customer. You are free to make any business decision you would like to make. What you are not free to do is make up fake laws because you don't have the gonads to tell the customer the truth.

 

[firework]

I thought we are talking about "laws" here, not "customer service reasons". If you want to keep the customer, then don't say anything, just give the refund trash the pills and say "thank you for shopping with us".

Make your mind up. Either there is a law or there isn't a law. There are valid customer service reasons why you would refund a prescription a prescription from a customer. You are free to make any business decision you would like to make. What you are not free to do is make up fake laws because you don't have the gonads to tell the customer the truth.

 

[Old Timer]

I thought we are talking about "laws" here, not "customer service reasons". If you want to keep the customer, then don't say anything, just give the refund trash the pills and say "thank you for shopping with us".

Why would you do something illegal for "customer service" reasons.

You are either legally permitted to take back medication or you are not legally permitted to take back medication. It can't be both. Whether you should or should not take back medication from a patient is something decided on a case by case basis depending on the facts of the case. I merely responding to the mistaken assumption that it is against the law, which it clearly is not except in the great state of Georgia.

 

[Ilikechemicals]

I have to agree with Oldtimer. From a business stand point, it makes more sense to take a small loss (refund) than a big loss (lose a customer.

Besides, it looks like you can still do the refund in Georgia. You just cant take the meds back.

 

[PharmD RPh]

I have to agree with Oldtimer. From a business stand point, it makes more sense to take a small loss (refund) than a big loss (lose a customer.

Besides, it looks like you can still do the refund in Georgia. You just cant take the meds back.

If it's hctz, fine take it back. It's not worth the time of arguing. If its a regular then ok i can do it this time but not in future. If it's enbrel or c2, then no way, it's yours now. IMO.

 

[Hibiclens]

I have to agree with Oldtimer. From a business stand point, it makes more sense to take a small loss (refund) than a big loss (lose a customer.

Besides, it looks like you can still do the refund in Georgia. You just cant take the meds back.

I would love a legal mind to chime in whether it is legal to refund an rx in Georgia even if you don't resell it. It may be a crazy and unenforcable law, but it is on the books.

 

[PharmDstudent]

If the doctor writes for the wrong strength and it's one or more days after the med was sold, then just call the insurance company for a dosage change override. No refund required! Maybe you would have to wave the copay but tough!

 

[PharmD RPh]

If the doctor writes for the wrong strength and it's one or more days after the med was sold, then just call the insurance company for a dosage change override. No refund required! Maybe you would have to wave the copay but tough!

Why should everyone subsidize the doctor's mistake? If I make a misfill, can I call the doctor and ask them to pay for my misfill? I'm pretty sure their answer would be NO!

 

[clachan3]

Just wondering what the consensus is on rx returns in the sense that a customer just wants to return it after they leave the store for no apparent reason? For example, someone buys some lipitor calls you up the next day and says I changed my mind and want a refund.

This is an interesting post. I have had a few return/refund requests for rxs in the past 4 years. I have only given refunds for $4 drugs and I always stressed that this is a one time thing for this patient. I feel that they need to be aware of what medications they are taking/paying for.

Anyway, it's been so long since I had a refund request, I almost forgot how to handle these situations. So this lady wanted to get a refund for a generic face wash that apparently didn't work for her daughter. She has gotten the brand before, and had worked wonderfully, unfortunately the brand wasn't available, so we gave her the generic that was available at the time.

So about 3 weeks after she had given her daughter this face wash, her skin became worse, so the mom called my pharmacy. She said the generic face wash was thin, and nothing like the brand. I asked if they shook bottle before each use, just in case, she said yes they did. I explained to her that I could not take returns, but I could replace the product if it was defective.

She said she would call the dermatologist office, and the nurse told her that the generic we gave her son was discontinued, and told her that it usually meant that the product was ineffective. They were shocked that she was given the discontinued generic face wash, the mom was disgusted she said. I said we provided them the correct substitution for her at the time. Of course she wanted to talk to the manager, well, my manager is the store manager is the store manager who doesn't know anything about drugs. I asked her bring in the face wash and I will compare with the one I have in the pharmacy, and I'll see what I can do.

It's kind of weird to me that people actually think that can have their money back when a medication doesn't work for them.

 

[wezvidz]

Something similar just came up for me. A nice gentleman who just got a 90 day supply of lisinopril 40mg last week came in a week after getting a new generic we're carrying saying his BP is consistently 10 points higher since starting this new generic and he wants the old one. We had a few tablets of the old one left, so I took back and discarded all 83 of the tabs he wanted to return, gave him the few I had of the old generic and have a new bottle on the way from our outside vendor to give him the rest of his #90.

I don't really argue if it's a cheap drug like the above situation.

I had somebody pick up a week supply of Lovenox after hospital discharge then 2 days later call saying "I don't know why they prescribed this or why I need it, I want to bring it back". I flat out refused in that case.

 

[Ackj]

It's kind of weird to me that people actually think that can have their money back when a medication doesn't work for them.

Unfortunately, we're in a society that allows something like that. Didn't like your dinner? Yell at the waiter/waitress and send it back. Didn't like your rx? Yell at the pharmacist/tech and send it back.

 

[StringTheorist]

As long as you don't return it to stock, that is the only aspect of this that deals with law.

If it is our mistake, we refund the patient and give them the right script for free. Just mark the return as damaged.

If the patient just changes their mind, I would call the pharm sup on it. I know it's pretty immoral on the patients end, but if we would lose their loyalty over it, I'm sure the pharm sup would say just give them the refund.

 

[MindOverMatter]

Has anyone here ever actually called a doctor's office to let them know that they wrote for the wrong drug/strength/whatever, and that they have to reimburse the patient? Anyone?

 

[kirson01]

At CVS in Maryland we would take back any rx and put it in damages. It was a matter of customer service. CVS would take the loss and the drugs for obvious reasons would and could not be resold.
At the place I work at now they will not take back any returns unless it was their mistake or a class 1 recall.
Regards,
Kirson

 

[MountainPharmD]

Has anyone here ever actually called a doctor's office to let them know that they wrote for the wrong drug/strength/whatever, and that they have to reimburse the patient? Anyone?

Once a few months ago. There is a docs office close by that employes the most incompetent staff ever. They screw up about every 10th e-script they send out. We dispensed med that turned out to be the wrong strength from the doc. Patient wanted to bring it back and I said no because the docs office made the mistake. A little while later one of the idiots at the docs office called and asked if we could do them a favor and refund the patients money. I had a hard time holding back what I rewally wanted to say but I just said no if the patient wants reimbursed who ever made the mistake at your office needs to reimburse them. Never heard anything else about it. Still see lots of scripts from the doc and every 10th one still has something wrong with it.

 

[MountainPharmD]

At CVS in Maryland we would take back any rx and put it in damages. It was a matter of customer service. CVS would take the loss and the drugs for obvious reasons would and could not be resold.
At the place I work at now they will not take back any returns unless it was their mistake or a class 1 recall.
Regards,
Kirson

The bottom line is it's a judgment call. No, you cannot re-dispense a medication that has been returned. I agree that the pharmacy should not have to take the a loss on something that was not their fault. However, for a good regular customer is it worth losing their business or creating ill will? You have to look at each situation individually and make a decision that will result in the best outcome.

 

[phathead]

The bottom line is it's a judgment call. No, you cannot re-dispense a medication that has been returned. I agree that the pharmacy should not have to take the a loss on something that was not their fault. However, for a good regular customer is it worth losing their business or creating ill will? You have to look at each situation individually and make a decision that will result in the best outcome.

Winner!

Like I said in another thread, if someone is going to take their business elsewhere because they changed their mind or through a fault of their own, they're not worth the business.

And for the record, in all four states I have worked in each state said we could not accept a med back once it left the front door.

 

[bananaface]

In Iowa it is legal to accept a return and then redispense it so long as the Rx is a non-controlled med and the pharmacist believes it to have been stored properly and not tampered with. So, your tech wants to return a birth control Rx and you trust her to have stored it properly, you can take it back and redispense it to anyone. Controlled substances can be accepted for return but only re-dispensed to the same patient. As always, you can take back personal contact items at a loss but may not redispense them.

For those who like references:
http://www.legis.state.ia.us/aspx/ACODocs/DOCS/6-1-2011.657.6.15.pdf

 

[dgroulx]

Basically, if you can prove the product was not adulterated, then it can be redispensed. I work in hospital pharmacy and we return and redispense any medications in unit dose packaging. Anything else, like insulin pens, inhalers, are disposed of. I know nursing homes can also return unit dose meds that are packaged in bingo cards.

In Iowa it is legal to accept a return and then redispense it so long as the Rx is a non-controlled med and the pharmacist believes it to have been stored properly and not tampered with. So, your tech wants to return a birth control Rx and you trust her to have stored it properly, you can take it back and redispense it to anyone. Controlled substances can be accepted for return but only re-dispensed to the same patient. As always, you can take back personal contact items at a loss but may not redispense them.

For those who like references:
http://www.legis.state.ia.us/aspx/ACODocs/DOCS/6-1-2011.657.6.15.pdf

 

[Ackj]

pharmacist believes it to have been stored properly and not tampered with.http://www.legis.state.ia.us/aspx/ACODocs/DOCS/6-1-2011.657.6.15.pdf

This seems to be the major issue. You really have no idea where this has been. Has it been left in a hot car all day? Have the pills been spilled in mud and then wiped off and put back in the bottle? If they're capsules, they may even have been opened up and tampered with. Let's face it, patients can't be trusted to take action when their bottle says "no refills" until they're all out and it's time to take a dose, so it's a very tough call to trust the patient has stored them properly.

 

[kvl1027]

When you decide to return something and take a loss a lot of factors come into play. I know an independent community pharmacist who wouldn't take back something and the patient left and came to my pharmacy along with his $15,000.00 of yearly prescription spending. Would you eat a $100.00 to keep $15,000.00 a year in sales, the answer is yes.

There is a clear difference between refunding and re-selling. The former is permitted in many situations while the latter is prohibited by state and federal regulations. It's a matter of professional judgement and I prefer pharmacists exercise said judgement rather than hide behind imaginary laws in order to avoid a difficult conversation. They would rather say "I can't" instead of "I won't". I tell people all of the time that I won't take back medication because I can't re-sell it. I ask them if they want medication that was at somebody else's house for a week. They always say no.

If a patient wants to return something and the return was not prompted by something we did wrong, I will usually take it back to provide good customer service. Old Timer is right, sometimes you have to take a hit initially to get a good pay-off in the end. There have been a few instances in which i have refunded the patient what they paid minus the drug cost, so that I could at least get the cost of the drug covered. I explain to the patient that I can take it back, but I have to destroy the medication, because law prevents me from putting it back into circulation, because the product would be classified as adulterated. Most of these patient are ok with this, since it was not my error. I have even helped a patient get a refund from their doctor for an error the physician made.

Sometimes it is really easy to find out who works in an Independent and who is bitterly employed by a chain. Old Timer has more pharmacy experience that most everyone on here, I think it would be wise to take his advice.