Controlled Substance Law: 30 Days From Fill Or Pickup?
In our latest question and answer, the pharmacist discusses controlled substance "fill dates" and how they differ from "pick-up" dates in regard to determining when a controlled substance can be refilled.
Last month my scripts were billed to my insurance on 2/07 and filled. I was out of the country and did not pick up my medication until 2/10. Today, I went to pick my scripts up and they refused to allow me to pick them up until 03/10 but this is a huge inconvenience due to the fact I travel for work. What is the law for I-STOP with picking up/filling a controlled substance? Does that law state 30 days from the day the scripts were filled or picked up?
- Laws regarding controlled substance fill dates vary by state.
- In general, pharmacies will use the pick-up date, and not the fill date, of the prior prescription to determine when someone is due for their next fill as that is a better indicator of how much medication someone has on hand.
- Some online state prescription monitoring systems (PMPs), like I-STOP in New York, only require pharmacies to electronically submit the fill date, not the pick-up/sold date.
- Your pharmacist may use the last fill date to determine when you are due for a refill if the last pick-up date is not available.
Hello and thank you for your question!
Before getting into the answer here, I want to start out by saying that controlled substance laws vary by state in regard to how early you can fill and pick up your prescription.
I'll be speaking in some generalities here that are broadly applicable, and give some specific examples, but for a definitive answer for your particular situation, I'd ask your local pharmacist that knows your history.
Is It The Pick-Up Date Or The Fill Date?
In most states and situations, the date that your pharmacist will use to calculate when you can refill your controlled substance prescription is the pick-up date, not the fill date (or the insurance billing date).
- Your prescription was filled on 2/7 by the pharmacy
- Your prescription was billed to the insurance on 2/7 by the pharmacy
- You picked up the prescription on 2/10 at the pharmacy
In the example above, when you are ready to fill your next prescription, the pharmacy will calculate the day supply you have left based on the pick-up date as that date is the more accurate indicator of when you actually started taking the medication.
Therefore, your pharmacy will begin counting your due date for your next prescription from 2/10, not 2/7.
Controlled substance fill limitations are designed to limit the amount of drug someone has on hand. Calculating the amount of drug someone has on hand would be most accurate when going by the date someone actually picked up their medication.
There is one very big caveat to all this, which is discussed in the next section.
Fill Date VS. Sold Date: Problem With Prescription Drug Monitoring Programs
As written above, your pharmacist would generally use the date that you picked up a prescription when calculating when you are due for your next fill.
However, and this is a very important point, most prescription drug monitoring programs run by the states only require the fill date, and the pickup, or sold date, is optional.
This is because pharmacies themselves are required to submit their controlled substance prescription records to the state, and they do so, by having their pharmacy system generate an electronic report that is then submitted. The pharmacy system 'knows' and records when a prescription is filled.
Unfortunately, many 'point of sale' systems do not link with the actual pharmacy software in regard to reporting when a prescription is sold out/picked up by someone.
Due to this, many online prescription drug monitoring programs only show the fill date and this is acceptable to many programs. One such example is Pennsylvania. Below is from their PMP (prescription monitoring program) FAQ section:
Q:Do dispensers need to report the date the prescription was filled or the date it was picked up?
A: If a dispenser has the date the prescription was sold or picked up, then they must report that. This is only possible if the pharmacy has a point-of-sale system that is integrated with the pharmacy management system to allow a bidirectional flow of information. If the date the prescription sold is not available, submitting the date it was filled is sufficient.
So, let's say you drop off a controlled substance prescription to a pharmacy you usually don't go to, and they don't have your prescription records.
They could look up your controlled substance fill history on the state-run prescription monitoring program, but, if it only shows your fill date history and not your pick-up date history, they would generally just go by that information when determining whether or not to fill your prescription.
All in all, in most cases, your pharmacist will use your last pick-up date if they have it, but if they don't, like in the example above, they would likely just go by your fill dates instead.
How Soon Can You Refill A Controlled Substance?
The reason most people ask about whether controlled substance dates are counted from the fill date or pick-up date is due to the fact that states have laws in place regarding how early someone can fill their prescription.
New York is one of those states. Part 80: Rules and Regulations on Controlled Substances in NYS states:
No additional prescriptions for a controlled substance may be issued by a practitioner to an ultimate user within 30 days of the date of any prescription previously issued unless and until the ultimate user has exhausted all but a seven days' supply of that controlled substance provided by any previously issued prescription.
In New York, the above is informally referred to as the "seven-day rule", meaning that an individual can have up to a 7 day supply on hand of a controlled substance. If an individual has more than a 7 day supply on hand, regardless of the prescription "fill date", the pharmacy cannot legally fill the prescription.
Utah is another example of a state that has specific rules:
No refill may be dispensed until such time has passed since the date of the last dispensing that 80% of the medication in the previous dispensing should have been consumed if taken according to the prescriber's instruction
In addition to laws regarding controlled substance refill dates, there may be certain scenarios where an individual is held to a particular date that is stricter than what the law states:
- The prescriber has indicated to "fill only when due" or a specific date.
- The pharmacy has a specific policy regarding controlled substance fill dates.
- An individual has a history of filling controlled substances early and further fills may be left to the professional judgment of the pharmacist.
- Pennsylvania Department of Health, https://www.health.pa.gov/topics/programs/PDMP/Pages/QA.aspx
- Part 80: Rules and Regulations on Controlled Substances in N, Health.ny.gov
- R156-37. Utah Controlled Substances Act Rule, DOPL
- Dr. Brian Staiger, PharmD
- 4515 views