Expiring Controlled Substance Prescription Fill/Pick-Up Question

Hi Sandy and thank you for your question!

I can certainly answer this and be fairly confident that the vast majority of pharmacies operate the way I describe, but there may be some places that operate a little bit differently. I just want to make this caveat.

You don't specify what expiration date for a controlled substance prescription you are referring to.

You could mean the expiration date of a controlled substance prescription that is being filled for the first time or you could be referring to the expiration date of the refills on your controlled substance prescription.

Either way, the answer I discuss below is the same.

First, we need a little background on how prescription billing works in regard to pharmacy filling operations.

When Do Pharmacies Bill Your Insurance?

Essentially all outpatient pharmacies in the United States (e.g. Walgreens, CVS, Rite Aid, etc...), as far as I am aware, will submit your prescription to your insurance company before it is physically filled, and well before you actually pick it up (or get it mailed to you). This is an important point.

In general, the first step of the prescription filling process is a data entry step, where the information on the prescription (e.g. patient, drug, directions, quantity, refills, etc...) is entered into the computer system.

Once all the information is in the pharmacy system, it is then billed to your insurance (or submitted as a cash claim).

This is done for a few reasons:

• To ensure the pharmacy receives a paid 'claim' prior to filling, or ordering expensive drugs
• To ensure the drug doesn't need prior authorization from the insurance company
• To ensure the cost of the prescription to the patient is known
• To ensure no other requirements are necessary prior to filling the prescription (many drugs have extra requirements, such as isotretinoin, or REMS drugs)
• To allow the drug to go through a 'third-party' drug utilization review (since the insurer has your past drug claims and could potentially find clinical problems with your prescription).

You can imagine how much of a hassle it would be if your prescription were billed to your insurance right when you came to pick it up and there was a problem with it (e.g. it wasn't covered or needed a prior authorization).

This would mean wasted time for you, expecting to receive a prescription that you can't afford or don't want to pay for, and the pharmacy, for filling a drug you won't end up getting.

Since your prescription is billed and processed before filling, when you pick it up, it is not billed to the insurance or run through the pharmacy system again.

Controlled Substance Expiration, Fill Date, and Pick Up Date

In the prior section, I established that your prescription is billed and processed before you come in to pick up.

This brings me to the answer to your question.

If you have your controlled substance prescription filled by your pharmacy on the last day before it expires, it will go through the pharmacy system (assuming there is no insurance rejection or clinical problem).

At this point, you can pick up your prescription within the pharmacy pickup window (usually 10 days or so after filling before it is 'returned to stock') and you shouldn't have any problems.

Again, this is because when you pick up your prescription, it has already been processed through your insurance, and the pharmacy system, the two points at which a prescription would be held up due to an expiration problem.

You'll notice that the dates on your prescription bottle, and prescription paperwork, indicate the fill date...not the date you actually picked up the prescription. The fill date is the date is was actually billed and processed through the pharmacy system.

So, let's use an example based on what I have written above.

Your controlled substance prescription expires on 7/7/2021. You fill it on 7/6/2021. When it is filled, it is processed through the pharmacy system, and the insurance, both of which will check the expiration date.

The prescription is filled and is waiting for you to pick up (or is mailed to you).

You come in to pick up your prescription on 7/11/2021. Even though the prescription is technically expired on this date, you more likely than not will not have a problem picking it up as it has already been processed.

You will only really run into an issue if the prescription is 'rebilled' (e.g. you need it run through different insurance) or if the prescription is returned to stock at the pharmacy (as your pharmacy will reverse the claim through your insurance).

Most pharmacies have a set amount of time they will hold a prescription that has been filled. This is generally 10 days, so, you could say as long as your controlled substance prescription has been filled prior to expiration, you have within the time frame your pharmacy will return your prescription to pick it up.

Final Words

I hope this answer helped you!

As I said at the beginning, this answer regarding controlled substance expiration and pick-up times, is applicable to the vast majority of pharmacies out there.

There could be some edge-case scenarios where things may be different at a particular type of pharmacy, so be sure to ask your specific pharmacy for information regarding your situation.

Thanks again!