A recent Wall Street Journal investigation found that mail-order pharmacies significantly over-dispensed medications to Medicare patients, resulting in an estimated $3 billion in excess drugs between 2021 and 2023. While accounting for around 9% of all Medicare prescriptions, mail-order pharmacies were responsible for roughly 37% of the surplus medications, often due to automatic early refills that shipped drugs before patients had finished prior supplies. These practices led many seniors to accumulate excess quantities of pills, including common prescriptions like statins, diabetic treatments, muscle relaxants, and psychiatric medications with some patients receiving hundreds of extra pills at a time. The oversupply raises patient safety concerns, such as confusion, dosing errors, potential overdose risk, and challenges with polypharmacy, particularly among older adults. Experts also point out that financial incentives for insurers and pharmacy benefit managers may contribute to these patterns, as quality metrics tied to medication adherence can encourage higher refill activity. Regulators also relaxed refill restrictions during the COVID-19 pandemic, a change that likely amplified the issue. While some companies have since tightened policies, questions remain about aligning pharmacy practices with patient-centered care and cost efficiency.
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