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Counting Your Pills at the Pharmacy Can Pay Off

Laura is a technical writer. She enjoys playing the piano, traveling, fine art, and making jewelry.

Don't rely on the pharmacy to always count correctly. If you have critical or highly expensive medicine, do your own counting sometimes just to be sure you're getting what you paid for.

Don't rely on the pharmacy to always count correctly. If you have critical or highly expensive medicine, do your own counting sometimes just to be sure you're getting what you paid for.

It's Important to Do Your Own Quality Control Check

There are many important reasons why you should count the pills you get from your pharmacy at least periodically.

When should a home quality control check (self-counting) be done on the prescriptions you pick up from your pharmacy?

1. If the medicine is critical, and you cannot ever be without it without suffering serious consequences, it's important be absolutely sure you're getting what you've paid for. Insulin and needles come to mind, along with heart pills, asthma or anti-seizure medicines, and many others. Anything that can affect your well-being or ability to function should be assessed for accuracy. This is particularly true if you need your medication to function at work.

2. If you have ever run out of medicine early in the past or suspect that the count was incorrect. Note that this is not blaming pharmacy staff—everyone makes mistakes. Some pills are counted by machines that make mistakes, pharmacies sometimes have new employees who aren't yet as seasoned, and counting pills isn't easy to do, let alone all day long. However, at the same time, if you cannot drive to work if you don't have any more of your meds, and could potentially lose a whole day's pay, that's serious. If the prescription bottle indicates that enough medicine has been dispensed when, in fact, it hasn't, then you need to take the time to recount everything as soon as you're home from the pharmacy for the next few months.

3. Every few months, do a spot-check of your most expensive prescription at least to make sure you're getting what you (or your prescription insurance company) paid for. The corollary of this is to keep pharmacy staff honest and not short-changing you on the expensive pills (stealing).


Report any shortages or overages (amounts different than what is on the bottle's label) that have been dispensed to the pharmacy's manager directly (do not leave a message with someone else on staff). Perhaps there is a problem with one employee's counting method, a pharmacy machine, a pharmacy standard procedure, or (in the case of expensive medicine) perhaps someone is pocketing a few pills to resell to folks in a similar position as you are: coming up on the end of the month and not having as much medicine as the bottle indicates with no way to prove that YOU didn't take or lose those pills.

Reason #1: Prescriptions Are Expensive

The first reason is that most prescription medicines are expensive. That means they have "street value" even if they're not traditional "addictive" types of drugs.

If you are missing two or three pills out of a 30-pill supply of a $100 prescription, that's $6.67-$10.00 out of your pocket or your health insurance company's pocket (which trickles down to you in the form of higher insurance premiums).

With the high cost of healthcare today, insurance companies are tightening their belts in many ways, one of which is by limiting how soon you can get a prescription refilled. This, in turn, causes problems for the consumers, if only that you can never go on a vacation longer than the lead-time by which your insurance company will pay for the next 30-day supply of pills. For example, one insurance company, even when begged for permission to refill just a few days early, refuses to do so, and the patient is therefore tied to five days trip to their pharmacy.

Reason #2: Avoid Problems With Insurance

This brings us to the second reason for counting your pills when you get a prescription filled: if you are missing 2-3 days worth of medicine consistently every month, after awhile your insurance company will not pay for your prescription until you are closer to running out according to their records. They typically won't refill a prescription more than a week in advance of when you should run out.

Blue Cross and Blue Shield of Minnesota, for example, will not make exceptions to this rule even if you are planning on going on vacation and will run out of medication during your trip. Whether you are vacationing or missing pills, therefore, you will need to pay out-of-pocket for the cost of the additional medicine you'll need to get through the days until your insurance company will cover the prescription cost again.


Whether due to human error or deliberate employee theft, your pharmacy purchases should be checked for accuracy at least periodically to ensure that you are getting what you need: what you paid for.

If you find an error, report it to the pharmacy manager immediately and request that your pills be counted twice by pharmacy staff to help prevent errors in the future.

In extreme cases, you may need to stand at the pharmacy counter and count out the pills yourself in view of the pharmacy staff because pharmacies cannot take "returns" and may not believe you if you claim to be missing high-value pills again and again, which would be the case if someone in the pharmacy were deliberately short-changing you.

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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2009 Laura Schneider


Laura Schneider (author) from Minnesota, USA on January 01, 2012:

Nagash01, you are correct, I made the generalization that "most prescription medications are expensive" based only on my own experiences over the last 40+ years, those of my family members and friends and neighbors, and those of my best friend who is a well-respected pharmacist at a famous hospital in Minnesota. Because I have already been through and "worn out" (or been allergic to or had serious side-effects from) generics and older, more affordable prescriptions, my prescriptions are usually all brand names that cost a fortune: I've simply already been on all the existing, more-affordable meds; it's not that my doctor and I are unaware of them.

My apologies that you and possibly other pharmacists or technicians took offense at my comment: I meant no disrespect, I was simply pointing out the fact that many drugs are expensive (whether monetarily or health-wise) and consumers should count their meds just like they count their change at a cash register.


Someone on August 04, 2011:

@Nagash - Agreed on all counts!

Nagash01 from Santaquin, Utah on June 01, 2011:

While it is true that errors in counting do occur, it is not the norm. The problem you are describing usually happens because an odd shaped or extremely tiny/large tablet is counted twice. For instance lorazepam 0.5 mg tablets which are very tiny. These tablets can sometimes be counted twice by mistake. However since they are a controlled substance the pharmacy staff will count the whole quantity twice and document it. In other cases the error could be due to automatic dispensing machines such as the Baker System. In any case and for the most part, such shortages of one to two tablets even out thanks to the law of averages. Believe it or not, you sometimes get too much medication too. However if you have been shorted you can request the pharmacy do a backcount of the medication on hand. Their inventory records should match up. And unless you are patronizing a terrible pharmacy, it isn't even necessary to speak with the manager to resolve the issue. Even the technicians have the capacity to figure out if an error of quantity was made. Just be nice about it. If you storm in and are mad, upset, rude, or callous, you can expect the same treatment back. However if you are pleasant you can expect the error to be fixed with very little hassle.

And on another subject, it is a compete fallacy that, as you say, "most prescription medications are expensive." There are hundreds of cheap, generic medications for every five expensive brand-name medications. If you find yourself constantly buying ridiculously expensive medications, blame your doctor for choosing the top of the line medications to treat your runny nose. The pharmacy fills prescription orders from a physician. If that physician constantly relies on the newest, greatest thing, then you will no doubt be paying for it.

Cat on May 01, 2010:

Last month, almost half of the pills prescribed to me were missing from the pill bottle, so I had to go back to the pharmacy to obtain the remainder of the pills. How could they make such a big mistake? Now this month with the same exact prescription, I decided to count the pills immediately when I arrived home. Two pills are missing. So that's twice in a row that this pharmacy made an error. I'm not happy about this, as it makes me wonder how many other errors they make.

Laura Schneider (author) from Minnesota, USA on November 10, 2009:

Georzetta, I totally agree: refilling a few days early each month is the way to go. You definitely don't want to be in a position where you're sorting out pills into your weekly reminder case and run out halfway through a week--it's really hard to keep it all straight then.

Georzetta Ratcliffe from Pennsylvania on November 07, 2009:

You are so right about this.I have come up short any number of times over the last 15 years.

For what it's worth, if you use the same pharmacy they are far more likely to replace your medication free of charge particularly if it is maintenance medication for blood pressure, asthma, or similar type condition.

It's also useful to try to refill your prescriptions a few days early each month. How much you can get away with will depend on the insurance company, as you mentioned.

If I'm careful, I can end up with almost 1 full month of medication by the end of the year.

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