Hoard

A friend of mine on antiepileptics asked me why physicians only prescribe the exact amount of medication needed. We give a thirty day supply for a month, ninety day supply for three months. We schedule our follow-up visits right before that time's up. There's no leeway for picking up a prescription late or the pharmacy being closed for the holidays or having your physician go on vacation. For some medications like contraceptives, running out of pills is a big inconvenience. For some diseases like seizures, missing a dose is a big deal. It completely incapacitates someone, and once seizures start, picking up a prescription and getting them under control becomes so much harder. Our system also doesn't plan for contingencies like natural disasters. Shouldn't patients have a cache of emergency pills?

From a physician perspective, I'd be happy to give patients an extra week or two in case of an emergency. Other than controlled substances, antibiotics, and medications that can be dangerous in overdose, I don't think there are too many problems in having a few extra tablets. I don't think most patients would abuse this. Perhaps why we don't do this is that insurers have little incentive to provide for an extra week's supply of medications that may never be used. Nevertheless, the insurance against unnecessary hospitalization if someone misses crucial medications might make it worthwhile.