If you have hypertension, hyperlipidemia, diabetes, a history of heart attack, inflammatory bowel disease, or rheumatoid arthritis—you name it—you're taking lifelong medication. A statin, metformin, aspirin, mesalamine, Humira.
When I prescribe these types of medications to patients, I'm generous—I write a 90-day supply with 3 refills, which lasts one year. For that entire year, you shouldn't need to message me for refills since they're already prescribed. But when that year ends, I'm required to rewrite the prescription.
The moment refills run out is a critical point for medication adherence. Key barriers to medication renewal:
The patient may need an in-person visit, which could take weeks to months.
The refill request gets buried in portal messages, prior auth threads, or pharmacy faxes—so it sits until someone notices.
Patients may not know they’re out of refills (or how renewals work), and they stop the medication while waiting instead of escalating.
One of the main reported reasons for non-adherence is simply "ran out!"
As I discussed in a prior article on medication adherence, all of this disrupts medication adherence, increases complications from uncontrolled conditions, and drives up healthcare costs through preventable hospitalizations.
Around 4 billion prescriptions are written annually, yet 20% of new prescriptions are never filled, and around 50% are taken incorrectly. This non-adherence issue is widespread, as highlighted by a study published in JAMA, which found that 30%–50% of adults with chronic illnesses do not adhere to their prescribed medication plans. This non-adherence leads to serious consequences, contributing to approximately 10% of all hospitalizations, around 125,000 deaths annually, and an estimated $100 billion in healthcare services each year.
Every part of the system is impacted by this renewal issue, as I explain below…
