Early Refills

Here is what it looks like: a 30-tablet prescription is refilled in 9-10 days. Less than 33% of the prior supply has been consumed, but the patient is already receiving a full new supply. Each individual dispense looks normal — the drug is correct, the quantity is standard, the prescriber is valid.

Early refilling is particularly hard to detect because each transaction appears perfectly legitimate in isolation. It is only when the temporal pattern is analyzed — the rate at which the patient consumes and refills — that the anomaly becomes evident.

This pattern is especially prevalent in chronic medications like statins, antihypertensives, antidiabetics, and insulin. These are medications patients need indefinitely, which creates the opportunity for long-term stockpiling or diversion to informal markets.

1 in 16 subscribers showed this pattern in an analysis of Latin American health insurance claims. It is not an isolated case — it is systematic behavior that, because of its frequency, has significant financial impact.

At $41 median per dispense, early refills have the highest per-transaction cost among waste patterns. The annual projection is $176K per 50,000 subscribers.

Stockpiled medication can have several destinations: resale on the informal market, excessive patient hoarding, or simply waste. In any case, the insurer pays for medications that are not being used as prescribed.

The affected chronic medications — statins, antihypertensives, antidiabetics, insulin — are essential for patient health. Ensuring they are dispensed at the correct rate not only saves money but may improve treatment adherence.