You’ve just come from a doctor’s appointment, and they wrote you a prescription for a new blood pressure medication. Your doctor tells you that it should be ready to pick by the time you get to the pharmacy. When you get there, there is only 1 person ahead of you in line; but when you get to the counter, the pharmacy tells you it will be 30 minutes until your prescription is ready. How can this be??

THE TRUTH BEHIND DISPENSING MEDICATION

There is more than what meets the eye when it comes to processing prescriptions. Though it may seem simple (how hard can it be to grab a medication off the shelf, fill a bottle, and pass it to the patient?), there is a reason pharmacists go through 6+ years of higher education and are required to obtain a doctorate degree. Each prescription that comes through is clinically evaluated, no matter how simple it may seem. Patient safety and wellbeing are at the forefront of everything we do at the pharmacy.

SO WHAT ACTUALLY HAPPENS WHEN THE PRESCRIPTION IS SENT IN?

Prescriptions can be sent to the pharmacy in one of a few different ways: via electronic communication, physical paper, or over the phone. When a script is sent electronically, it can have a delay of up to 10 minutes before the pharmacy actually receives it. It must go through a clearing house before it hits the pharmacy’s system. The doctors themselves may also be balancing back-to-back appointments and might not have a chance to send the prescription until much later after your appointment has concluded. When a prescription is received either physically or over the phone, the person receiving it must transcribe all the information into the computer, which can take a bit of time depending on how complex the prescription is. Unfortunately, pharmacies legally cannot begin processing prescriptions until we have physically received them, even if we know we should be receiving them shortly.

MY PRESCRIPTION HAS BEEN RECEIVED, NOW WHAT?

Depending on how many prescriptions are already waiting in the system, there may be some time before the pharmacy actively begins processing it. Scripts are “typed” or processed in the order that they were received, unless the patient requests it sooner. If there are already 100 prescriptions waiting to be looked at, your new one will become number 101 in the queue.  Scripts can even continue to come in after pharmacy hours – which results in an even longer queue the next opening morning! Processing time can be further prolonged as the pharmacy team consistently balances other responsibilities including vaccine appointments/walk-ins and patient counseling.

Sometimes during the typing process, we notice details that might be missing or unclear. This could include vague instructions, an unexpected change in dosing, or may be missing details that make a prescription valid and complete. In these cases, we call the prescriber’s office to collect more information and get clarification. Quite often, the prescriber is unavailable as they are very busy individuals too. We can leave a message and wait for a callback or even try again at a later time. But ultimately, we will need to get a response from them before we can proceed.

THE INSURANCE DILEMMA

Love it or hate it, insurance and prescription coverage are a critical part of dispensing medications. Most of the time, insurance can bring the cost of expensive medications down to a reasonable price  the patient can afford. However, in some instances where a medication is not covered, it can significantly delay the dispensing process. There are many different reasons why insurance might reject coverage: it may not be listed as an approved drug to be covered, incorrect dosage, refill too soon, or refilled already at another pharmacy. In some cases, we may be able to submit a prior authorization (PA) request. This is a request sent to your doctor to submit an appeal to your insurance company explaining why you need the medication. Even after the PA has been submitted by your doctor, the insurance company may take additional time to respond with their decision.

There are also rare situations where the doctor accidentally sends a prescription to two different pharmacies. Depending on who processes the prescription first, another pharmacy may have already billed your insurance and filled the medication. If this happens, the other pharmacy must unbill the insurance before our pharmacy is able to dispense the medication for you. Unfortunately, the only way to bypass all the insurance processes is to pay for the prescription out of pocket. However, for many people this is not a feasible option.

FINALLY TIME TO FILL

We’ve finally made it to the exciting stage of the prescription filling process where we can dispense the actual medication! Picture this: you’ve gone through all the steps of receiving a prescription, typing it up, running it through insurance, and when you go to grab the bottle off the shelf, there is nothing there. This is an unfortunate reality sometimes, and it is frustrating for all parties involved. Fortunately, we are typically able to place an order to be received the next day. Understandably, some people need their prescriptions ASAP and this situation further delays them getting treatment. In some cases, we can partially fill the prescription and fill the remainder once more stock has arrived.

PHARMACIST CHECK

One of the very last things that happens before a prescription is ready for pickup is a pharmacist double check. This is when our clinically trained PharmDs evaluate each dispensed prescription one last time and ensure it is appropriate for the patient to take home. This means double checking the prescription to confirm everything is filled out correctly, that the dose and what the medication was prescribed for makes sense, that the medication won’t cause further problems based on the patient’s past medical history, that there are no drug or allergy interactions that could be harmful, and that what was dispensed is the correct medication. Though it may look like the pharmacist is just taking a quick look at each bottle before hitting verify on autopilot, there is quite a lot running through their brain for each bottle.

CAN I HAVE MY MEDICATION YET?

We have finally reached the very last step of the dispensing process: giving you your medicine. You head to the counter, the team member rings you up, and you sign for your bottle. They then let you know that the pharmacist needs to speak with you about the new blood pressure medication. You think: can’t I just read the bottle?

It is important (and required by law) that we counsel patients (or at least offer counseling) on all new medications. This is not because we want to take more time out of people’s day, but to ensure everyone knows what to expect and has the opportunity to ask questions. We never assume you’ve had a chance to talk to your doctor about everything. Our job is ultimately to ensure people feel confident in their health management, and know what symptoms to look out for and how to approach them when starting a new therapy. Patient safety is always at the forefront of everything we do!

HOW CAN I SPEED UP THIS PROCESS?

Though we try our best to be efficient, there are many ways that you as the patient can help us get your medication to you as quickly as possible. This includes answering the phone if you see a phone call coming from us, letting us know ahead of time if you will be coming in to pick up a prescription and/or requesting an ETA on when it will be ready to pickup if you are coming soon after it was prescribed, sharing any allergies or health conditions we may be unaware about, and staying ahead of your refills. As you can see, there is a lot that goes into filling a prescription, and there can be many roadblocks that we might hit along the way. Sometimes processes, even refills, can take a couple of days to be resolved, so anytime you can plan ahead helps us out a ton! Each pharmacy is unique in terms of workflow, volume of prescriptions, staff responsibilities, and internal checking systems, so it is also important to check with your specific pharmacy if you have further questions.

Prepared by Kathryn Versteeg PharmD Candidate 2026