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Prescription refill policy criticized by healthcare activists

Thousands of people with chronic diseases are forced to seek unnecessary outpatient appointments every day because hospitals do not give out enough prescription refill slips for the medicines they need, the Taiwan Health Care Reform Foundation said yesterday.

The lack of refill slips not only wastes a lot of time and effort but also costs more than NT$400 million (US$12.2 mllion) annually in insurance co-payments, the foundation said.

Patients seeking prescription refills also take up time doctors could have spent seeing people with more urgent needs, it said.

“Though the Department of Health recommends that doctors give out prescription refill slips to 24 percent of all patients with chronic illness, 87 percent of hospitals fail to meet that target,” foundation chairwoman Chang Li-yun (張苙雲) said.

The nation’s aging population means an increasing amount of governmental funding will be needed to care for the elderly, as is happening elsewhere in the world, she said.

“Many governments around the world now issue refill prescriptions [for chronic illnesses] to medically stable patients to alleviate the burden on both patients and doctors,” she said.

Although the department originally planned for at least one-third of all patients with chronic diseases to be eligible for refill prescriptions, that figure was reduced to 24 percent after negotiations with hospitals and doctors, Chang said.

However, “in the 84 public hospitals we investigated, 73 have not met that goal,” she said.

Chronically ill patients, who could have had their prescriptions filled by certified pharmacists near their homes, make a total of 780,000 outpatient visits each year and pay NT$440 million in insurance co-payments, Chang said.

“For every prescription refill slip a doctor fails to issue, a patient needs to go to a clinic or hospital twice, pay two more registration fees, and three more co-payments to get their medications,” Chang said.

The government must do more to promote refill prescriptions and defend the rights of people with chronic illnesses.

“Hospitals should be judged in their annual evaluations on how they are complying with the refill policy so they will fully execute the plan,” she said.
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