9 Reasons Why Pharmacists Might Refuse to Fill a Prescription

Have you ever taken a prescription to the pharmacy only to find out that your pharmacist can’t fill it? Chances of this happening are low. But if such a situation comes up, it’s usually for good reason — like protecting you from potentially dangerous health risks. 

The good news is, there are steps you can take to prevent issues from coming up in the first place and get your prescription without significant delay. Below are 9 reasons why your pharmacy may not have your prescription ready, and what you can do about it. 

Can a pharmacist refuse to fill a prescription?

Yes. In general, a pharmacist can refuse to fill a prescription for the following reasons:

• The prescription isn’t considered standard care or therapy.

• The prescription is likely to cause harm because its risks clearly outweigh the benefits.

• The pharmacist is having trouble verifying the prescription’s validity.

• The pharmacist has moral or religious reasons that prevent them from filling the prescription. But this reason is rare.

Let’s take a look at these and other possible reasons in more detail. 

1. The prescription is missing information

Pharmacies receive prescriptions in a few different ways: They can be physically dropped off, called in over the phone or faxed, or sent in electronically. In order to fill your prescription, the pharmacy must have all of the necessary information (keep in mind though, these requirements may vary by state): 

• Your full name and address

• Name and strength of the medication

• Dosage form (e.g., tablet, capsule)

• Medication quantity

• Directions for use

• Number of refills (or lack thereof)

• Date of issue 

• Information about the prescriber

• Your healthcare provider’s signature or verbal approval

If your prescription is for a controlled substance (a potentially habit-forming medication), then the pharmacy will also need additional information. If something is missing, your pharmacist will need to contact your healthcare provider’s office before filling the medication for you.

So what can you do?

If your healthcare provider writes a prescription and gives it to you during your appointment, give it a quick look to ensure that it seems complete. If you notice that something may be missing, make sure to let your healthcare provider know before leaving your appointment to avoid running into issues and delays at the pharmacy.

2. The prescription is hard to read

Some healthcare providers’ prescriptions are difficult to interpret. If the pharmacist is unable to read a prescription, they are required to contact your healthcare provider's office and confirm the information. 

What can you do?

If you’re having trouble reading your hard copy prescription, be sure to leave your updated contact information with the pharmacy. Request that your pharmacy call you in case there are any problems. This way, the staff can get in touch with you without you needing to make a trip to the pharmacy when your prescription isn’t ready.  

3. The medication needs to be ordered

Most people expect a pharmacy to have their specific medication in stock. But pharmacies don’t keep every medication in stock, especially rarely-used or expensive medications. 

A drug shortage or backorder is another possible reason why your pharmacy may not have something in stock. Either way, the pharmacy staff may need to order your medication before they can fill your prescription or request an alternative.

What can you do?

If you want to make sure the pharmacy has your medication on hand, call them ahead of time to check. Most pharmacies can order an out-of-stock medication and have it ready for you the following business day. If you can’t wait a full day, check with other pharmacies in your area to see if they have your prescription in stock.

You can also keep track of drug shortages by visiting the FDA and American Society of Health-System Pharmacists (ASHP) websites. 

4. The prescription appears to be altered or forged

Pharmacists must make sure that you have a valid prescription, so they may question prescriptions that seem to be damaged or altered in some way. Was it taped back together? Is information scratched out? Are there missing security features? Additionally, if any information on the prescription concerning the date, strength, or quantity appears to be altered, your pharmacist may not fill your medication.

What can you do?

Check your prescription. If you notice your healthcare provider scratched something out, ask if they can write you a new prescription. Doing this will prevent the pharmacy from questioning the prescription, and save you time at the pharmacy.

6. The pharmacy computer system is down

Maybe you have gone to the pharmacy counter and learned that their computer system is down. This is rare. But when it happens in pharmacies that rely on computers for their filling process, your prescription can’t be processed. 

What can you do?

You can either wait or request the pharmacy to give you a call or text when your prescription is ready. You may also ask your pharmacy to hand back the original written prescription for you to go to a different pharmacy.

If it’s a telephone, fax, or electronic prescription that was already in the computer system before it shut down, then transferring to another pharmacy might be possible for certain prescriptions. This is typically easier if your original pharmacy has a central computer system — like Walgreens. Then, another Walgreens pharmacy can access your prescription from the original one fairly soon, provided that the medication isn’t a controlled substance and has refills remaining.

But if both pharmacies aren’t connected by this type of computer system, then the transfer process might be a little more difficult. Another option is to ask your healthcare provider to call or send the prescription again to another pharmacy of your choice.

The insurance billing system is down 

A similar situation would be when insurance companies have outages. Although this also isn’t common, this problem can’t be solved by going to a different pharmacy because this is a problem on the insurance company’s end.

When an insurance billing system is down, it doesn’t necessarily mean you can’t get your prescription, but it might mean that you can’t count on your insurance to pay your bill right away.

What can you do?

If you need your prescription right away, you can pay the pharmacy’s cash price (cost of medication without insurance) and get your medication soon after. Once your insurance billing website is up and running, talk with your pharmacist about re-billing your prescription. The pharmacy might be able to refund you the difference between the cash price and your insurance copay.

If you choose to leave your prescription at the pharmacy and wait for the insurance billing system to be fully functioning again, consider leaving your updated contact information and asking the pharmacy to give you a call when your prescription has been properly billed and is ready for pick-up.

7. The insurance company rejected the prescription

Have you ever been told that your insurance rejected your prescription? This happens relatively frequently. A common rejection may include medications that need prior authorizations (PAs). And since medications can be expensive, people may not be willing to pay out of pocket. As a result, pharmacists can’t fill the medication.

What can you do?

Consider making it a practice to leave your contact information and asking the pharmacy to call you about any insurance issues. Some insurance issues can be resolved over a phone call with you or your healthcare provider. When a PA does get approved, it usually only lasts for a certain amount of time. So, it’s best to ask your healthcare provider early on to work on the PA paperwork for when you need a refill later on. 

For example, with a PA rejection, your insurance likely prefers a different (typically cheaper) medication to treat the same medical condition. In this case, the pharmacy will need to get a new prescription from your healthcare provider to replace the one that’s being denied.

8. The new medication could cause a dangerous interaction

You can usually rely on your pharmacist or healthcare provider to let you know if medications you take have any unsafe interactions. Not only do certain prescription medications interact dangerously with one another, but they can also interact with over-the-counter (OTC) medications, vitamin and mineral supplements, or even certain foods. 

What can you do?

Make sure you keep an up-to-date list of all of your current prescription and OTC medications as well as supplements, and share it with all providers you see.

If you need your medication urgently and your pharmacy is waiting on a call from your healthcare provider’s office to verify the safety of your medication, feel free to reach out directly to your healthcare provider. But it’s important to keep in mind that this might take a while as some providers’ offices might not return calls until the end of the day or later.

9. The pharmacist doesn’t feel comfortable filling the prescription

As previously mentioned, there are a number of reasons why a pharmacist might not feel comfortable and could refuse to fill a prescription. 

In some states, there is a conscience clause that allows pharmacists to refuse a prescription for moral or religious reasons. For example, state abortion bans aside, there have been reports of some pharmacists refusing to fill prescriptions for misoprostol (Cytotec), a medication that can be used with mifepristone (Mifeprex) to end a pregnancy or miscarriage. 

What can you do?

If a pharmacist refuses a prescription — like misoprostol to end a pregnancy — for moral or religious reasons, consider talking with another pharmacist at the same pharmacy. You can also try transferring your prescription to another pharmacy to be filled, although this can add some inconvenience.

What should I do if the pharmacy doesn’t have my prescription?

If the pharmacy doesn’t have your new prescription on file, ask the pharmacy staff to check their voicemail, faxes, and new escripts. Keep in mind that faxes and escripts might take longer to come in. Otherwise, you can ask the pharmacy to reach out to your healthcare provider.

Why trust our experts?

Written by:

Ross Phan, PharmD, BCACP, BCGP, BCPS

Ross Phan is a board-certified clinical pharmacist. She has roughly two decades of healthcare experience — with most of her experience being pharmacy related.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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