Reordering, reviews and running out

A reorder is a review, not a repeat

The word “reorder” makes it sound like a repeat purchase. Clinically it is not. Before a further supply is approved, a prescriber looks at how the last one went and decides whether to continue at the same strength, change it, or stop. That decision is the reorder; the dispensing is what follows it.

This is why the check-in asks questions rather than just confirming an address.

What the check-in asks

• Side effects — what you have had, how severe, and whether they are settling.
• Your current weight, so that the change over time is real rather than remembered.
• Doses missed, and when.
• New medicines, including anything started by another clinician.
• New conditions or diagnoses since your last supply.
• How you are finding it — a treatment somebody cannot live with is not a treatment that is working.

Your answers are not read once and forgotten. They are compared with the last cycle, which is what makes a pattern visible — a side effect that is getting worse rather than better, a weight trend that has flattened, a strength that was tolerated at first and no longer is.

What the prescriber decides

Four outcomes, in plain terms:

Continue at the same strength. The commonest outcome, and not a failure to progress. Some strengths are strengths people stay on.

Increase. Only where the minimum interval at the current strength has been met, side effects are not a barrier, and the prescriber judges it appropriate. Why increases are gradual, and why they cannot be brought forward, is covered in why dose increases are gradual.

Reduce. Because of side effects, a faster change than expected, or a new medicine that interacts.

Stop and review. Something in the check-in needs looking at before anything else happens.

Nothing about that list is automatic. It also is not a negotiation: a strength is prescribed on clinical grounds, and asking for a higher one is not a route to getting one.

Timing, and why we remind you

One unit of an injectable treatment is a pen containing four weekly doses, so it covers 28 days. A month of tablets covers a month. From the date your last supply was dispensed, we know roughly when it runs out, and we tell you before it does rather than after — because an interrupted course is a clinical problem before it is an inconvenience.

You are reminded a week before your supply is due to run out, again a few days before, and again if the date passes. If a longer period goes by, your treatment plan is marked as lapsed and coming back is treated as a restart.

Why a gap means going backwards

Tolerance to these medicines is built up, and it is lost. That is the whole reason a course starts low and climbs slowly. After a long enough break, the body is no longer where it was, and going straight back to the strength you stopped at risks the same side effects that the original slow climb existed to avoid.

So a restart usually means beginning again at a lower strength and working up. It is not a penalty and it is not an upsell. Where you restart from is a clinical judgement your prescriber makes based on how long the gap was and what you were taking.

If you know a gap is coming — a holiday, a supply problem, a change in circumstances — tell us before it happens rather than afterwards. There is usually more that can be done in advance.

Money follows the dose

There is no subscription and no card kept on file to charge. Each supply is a payment you make after a prescriber has approved it. Where a change of strength changes the price, a payment to approve is sent to you rather than taken automatically; where the change is downwards, the difference is refunded. Some steps cost the same as the one before them, so a clinically significant change can make no difference to the price at all.

Prices for every strength of everything this pharmacy dispenses are published on the treatments pages, before you start and without signing in.