RxRescue
Notes from the field
Practical writing on pharmacy inventory, DSCSA, expiration management, and what we're learning building RxRescue.
Published June 22, 2026 · By John Thieszen, MD
Manual inventory checks sample the shelf. Barcode scanning records every bottle — and that difference is where most pharmacy expiration losses hide. Why the return credit window is the key deadline, what a daily scan actually catches, the math on what it’s worth, and what to look for in an electronic inventory system.
Published June 9, 2026 · By John Thieszen, MD
If your correctional facility stores prescription drugs on site, federal law almost certainly calls it a “dispenser” — with a November 27, 2026 DSCSA deadline. What’s already enforceable today, the $10,000–$30,000/year in expired-stock waste most facilities can recover, why “the wholesaler/EHR/contractor handles it” falls short, and five questions to ask your pharmacy team this week. Cited; written from inside a correctional med room.
Published June 9, 2026 · By John Thieszen, MD
Every pharmacy keeps reordering a handful of SKUs it almost never dispenses. Dead stock ties up cash, fills shelf space, and — the part that stings — usually leaves as an expired write-off rather than a sale. Why it accumulates, how to find it by movement rather than quantity, and the cross-check that turns a slow-mover list into recovered credit instead of thrown-away product.
Published June 9, 2026 · By John Thieszen, MD
The expiration date looks like the simplest field on a bottle, and it's one of the most misread. A month-only date means the last day of that month; all-numeric dates can be U.S. or international order; a beyond-use date can fall before the printed expiration; and the lot number isn't the expiration date. The conventions nobody is formally taught — and why scanning the date beats reading it by eye.
Published June 9, 2026 · By John Thieszen, MD
FIFO rotates stock by arrival date; FEFO rotates by expiration date. They sound interchangeable — but in a pharmacy, arrival order and expiration order diverge often enough that the gap becomes expired stock on the shelf. Why short-dated deliveries, lot-to-lot dating, and re-shelving break FIFO, what that costs you, and how to make FEFO the default instead of the good intention.
Published May 29, 2026 · By John Thieszen, MD
Independent pharmacies carry the same DSCSA, recall, and audit obligations as the chains — without the chain's budget or IT staff. The good news: most of the compliance stack is tools you already own. Where the gap really is, why enterprise suites are the wrong answer, and the one affordable layer that closes it.
Published May 29, 2026 · By John Thieszen, MD
The day a bottle physically arrived is different from when it was ordered, invoiced, first dispensed, or scanned — and it's the one date most systems don't record cleanly. Why that small field quietly drives expiration and FEFO decisions, return credit windows, dead-stock analysis, and recall traceback — and what good receiving-date tracking actually looks like.
Published May 26, 2026 · By John Thieszen, MD
The traditional annual physical count costs revenue, exhausts staff, and is wrong by Tuesday. Cycle counting is the alternative — small rotating counts that keep inventory fresh continuously, without shutting the pharmacy down. How to design sections, calibrate cadences, and what software actually needs to do to support it.
Published May 26, 2026 · By John Thieszen, MD
Pharmacy staff scan dozens of NDCs every shift; almost nobody reads them. The last segment — the package code — is the one that ties the digital record to the physical container, and it's the one most pharmacy management systems strip. Why it matters for cycle counts, billing-unit reconciliation, repackaged stock, and receiving discrepancies — and how to keep it in your workflow.
Published May 26, 2026 · By John Thieszen, MD
The clipboard walk-through is the default expiration workflow at most pharmacies. It is also the reason short-dated bottles slip past, credit windows close, and expired stock ends up on the dispensing shelf. What works better — and how to make the routine survive staff turnover.
Published May 26, 2026 · By John Thieszen, MD
Correctional pharmacies are dispensers under DSCSA, with the same November 27, 2026 obligations as any community retail pharmacy — but the staffing, the network, the workflow, and the audit cycle are all different. What works in this environment, and why generic pharmacy software falls short.
Published May 23, 2026 · By John Thieszen, MD
An FDA inspection of a small dispenser is mostly a records request. Six specific things they ask for, what each one is really testing, and what "ready" looks like in practice ahead of the November 27, 2026 DSCSA enforcement date.
Published May 23, 2026 · By John Thieszen, MD
The all-or-nothing pharmacy inventory count is what makes audits painful. Breaking the shelf into named sections and cycling through them on a defined cadence is quieter, faster, and more accurate — and the audit is never a project, it's just always partway done.
Published May 18, 2026 · By John Thieszen, MD
Pharmacy compliance has quietly become a stack of background systems — the PMS, the wholesaler portal, a compliance service nobody opens. The trouble with background systems is that they fail invisibly. Why the physical shelf is the one layer you can actually see, and why visible compliance is the kind you can trust.
Published May 15, 2026 · By John Thieszen, MD
Expired-stock write-offs are mostly preventable. Why pharmacies quietly lose money to expired medication, what good first-expired-first-out tracking looks like, and the steps any pharmacy can take this month — no software required for most of them.
Published May 7, 2026 · Updated May 14, 2026
The November 27, 2026 DSCSA enforcement date for small dispensers is roughly six months out. Here's what serialization at the package level actually means, what changes in your day-to-day workflow, and the four checks any pharmacy can do this week to know whether it's ready.
Published May 17, 2026 · By John Thieszen, MD
A step-by-step walkthrough of the full physical count process — zones, scanning, expiration handling, controlled substance rules, reconciliation against the PMS, and documentation — with an FAQ covering the most common questions pharmacy managers have.
Published May 17, 2026 · By John Thieszen, MD
A seven-step daily checklist for monitoring FDA drug recalls, matching recalled lots against your actual inventory, quarantining affected stock, and maintaining the documentation log that an inspection or audit will ask for.
Published May 17, 2026 · By John Thieszen, MD
What NCCHC's 2026 Jail and Prison Health Standards expect for medication inventory in correctional facilities — expiration controls, lot-level accountability, recall response, physical counts, and the documentation gaps that most commonly surface during accreditation reviews.
Published May 17, 2026 · By John Thieszen, MD
A perpetual inventory is the running tally your PMS keeps — what should be on the shelf. A physical count is what is actually there. Why they diverge, what each one is useful for, and where the physical inventory layer fits alongside a pharmacy management system.
More posts coming. Have a topic you'd like covered? Email info@rxrescue.us.
In-depth reference articles on the topics that matter most for pharmacy inventory and compliance.
What the Drug Supply Chain Security Act actually requires of dispensers — serialized barcodes, FNC1 handling, verification obligations, and the November 27, 2026 small-dispenser deadline.
What first-expired-first-out inventory means in practice, how it differs from FIFO, and what good expiration tracking software actually looks like for pharmacies.
How correctional med-room workflows differ from retail pharmacy, what tools break down in that environment, and how scanner-driven inventory actually works in a jail pharmacy.
How expired-medication returns work with Cardinal, McKesson, and AmerisourceBergen — credit windows, manifest formats, and how to stop leaving recoverable credit on the table.