In New Zealand, I sometimes receive prescription medication in a generic box full of blister packs, where the last blister pack has been cut down to match the prescribed number of doses. Occasionally I'll get a couple of cut down sheets, presumably using up the leftovers from other people's prescriptions.

> The disadvantage is that there are some leftover pills most of the time. E.g. you need 30 pills and there are only units of 20 available.

This is the exact reason why they count pills. You have a prescription for X pills, you get X pills.

It's been a while since I've had a prescription filled, but I think that in New Zealand it's the same. Most prescription drugs like opiate painkillers or antibiotics are counted and bottled.

Here in India, they'll either cut the blisters to your prescription or give already cut blisters from previous orders.

Yes, but is it worth the trouble?

Also, you may be able to build robots to dispense pills. But have you seen a European automated pharmacy supplier? Everything is automated. They dispense all the blister packs into a small cart that gets delivered to the pharmacy. In the end it does not matter if you supply a pharmacy with 2-20 medicines or a consumer with 1-10.

  Yes, but is it worth the trouble?

The "schedule II drugs" jeherr mentions as being counted twice are things like cocaine, methamphetamine and fentanyl. i.e. drugs that could be readily sold onto the black market.

While cocaine and methamphetamine are schedule II, those are poor examples. I don’t think pharmacies ever carry them, and their medical use is very rare.

Fentanyl is commonly carried in pharmacies but it’s not a commonly prescribed medication. Better examples would be adderall, vyvanse, norco and oxycontin.

I used to work at a mail order pharmacy. Even though a machine counted the pills a pharmacist had to certify every bottle. This amounted to bottles coming down a conveyor and the pharmacist picking each one up, scanning it, and looking at a picture of the pills on a screen to make sure they are the same. I wouldn’t doubt if Amazon would need to do the same were they to use individual pill counts.

It's the much superior way to do it though, in France all estimate say we would save a lot of money by doing this, but with such a strong phamaceutical lobby it just never happens. Same reason why somehow we have homeopathy being reimbursed as if it was a real medicine, Boiron is french !