Refill lapse rate
Refill lapse rate is the share of active patients in a period whose medication supply ran out before their next shipment arrived — computed per patient from the last shipment date plus days’ supply against the next delivery date — and it is the leading indicator of churn in subscription telehealth.
- Share of active patients who ran out before the next delivery
- Leading indicator of churn
- Spans pharmacy, carrier, clinical, billing, and product systems
- Fixed by running renewals on the supply clock
Lapse versus churn versus adherence
Churn is the cancellation; lapse is the gap that usually precedes it. Adherence is whether the patient takes what they have; lapse is whether they have it. A program can have adherent, subscribed patients who lapse because a renewal sat in a queue or a shipment was late — a program failure, not a patient one.
Why it goes unmeasured
The inputs live in different systems — pharmacy ship dates, carrier deliveries, clinician decisions, billing renewals, patient check-ins — and no single one of them sees the gap. Programs that measure lapse are the ones whose infrastructure emits each of those moments as an event they can join.
Closing the gap
A cadence engine keyed to each patient’s run-out date: check-in prompted at run-out minus ten days, renewal authorized within hours, shipment by run-out minus three, delivery confirmed and the next cycle scheduled. Agent-run check-ins fit the first step well; the clinician still authorizes.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
How do you calculate refill lapse rate?
For each active patient: run-out date = last shipment date + days’ supply; lapse days = max(0, next delivery date − run-out date). Lapse rate = patients with lapse days above zero whose run-out fell in the period, divided by active patients.
What is an acceptable lapse rate?
Lower every month. Report the distribution alongside the rate: many one-day lapses point to shipping buffers; a few long lapses point to queue, payment, or address problems.