Conducting regular back counts is a powerful tool for pharmacies, offering benefits that go far beyond meeting regulatory requirements. While the practice itself isn’t new, the need for efficient and streamlined back counting workflows is growing rapidly as the pharmacy industry adapts to new challenges.
In this post, we’ll break down the fundamentals of back counts, explore why many independent pharmacies struggle to perform them consistently, and explain how they strengthen operational accuracy, accountability, and patient safety. We’ll also show how C2 Keep makes the process easier, faster, and more reliable, turning back counting into one of the most effective habits your team can adopt.
What Are Back Counts and Why Are They Overlooked?
Back counts are physical inventory checks performed after a change in stock to ensure remaining quantities match the expected amount. It’s most often conducted during key activities such as receiving shipments, dispensing medications, or amending transactions.
While many pharmacists reserve back counts for just Schedule II substances, the growing challenges of diversion prevention and opioid stewardship make it increasingly important to perform them for other controlled substances and compounded medications as well.
However, the reality is that many pharmacies struggle to make back counts a consistent part of their workflow. The most common barrier? Time.
With the recent wave of pharmacy closures, those that remain, especially independent pharmacies, are often overburdened. Cumbersome manual workflows can’t keep pace with increased patient volume. Even when teams do find the time, paper logbooks and other outdated methods increase the risk of human error and make it difficult to maintain accurate, organized records.
Despite these challenges, many pharmacies continue to prioritize back counts, not just for compliance, but to better serve and protect their communities.
Why Back Counts Are Worth the Effort
The return on investment for doing regular back counts is substantial. Under the Controlled Substances Act (CSA), violation fines are climbing sharply. Over the last 9 years, fines have increased by 28% and are showing no signs of slowing down. As of July 2025:
- Record-keeping violations cost $19,246 per occurrence
- Prescription violations can reach $82,950 per occurrence
Beyond the financial risk, these violations can lead to legal action, license suspension, reputational damage, and worst of all: harm to the local community.
Back counting helps address operational issues before they happen by reconciling inventory in real time, eliminating the need to dig through months or years of records during an audit. This proactive approach saves both time and resources while keeping your pharmacy audit-ready.
Even more importantly, back counts protect your community and staff. Opioid stewardship is now a core responsibility for pharmacies, and early detection of errors or discrepancies is critical. A single missed mistake can quickly escalate into a serious diversion incident. By taking just a few minutes to run back counts after transaction, you can safeguard your controlled substances, ensure compliance, and maintain peace of mind.
How C2 Keep Makes Back Counts Simple and Reliable
C2 Keep is your all-in-one controlled substance compliance solution designed to ensure back counts are seamless and stress-free with features such as:
- Customizable Protocols: Choose which activities and schedules require back counts, including damaged/expired medications, lost/stolen items, wholesaler returns, reverse distributor sales, wasted/destroyed drugs, compounded preparations, and amended transactions.
- Automated Alerts: For every transaction type you indicate requires a back count, C2 Keep prompts staff to conduct it right away and resolve any discrepancies, ensuring no step is skipped or forgotten over time.
- Organized Recordkeeping: All back counting data is stored electronically in the cloud in a secure, easily accessible format, so you’re prepared for unexpected DEA inspections or audits.
By replacing manual processes with C2 Keep, pharmacies can save up to 25 hours per month, the equivalent of about $15,000 annually in labor costs, while eliminating the inefficiencies and risks of paper logbooks.
The Bottom Line
As CSA fines continue to climb and regulations like the Drug Supply Chain Security Act (DSCSA) transform the retail pharmacy landscape, manual workflows are quickly becoming outdated and unsustainable. performing regular back counts remains one of the simplest yet most effective safeguards for protecting your inventory, your team, and your patients. With the opioid crisis still posing a serious threat, pharmacies play a critical role in leading the nation toward recovery. By proactively adopting tools and processes that strengthen safe dispensing workflows, pharmacies can not only prevent costly compliance issues, they can help save lives.
With C2 Keep, independent pharmacies can integrate back counting into their daily operations effortlessly, making compliance a built-in habit rather than a burdensome task.
Make back counting part of your standard dispensing protocol
Schedule a free demo with C2 Keep CEO Roland Achenjang and see how we can help your pharmacy save time, reduce risk, and stay audit-ready year-round.
