Systems and methods for prescription drug packaging are described. In some embodiments, a determination that a member of a pharmacy benefit plan has had a plurality of prescription drugs previously filled is made. An adjudication request for a prescription drug prescribed for the member is received. The adjudication request is based on a fulfillment request to fill the prescription drug. A determination that a blister packaging criterion has been met may be made based on a drug type of the prescription drug and a determination that the member has had the plurality of prescription drugs that have previously been filled. A blister fill instruction is transmitted based on receipt of the adjudication request and a determination that the blister packaging criterion has been met, wherein the blister fill instruction reflects that a pharmacy is to fill the prescription drug utilizing blister packaging. Additional methods and systems are disclosed.