Apparatus and methods relating to a metered pill dispensing system are disclosed herein. A preloaded cartridge having multiple compartments containing dispensable contents, such as pills, is inserted into a cassette. The cassette has an actuatable member, such as a film or a belt, wrapped around it. The actuatable member has apertures through which the contents of the preloaded cartridge may pass. The actuatable member may be controlled to meter the dispensing of the contents.