Medicine Wastage Research Articles

Returned medicines in community pharmacies of Barcelona, Spain

To monitor the amount of unused drugs and the cost to the public health system. Setting A random sample of community pharmacies in Barcelona, Spain. Method The drugs were collected from 38 community pharmacies over a period of 7 consecutive working days (excluding Sundays). A questionnaire was designed to evaluate each returned medicine. The resulting data were analyzed and evaluated. The number of drugs collected at the pharmacy, the characteristics of the clients and the reasons why they returned the drugs, and finally the economic value of the drugs returned and the cost to the public health system. A total of 227 clients (54.6% women, 64 +/- 20 years-old) returned 1,176 packages to the pharmacy. The number of packages collected in one return ranged from 1 to 121. The number of packages collected per pharmacy ranged from 0 to 188. In more than half of the cases (52.4%) the patients returned their drug in person and in 32.2% of the cases a relative returned it on their behalf. The main reason (28.2%) why drugs were returned was the expiry date. In 24.9% of the cases the patient's condition had improved and there was no further need for the drug. In 20.8% the patient had died. The estimated total cost of the collected drugs was euro8,539.9. Over 75% of this amount (euro6,463.9) had been paid by the public health system. This study confirms the importance of analyzing the return of unwanted medicines to reduce unnecessary health expenditure. It also highlights the inadequacies of the Spanish health system in the areas of prescription, dispensing and use of medicines. Establishing strategies to reduce the wastage of unused medicines is necessary.

Unnecessary Medicines Stored in Homes of Patients at Risk of Medication Misadventure

ABSTRACTBackgroundThe storage of unnecessary medicines poses safety concerns including patient confusion, inappropriate medication use and unintentional ingestion by children. Consumer storage and wastage of medicines is of concern to health practitioners and the Australian government.AimTo describe, quantify, establish safety concerns, and estimate the cost of unnecessary medicines stored in patients' homes.MethodPatients discharged from two hospitals in 2002 who were part of a study of a community liaison pharmacy service, had their unnecessary medicines removed (with permission) during the home visit. Details of removed medicines, including costs, were recorded and analysed.ResultsA mean of 4.6 medicines/patient (range 1–21) that had expired or no longer required were removed from the homes of 85 patients. A quarter of the items had expired at the time of collection. There were significant alterations to, or deficiencies in, the removed medicines. The mean cost of medicines removed was $65/patient.ConclusionPatients place themselves at increased risk of medication misadventure by storing unnecessary medicines in their homes. As well as creating risks to the safety of patients and children, this practice results in wastage of health resources.

Daily cost of beta-adrenergic blocker therapy.

To evaluate the daily cost of beta-blocker therapy among commercially available products. Ten different beta-adrenergic blocker preparations, each in 10-mL bottles (except Timoptic-XE [Merck brand of timolol maleate gel-forming solution], which was in a 5-mL bottle), were acquired from a local pharmacy. Each of 10 subjects dispensed 10 drops from each bottle onto an analytical scale. The mean drop volume for each preparation was then calculated. The fill volume of each bottle and the amount of each medicine that was wasted upon dispensing also were determined. Additionally, 60 pharmacies in the United States were randomly chosen to determine the average cost of each preparation studied. Based on all data obtained, an average daily cost of each medicine was calculated. The generic formulation of timolol maleate (Falcon) ($0.55) and Betimol (Ciba Vision Ophthalmics brand of timolol hemihydrate) ($0.57) demonstrated the lowest cost per day of therapy. In contrast, Betoptic-S (Alcon brand of betaxolol hydrochloride) ($1.60) and Betagan (Allergan brand of levobunonol hydrochloride) ($1.35) had the highest daily cost of therapy. Ocupress (Otsuka America brand of carteolol hydrochloride) had the smallest drop volume (31 microL) and Timoptic-XE had the highest (49 microL). Most preparations were close to their stated bottle fill volume. The amount of wasted medicine varied and was least with Ocupress (27%) and greatest with Betoptic-S (54%). The mean pharmacy price for a 10-mL bottle was lowest for OptiPranolol (Bausch & Lomb brand of metipranolol) ($25.51) and Betimol ($28.28); Betoptic-S ($44.80) and Betagan ($43.67) were the most expensive. Although all commercially available beta-adrenergic blockers effectively lower intraocular pressure, one differential factor between medicines is cost, which may be influenced by the price at the pharmacy, volume of medication per bottle, drop size, and medicine wastage.