Time-temperature Indicators Research Articles

Highly Efficient Manganese Bromides with Reversible Luminescence Switching through Amorphous-Crystalline Transition.

While luminescent stimuli-responsive materials (LSRMs) have become one of the most sought-after materials owing to their potential in optoelectronic applications, the use of earth-scarce lanthanides remains a crucial problem to be solved for further development. In this work, two manganese-based LSRMs, (R)-(+)-1-phenylethylammonium manganese bromide, (R-PEA)2MnBr4, and (S)-(-)-1-phenylethylammonium manganese bromide, (S-PEA)2MnBr4, are successfully demonstrated. Both (R-PEA)2MnBr4 and (S-PEA)2MnBr4 show a kinetically stable red-emissive amorphous state and a thermodynamically stable green-emissive crystalline state at room temperature, where the fully reversible transition can be done through melt-quenching and annealing processes. Based on this property, a reusable manganese-halide-based time-temperature indicator is demonstrated for the first time. Furthermore, an X-ray scintillator with a low limit of detection (18.1 nGy/s) and a high spatial resolution limit (30.0 lp/mm) are achieved by exploiting the high transparency of amorphous states. These results uncover the multifunctionality of manganese halides and pave the way for upcoming research.

Environmental Outcomes of Reducing Medication Waste by Redispensing Unused Oral Anticancer Drugs

Medications are associated with substantial environmental outcomes, yet frequently end up being unused by patients. Waste-minimizing interventions, such as redispensing of quality-approved oral anticancer drugs remaining unused by patients at home, could reduce the environmental footprint of cancer treatment. To assess the environmental outcomes of redispensing quality-assured oral anticancer drugs and to explore how redispensing could be environmentally optimized. In this quality improvement study, a cradle-to-grave life cycle assessment was performed in the outpatient pharmacy of 4 Dutch hospitals, based on a prospective multicenter trial comprising 1071 patients with a clinical diagnosis of cancer and an active prescription for an oral anticancer drug stored at room temperature from February 1, 2021, to February 1, 2023, with a follow-up of 12 months per patient. Participants received prescribed oral anticancer drugs with additional quality-assurance materials (ie, seal bags and time-temperature indicators), so the pharmacy could redispense quality-assured drugs based on authenticity, appearance, remaining shelf life, and/or adequate storage. The estimated environmental outcomes avoided due to waste reduction (ie, production and transport and incineration of redispensed oral anticancer drugs) corrected for outcomes of process burdens (ie, quality assurance materials), quantified in 3 outcome measures: human health damage (disability-adjusted life-years), ecosystems damage (species × year), and climate change (kg of carbon dioxide equivalent [CO2-eq]) per patient per year. A volunteer sample of 1071 patients (median age, 70 years [IQR, 62-75 years]; 622 men [58.1%]) participated in the intervention. Redispensing oral anticancer drugs was initially associated with an environmental burden, mainly because of the high impact of time-temperature indicators. However, when quality-assurance materials were selectively used for temperature-sensitive oral anticancer drugs (ie, maximum storage temperature of 25 °C), redispensing was environmentally beneficial to human health and ecosystems, providing estimated climate benefits of 1.9 kg (95% CI, 1.4-2.6 kg) of CO2-eq per patient per year. In this quality improvement study, redispensing unused oral anticancer drugs was found to be a suitable strategy to reduce waste and improve environmental sustainability of cancer treatment after process optimization. Redispensing unused oral anticancer drugs could contribute to sustainability of cancer treatment through reduced costs and environmental outcomes.

A novel and facile oxygen-activated time-temperature indicator with wide temperature monitoring range and good stability based on the laccase-like nanozyme

BackgroundTime-Temperature Indicator (TTI) is an indicator device for real-time monitoring of the thermal history of the product. Due to the enzymatic reactions are affected by both time and temperature, enzymatic TTIs have been extensively studied and developed in recent years. However, enzymatic TTIs contain biologically active molecules (enzymes), which require high storage and use conditions. Most of them are designed to mix the system species together and irreversible reaction is undertaken. Nanozymes are the synthetic nanomaterials with similar biocatalytic functions as natural enzymes, which have extensive applications in analytical chemistry, biosensing, and environmental protection due to their facile synthesis, low cost, high stability and durability. ResultsThis work proposed to replace the natural laccase to laccase-like nanozyme, designed a novel and facile O2-activated time-temperature indicator for the first time. Nanozyme had excellent thermal and storage stability, which could maintain fabulous catalytic activity in the wide temperature range of 10–80 °C and after a long-term storage. Based on the O2 was required to participate in the oxidation of laccase-catalyzed substrates, a squeeze-type O2-activated TTI was designed by controlling O2 in the TTI system. The TTI was activated through extruding the O2-coated airbag ruptured and producing an irreversible color reaction. Combined with a smartphone to extract the chromaticity for portable visual real-time monitoring. Five sets of TTIs were prepared based on the concentration of nanozyme, and the activation energies (Ea) ranging from 28.45 to 72.85 kJ mol−1, which were able to be fitted to products with Ea ranging from 3.45 to 97.8 kJ mol−1 and the monitoring-time of less than 7 days. SignificanceCompared to the traditional enzymatic TTI, the TTIs designed based on nanozyme has the advantages of controlled activation, wider temperature monitor range and good stability. Providing a new approach to the development of real-time monitoring of smart devices.

Colorimetric polymer nanofilm-based time-temperature indicators for recording irreversible changes of temperatures in cold chain

Monitoring and recording subzero temperatures and humidity are essential activities for pharmaceutical, food-beverage, and cold storage industries, as product quality can be hampered during storage and transportation due to temperature disruptions. Traditional electronic subzero time-temperature indicators (TTIs) can be energy-inefficient, fragile, non-recyclable, and susceptible to data breaches and cyber-attacks. Hydrophilic colorimetric polymer nanofilms have been developed as colorimetric temperature and relative humidity (RH) sensors, however, the reversible color-changing behavior of these films significantly limited their application as TTIs, as cannot record temperature changes in the past. Herein, the first colorimetric polymer nanofilm-based TTI for recording an irreversible change of temperatures is reported. This device has shown quick color response in temperature ranges from 23 °C to -30 °C in fewer than 50 s. Remarkably, when the device experiences temperature disruption above a certain threshold time (tth), it shows irreversible color-changing behavior in response to the temperature change from subzero (-30 °C and -15 °C) to room temperature or above. It was demonstrated that tth, from minutes to days, of the TTI device can be precisely tuned by adjusting moisture absorber type and weight, interior RH, and storage temperature. Several field tests have demonstrated good versatility and applicability of the device.

Self-Regulated Assembly and Disassembly of Gold Nanoparticles for Low-Temperature Time Indication.

The color-changing self-assembly and autonomous disassembly of colloidal gold nanoparticles (AuNPs) is reported by simply mixing negatively charged phosphine ligand-capped AuNPs with partially oxidized polyethylene glycol (PEG). The assembly of AuNPs is initiated by PEG adsorption, which disrupts the hydration layer of AuNPs, leading to depletion attraction and reduction of hydration repulsion among the AuNPs. The oxidative species in PEG subsequently oxidize and remove the charged ligands from the AuNP surface, resulting in a decrease and reversal of the negative surface charge. This causes the PEG to adsorb on AuNPs in a tighter and more direct manner, providing strong steric shielding to the AuNPs, thereby triggering the disassembly of the AuNP assemblies. The self-regulated assembly-disassembly process can be tuned widely by controlling chemical conditions of PEG, nanoparticle concentration, and the environmental conditions, suggesting potential applications as colorimetric time-temperature indicators for food and medicine storage conditions. As a proof of concept, it is demonstrated that the lifetime of the color-changing assembly-disassembly process can be extended from tens of minutes to weeks when subjected to a refrigerated environment, with tunability achievable through varying polymer conditions and storage atmospheres.

Exploration and application prospect of the advanced technology of time–temperature indicators

The time–temperature indicator (TTI) is a kind of indicator that can monitor the safety of food, drugs and other products. It produces the cumulative effect of time–temperature through physical and mechanical deformation, chemical or biological reaction, and makes an irreversible and obvious color change, so as to record the temperature change course experienced by products. This review details the selection and characteristics of TTI materials in the last 15 years. The classification of TTIs, such as enzyme type, chemical type, microbial type, diffusion type, nanomaterial type and Maillard type, self-healing type and electronic type, are described in detail. Finally, the application of TTIs in various kinds of food packaging, such as meat products, aquatic products, fruits and vegetables and dairy products, is emphatically studied. This review provides ideas for the further improvement and research of TTIs, and provides a reference for the performance of TTIs in other commercial fields.

Assessing refrigerated preservation performance using Listeria predictive microbiology models and temperature data: Refrigerator performance indicator and time-temperature equivalent.

Time-temperature data for queso fresco (QF) cheese varieties stored in a residential refrigerator operating at 5°C and a predictive microbiology secondary model for Listeria monocytogenes in QF were used to estimate a refrigerator performance indicator (RPI) of microbial preservation. RPI values were used to assess how compressor technology (single [SS] and variable speed [VS]), ambient temperature (21.1°C [LT] and 32.2°C [HT]), and refrigerator load (22.5kg regular load and 39kg higher load) affected preservation performance. All deterministic and probabilistic RPI estimations slightly exceeded the desirable 1.0 value, i.e., the variable temperatures for the QF kept in the refrigerator were worse than keeping it constantly at the temperature recommended by food safety agencies for QF. Furthermore, the mean comparison of estimates of the time-temperature equivalent indicator previously developed by French researchers showed similar behavior to those observed for RPI. Finally, statistical analysis showed that Tambient was the factor with the highest impact on refrigerator performance because of its impact on the sample temperature increase during door openings and when exposed to ambient temperature during product use. This highlights the need to reduce the time for product temperature recovery by improving the compressor operation logic. Also important are consumer behavior changes such as a reduction in product exposure to ambient temperature and in the door opening duration and frequency. PRACTICAL APPLICATION: This study demonstrated how a quantitative tool (RPI) can assess refrigerator preservation performance. Although the findings presented can be applied to any cold chain segment, the data used was collected for its weakest link, the domestic refrigerator. Surveys show that 77% of them operate above the recommended 4°C. The RPI methodology is ready for use by refrigerator designers to assess performance improvements possible by modifications of the compressor operation logic. Moreover, it can be integrated into smart-hubs monitoring the frequency and duration of refrigerator door openings to inform consumers when their habits are compromising the preservation performance of the refrigerator.

Influence of biodegradable polymer films on conformation of polydiacetylene–silver nanocomposites as colorimetric time–temperature indicators

Time–temperature indicators (TTIs) are used to monitor the quality of packaged products by providing a visual indication of product deterioration due to time and temperature during transportation, storage, and distribution. This study aimed to investigate the effect of biodegradable polymer films on the limits of the color change mechanism in polydiacetylene. TTIs were prepared using biodegradable polymer films based on carboxymethyl cellulose, polyvinyl alcohol (PVOH), chitosan, and carboxymethyl chitosan (CMCh) with thermochromic properties provided by silver nanoparticles–polydiacetylene (10 % w/w AgNP–PDA). Vesicle and core–shell structures of AgNP–PDA appeared in the chitosan- and PVOH-based films owing to the effects of functional groups in the base polymer. Total color difference measurements indicated that the AgNP–PDA-containing films exhibited color changes in response to storage at 35 ℃ for a total of 14 days. Specifically, the AgNP–PDA in the chitosan- and PVOH-based films produced noticeable color changes from blue to reddish-purple or reddish-brown, respectively, which was influenced by the core–shell structure of AgNP–PDA embedded in the base polymer. The developed films are very promising for applications as TTI devices for tracking fresh products, supported by the compatibility of activation energy (Ea) from 29 to 79 kJ/mol.

Evaluation of Methylene Blue Migration from Time-Temperature Indicators Using LC-MS/MS.

The purpose of this study was to evaluate and validate methylene blue migration from printed time-temperature indicators (TTIs) into food. It also highlights the importance of establishing regulatory measures and safety standards for food packaging, suggesting that this can contribute to improving food packaging safety. Liquid chromatography-mass spectrometry (LC-MS/MS) was used to quantify methylene blue migration in various food simulant and food matrix samples. The results show that the level of methylene blue migration varies significantly depending on the chemical properties of the food mimetic and the composition of the food matrix. The established method demonstrated a high sensitivity, with limits of detection (LODs) of 0.0019-0.0706 μg/L (kg) and limits of quantification (LOQs) of 0.0057-0.2138 μg/L (kg). This study highlights the need for a regulatory framework to mitigate the health risks associated with methylene blue in intelligent packaging systems and argues that regulatory thresholds should be set to ensure food safety and quality.

Advancements in Predictive Microbiology: Integrating New Technologies for Efficient Food Safety Models.

Predictive microbiology is a rapidly evolving field that has gained significant interest over the years due to its diverse application in food safety. Predictive models are widely used in food microbiology to estimate the growth of microorganisms in food products. These models represent the dynamic interactions between intrinsic and extrinsic food factors as mathematical equations and then apply these data to predict shelf life, spoilage, and microbial risk assessment. Due to their ability to predict the microbial risk, these tools are also integrated into hazard analysis critical control point (HACCP) protocols. However, like most new technologies, several limitations have been linked to their use. Predictive models have been found incapable of modeling the intricate microbial interactions in food colonized by different bacteria populations under dynamic environmental conditions. To address this issue, researchers are integrating several new technologies into predictive models to improve efficiency and accuracy. Increasingly, newer technologies such as whole genome sequencing (WGS), metagenomics, artificial intelligence, and machine learning are being rapidly adopted into newer-generation models. This has facilitated the development of devices based on robotics, the Internet of Things, and time-temperature indicators that are being incorporated into food processing both domestically and industrially globally. This study reviewed current research on predictive models, limitations, challenges, and newer technologies being integrated into developing more efficient models. Machine learning algorithms commonly employed in predictive modeling are discussed with emphasis on their application in research and industry and their advantages over traditional models.

Colorimetric Quick Response (QR) Tags and Other Time-Temperature Indicators (TTIs) for Remote Quality Assessment: Theoretical Kinetics Aspects

Colorimetric Quick Response (QR) Tags and Other Time-Temperature Indicators (TTIs) for Remote Quality Assessment: Theoretical Kinetics Aspects

Cold and ultra-cold chain integrity monitoring via embedded resonant sensor indicators

An increasing number of products require transport at cold and ultra-cold temperatures, < 5 and −60°C respectively. Time-temperature indicators (TTIs) are used to monitor the integrity of the cold chain, however, they are frequently based on colorimetric changes that can be inaccurate for quantification and not possible to read through closed shipment materials. Here, TTIs were prototyped using microfluidic channels containing fluids (oils) that are tuned to melt above target temperatures. By coupling these TTIs to resonant sensors, the time-temperature information can be transmitted wirelessly and quantitatively by observing shifts in resonant frequency. Multiplexed TTIs containing fluids that melt at 9, 13.5, and 19.5°C are demonstrated. When coupled to the resonant sensor, the fluid flows as the temperature increases incrementally and generates a frequency shift of 3.5, 4.5, and 6 MHz at each threshold. TTI for ultra-cold environments were also designed using microfluidic channels with melt responsive fluids (ethanol). The resonant sensor coupled TTI was placed in a Styrofoam container containing dry ice, and over 1 MHz frequency shift is observed when read external to the container as the dry ice evaporates and the temperature exceeds −35°C. This augurs potential uses in inexpensive monitoring of food and pharmaceutical shipments that must remain cold for adequate quality.

Time-temperature indicator of hydroxyethyl cellulose ink labels for assessing pork freshness

Pork is widely consumed worldwide, and many consumers now utilize sensory evaluation techniques to determine the freshness of pork when buying it. A color-changing ink label utilizing bromocresol purple (BCP) and N-hydroxyphthalimide (NHPI) had been created to help consumers better and more rapidly determine the freshness of pork while it is stored. The ink was easy to prepare and could be readily transferred to A4 paper using screen printing technology. This study delved deeper into the impact of hydroxyethyl cellulose (HEC) on the functional properties of inks to enhance printing performance. The experiment demonstrated that a 1 % mass fraction of HEC improved thixotropy and facilitated the even distribution of ink on A4 paper, as confirmed by scanning electron microscopy. Screen-printed labels with varying concentrations displayed distinct color change rates when stored at different temperatures, indicating their capability to assess pork freshness. FT-IR, laboratory, and stability tests verified the ink's exceptional color change capabilities and printing attributes. An analysis using the Arrhenius equation revealed a substantial synergistic effect between BCP and NHPI, resulting in improved sensitivity and accuracy of the ink. This study offers a practical and feasible method to monitor the storage quality of pork effectively.

Robust, Ultrafast and Reversible Photoswitching in Bulk Polymers Enabled by Octupolar Molecule Design.

Improving the photoswitching rate and robustness of photochromic molecules in bulk solids is paramount for practical applications but remains an on-going challenge. Here, we introduce an octupolar design paradigm to develop a new family of visible light organic photoswitches, namely multi-branched octupolar Stenhouse Adducts (MOPSAs) featuring a C3-symmetrical A3-(D-core) architecture with a dipolar donor-acceptor (D-A) photochrome in each branch. Our design couples multi-dimensional geometric and electronic effects of MOPSAs to enable robust ultrafast reversible photoswitching in bulk polymers. Specifically, the optimal MOPSA (4 wt %) in commercial polyurethane films accomplishes nearly 100 % discoloration in 6 s under visible light with ∼ 100 % thermal-recovery in 17.4 s at 60 °C, while the acquired kinetics constants are 3∼7 times that of dipolar DASA counterpart and 1∼2 orders of magnitude higher than those of reported DASAs in polymers. Importantly, the MOPSA-doped polymer films sustain 500 discoloration/recovery cycles with slow degradation, superior to the existing DASAs in polymers (≤30 cycles). We discover that multi-dipolar coupling in MOPSA enables enhanced polarization and electron delocalization, promoting the rate-determining thermal cyclization, while the branched and non-planar geometry of MOPSA induces large free volume to facilitate the isomerization. This design can be extended to develop spiropyran or azobenzene-based ultrafast photochromic films. The superior photoswitching performance of MOPSAs together with their high-yield and scalable synthesis and facile film processing inspires us to explore their versatile uses as smart inks or labels for time-temperature indicators, optical logic encryption and multi-levelled data encryption.

Hydrogen Bond-Mediated Self-Shielded Moisture-Responsive Structural Color for Time-Temperature Indicating.

Effective monitoring of the time-temperature history of biological reagents, chemical drugs, and perishable foods during cold chain storage is crucial for ensuring their quality and efficacy. Time-temperature indicators (TTIs) are developed to assess the cumulative impact of time and temperature on product quality. However, current indicators face challenges related to complex wrapping procedures, narrow tracking ranges, susceptibility to photobleaching, and pre-use instability, hampering widespread use. Herein, the first moisture-responsive 1D photonic crystal (1DPC) TTIs featuring robust structural colors, customizable time-temperature ranges, and reliable renewability are demonstrated. The indicators exhibit distinct color-changing responsiveness toward water vapor, which remains observable after prolonged storage at low temperatures. Significantly, the moisture responsiveness gradually diminishes at elevated temperatures over time due to ambient water-induced hydrogen bond formation, effectively shielding the indicator from external stimuli. This property enables the naked-eye inspection of product efficacy during cold chain storage. Additionally, the endowed flexibility of the TTI facilitates its easy attachment to targets, functioning as a convenient indicator label. Remarkably, the indicator can be stably stored for an extended period at room temperature before use, thereby showcasing substantial market potential.

Temperature Control and Data Exchange in Food Supply Chains: Current Situation and the Applicability of a Digitalized System of Time–Temperature-Indicators to Optimize Temperature Monitoring in Different Cold Chains

The current situation of temperature monitoring in perishable food supply chains and the optimization of temperature control was studied by combining two approaches. First, a survey among German companies (production, processing, logistics, wholesale, retail) was conducted to analyze the current temperature monitoring and data management conditions as well as the use of novel monitoring systems, such as Time–Temperature-Indicators (TTIs). Second, the temperature conditions in three different supply chains (B2C for raw pork sausage, B2B for fish, B2C e-commerce for mixed products) were investigated to analyze the applicability of TTIs with an app-based read-out system to identify weak points and to optimize cold chain management under practical conditions. The results of the survey showed that mainly static conditions are tested along the supply chain. Thus, the actors rely mostly on visual inspection or best-before date labeling while TTIs are not widely used. Currently, temperature data are barely exchanged by stakeholders. In the B2C chain, mean temperatures on different pallet levels were comparable, also reflected by TTIs and the app-based read-out system, respectively. In the B2B chain, temperature interruptions during the unloading process were detected, revealing main challenges in perishable supply chains. Temperature monitoring by TTIs on a box level was possible by positioning the label close to the product. Results in the e-commerce sector showed heterogeneous conditions in different boxes depending on initial product temperatures and loading. TTIs and the app-based read-out system showed reliable results based on different temperature scenarios, when TTIs are positioned close to the most sensitive product.

Development of a microbial time-temperature indicator for real-time monitoring the quality of Australian vacuum-packed lamb

A time-temperature indicator (TTI) system based on the pH-dependent colour change caused by the growth of a Carnobacterium maltaromaticum strain was developed to specifically provide a real-time indication of quality and shelf life of Australian vacuum-packed (VP) lamb throughout cold chains. Each component of the developed TTI system was studied to select an optimal concentration of a chemical chromatic indicator (chlorophenol red, CR; between 0.01 % and 0.30 %) and supplementary glucose (between 0 % and 10 %), and an appropriate C. maltaromaticum strain (among four different strains) in a simple BHI medium. BHI medium containing 0.01 % CR and 1 % added glucose, inoculated with C. maltaromaticum strain 1 were required for development of the TTI system to indicate quality and shelf life of VP lamb. Different inoculum levels of C. maltaromaticum strain 1 (103 to 105 CFU/mL) were also examined at 8 °C for their effects on the TTI response. As expected, higher inoculum levels of C. maltaromaticum led to a shorter endpoint of the TTI system but it was found that a 3 log10 higher inoculum level in the TTI than the expected total viable counts of VP lamb was required to accurately predict VP lamb shelf life by the TTI. To further evaluate the applicability of the TTI system, we evaluated its response at two other temperatures (2 °C and 4 °C) relevant to the storage conditions for VP lamb. The data showed a strong agreement between the observed TTI's endpoints and predicted shelf lives of VP lamb. This indicated that the developed TTI has the potential to be developed further for commercial application to provide a real-time, distinct, and accurate indication of Australian VP lamb.

Intelligent food packaging for smart sensing of food safety.

In this contemporary era, with over 8 billion people worldwide, ensuring food safety has become more critical than ever. To address this concern, the introduction of intelligent packaging marks a significant breakthrough. Essentially, this innovation tackles the challenge of rapid deterioration in perishable foods, which is vital to the well-being of communities and food safety. Unlike traditional methods that primarily emphasize shelf-life extension, intelligent packaging goes further by incorporating advanced sensing technologies to detect signs of spoilage and contamination in real-time, such as changes in temperature, oxygen levels, carbon dioxide levels, humidity, and the presence of harmful microorganisms. The innovation can rely on various packaging materials like plastics, metals, papers, or biodegradable polymers, combined with sophisticated sensing techniques such as colorimetric sensors, time-temperature indicators, radio-frequency identification tags, electronic noses, or biosensors. Together, these elements form a dynamic and tailored packaging system. This system not only protects food from spoilage but also offers stakeholders immediate and adequate information about food quality. Moreover, the real-world application on seafood, meat, dairy, fruits, and vegetables demonstrates the feasibility of using intelligent packaging to significantly enhance the safety and shelf life of a wide variety of perishable goods. By adopting intelligent packaging for smart sensing solutions, both the food industry and consumers can significantly reduce health risks linked with contamination and reduce unnecessary food waste. This underscores the crucial role of intelligent packaging in modern food safety and distribution systems, showcasing an effective fusion of technology, safety, and sustainability efforts aimed at nourishing a rapidly growing global population.

Reliability of Time-Temperature Indicator From Corn and Red Palm Oil Blending For Monitoring Microbial Growth of Pasteurized Milk

Reliability of Time-Temperature Indicator From Corn and Red Palm Oil Blending For Monitoring Microbial Growth of Pasteurized Milk

Cost Savings and Waste Reduction Through Redispensing Unused Oral Anticancer Drugs

New strategies targeting waste are required to improve financial and ecologic sustainability of expensive therapies, such as oral anticancer drugs, that frequently remain unused by patients. Redispensing unused oral anticancer drugs seems to be a promising strategy when drug quality is guaranteed. To determine the waste reduction and net cost savings attained by redispensing oral anticancer drugs that go unused by patients compared with the standard practice of disposal. The ROAD study was a prospective single-group intervention conducted in the outpatient pharmacies of 4 hospitals in the Netherlands from February 1, 2021, to February 1, 2023, with 12-month follow-up of each patient. Patients with cancer and who had a prescription for an oral anticancer drug that could be stored at room temperature were included. Of 2426 eligible patients, 602 did not consent and 601 did not respond. Data analyses were performed from August 25, 2022, to April 19, 2023. Participants received oral anticancer drugs for use at home in special packaging (ie, sealed packaging with time-temperature indicator), to be returned to the pharmacy should these remain unused. The pharmacy ensured quality of returned drugs based on authenticity, appearance, remaining shelf life and adequate storage temperature. Drugs fulfilling quality requirements were redispensed to other patients. Total waste reduction and mean net annual cost savings per patient compared with the standard practice of disposal. Optimization of cost savings was explored by introducing variations in the quality assurance procedure and patient population. All analyses used the average exchange rate for 2021 €1 = US $1.18. Of 1223 patients with cancer who consented, 1071 participated (median [IQR] age, 70 [62-75] years; 622 [58.1%] were male). In all, 171 patients (16.0%; 95% CI, 13.8%-18.3%) returned 335 unused oral anticancer drug packages. Of the returned drugs, 228 packages were redispensed, which reduced waste by 68.1% (95% CI, 67.7%-68.5%) compared with the standard practice (disposal). Redispensing unused oral anticancer drugs comprised 2.4% (95% CI, 2.2%-2.5%) of total drug costs, providing mean net annual cost savings of US $680 (95% CI, $524-$837) up to $1591 (95% CI, $1226-$2002) per participant. The findings of this multicenter intervention study indicate that redispensing unused oral anticancer drugs is associated with waste reduction and cost savings, which in turn may improve the affordability and sustainability of cancer treatment. World Health Organization International Clinical Trials Registry Platform Identifier: NL9208.