Cost estimation of redispensing unused medicines that are returned to the pharmacy: A micro-costing study

Abstract

Background and Objective: Redispensing of unused medicines returned to the pharmacy by patients may optimise the use of health care resources and reduce medication waste. Little is known about the costs associated with the pharmacy proceedings for redispensing, and which medicines might be eligible for redispensing from a cost-perspective. The objective of this study was to estimate the cost of the redispensing process in the pharmacy and the minimal economic value (MEV) of unused medicines that are eligible for redispensing. Setting and Method: A micro-costing study was performed in four outpatient pharmacies in the Netherlands in 2016. First, all proceedings and resources needed for redispensing were identified from pharmacist reviews. Second, the time required to redispense unused medicines was measured by simulating the proceedings in each pharmacy. Third, time measurements were quantified into costs using salary scales and purchasing prices. Lastly, a model was made to calculate the MEV for medicines requiring room or cold storage. Influence of assumptions (market prices, proportion of dispensed medicines returned to the pharmacy and proportion of medicines eligible for redispensing) was assessed using sensitivity analysis. Main outcome measures: Measured time and related costs associated with performing the proceedings of redispensing medicines in the pharmacy, and the MEV for medicines requiring room or cold storage. Results: Redispensing medicines in the pharmacy require that an (electronic) system is dispensed with the medicines that assure proper home storage. This requires extra handling, which takes approximately 6.30 min for medicines requiring room temperature storage and 8.05 min for medicines requiring storage between 2 and 8 °C. Estimated costs amounted to respectively €5.95 and € 106.00 (due to additional resources needed for quality control like temperature chips). The MEV for room temperature stored medicines eligible for redispensing is €94 and for cooled stored medicines €201. Sensitivity analysis showed that the proportion of dispensed medicines returned to the pharmacy has the strongest influence on the MEV. Conclusion: Redispensing unused medicines in the pharmacy is not time consuming, however, only expensive medicines are eligible for redispensing from a cost perspective. Most costs are made with medicines' dispensing as only a small proportion of dispensed medicines are returned to the pharmacy.