Unused medicines returned to community pharmacy: An analysis of medication waste and possibilities for redispensing

Abstract

Background and objective: Unused medicines represent possible avoidable healthcare expenditures and threaten the environment. Decreasing medication waste is warranted and the redispensing of unused medicines might be an option to reduce this waste. The aim of this study is to determine the proportion of returned medicines that is considered as medication waste, and the proportion of medicines that is eligible for redispensing. Setting and method: We conducted a cross-sectional study in 41 Dutch community pharmacies. Individuals returning medicines during five consecutive working days were asked to complete a questionnaire on characteristics of the medicine and reasons for returning. Medicines were considered as unnecessary waste if the leftover medicines could have been prevented. Medicines were defined as potentially eligible for redispensing if the package was unopened, undamaged and the expiry date was at least 6 months after the moment of returning. The economic value was calculated using Dutch medicine prices. Descriptive statistics were used. Main outcome measures: The proportion of returned medicines that is considered as medication waste and the proportion that met the criteria for redispensing. Results: Data from 279 persons returning 759 medicines to the community pharmacies was collected. On average, an individually returned medicine had a median value of €1.75. The tree most expensive medicines were methylphenidate 54 mg, €180.00, ketensin 20 mg, €196.56 and ondansetron 16 mg, €482.80. 300 (39.5%) returned medicines were considered as unnecessary waste. 145 medicines of all returned medicines could potentially be redispensed (19.1%), with a median value of €4.56 per individual returned medicine. Within the group of medicines that were eligible for redispensing, the main reason for returning the medicine was the decease of the patient (30.3%). Conclusion: A substantial proportion of medication waste in the community pharmacy could have been prevented. Unused medicines in the community pharmacy are generally of low economic value, making it unlikely that the costs that pharmacies will make with the redispensing of unused medicines will be covered. Therefore, other actions to decrease medication waste in the community pharmacy, such as preventing that too much medicines are dispensed, should be considered.