April 30th is National Take Back Day in the US. Take back events encourage consumers/patients to return unused medicines that are lying around their homes to pharmacies, so that they can be disposed of properly. This reminded me of a recent experience that troubled me enormously.
Last Friday, as usual, I popped into my local pharmacist to pick up my partner's repeat prescriptions. Infuriatingly, for the umpteenth time, the contents of the bag contained two prescriptions that he has not required for at least 12 months. Despite cancelling these numerous times by telephoning or visiting the doctor's surgery in person, the boxes of unneeded pills appear in the bag every month. On trying to return the unopened boxes of pills to the pharmacist - I hadn't even left the premises - I was informed that they would be disposed of as, once dispensed, they cannot be reused. Even if the boxes and packaging are unopened and obviously brand new, the medicines must be destroyed. I was flabbergasted - what a terrible waste of valuable resources. And this led me to thinking - what is the actual cost of unused medicines?
I was shocked to find that in a 2010 report, the cost of unused medicines to the NHS was estimated to be a staggering £300 million each year.1 This estimate includes approximately £110 million worth of medicines returned to pharmacies, £90 million worth of unused prescriptions being stored in homes and £50 million worth of medicines disposed of by care homes. What's worse is that, in a system which is so resource constrained, £300 million could provide:
11,778 more community nurses or 19,799 more drug treatment courses for breast cancer or 80,906 more hip replacements or 101,351 more knee replacements 300,000 more drug treatment courses for Alzheimer's or 312,175 more cataract operations.2 Similar assessments of medicines wastage have been conducted in other parts of the UK.3 In Wales, more than 250 tons of out-of-date, surplus and unused medicines are returned to dispensing General Practitioner (GP) surgeries and pharmacies annually, amounting to a cost of approximately £50 million. The annual cost of unused medicines in Northern Ireland and Scotland is estimated to be £2.5 million and £44 million, respectively.
However, this issue is not localised to the UK and studies have been conducted in a number of developed markets including the US, Switzerland and New Zealand. A recent US study, conducted in the summer of 2015, assessed the cost...