Nelson pharmacies collect 200kg of unwanted medicines

07 July 2010

BY RAJESH KUMAR

More than 200kg of  medicines were returned by the residents of Nelson Bays during a campaign to dispose of unwanted medicines through pharmacies.

Salazopyrin, the anti-inflammatory medicine used to treat rheumatoid arthritis, ulcerative colitis and Crohn’s disease, topped the list of 866 different types of medicines returned. The total cost of returned medicines was about $82,000.

A detailed report on the campaign, run by Nelson Bays Primary Health (NBPH) during November 2009, has just been released analysing various types of medicines returned, reasons for their return, their cost and the wider health implications.

The report also makes 11 recommendations to Nelson Marlborough DHB to reduce waste and support prescribers, pharmacists and patients to utilise medicines more effectively.

The returned medicines included 1857 asthma inhalers worth $15,537, or around 18% of the value of all returned medicines. This suggests problems with compliance as hospitalisations due to complications of uncontrolled asthma are among the major health issues facing the local DHB.

NBPH pharmacy facilitator Caroline Allen quotes the report saying 61% of medicines were returned due to a change in the medicine treatment or condition, as reported by patients or their whanau, 32% were returned due to an excess stock /clean out/ bereavement, and 7% were returned due to an adverse drug reaction.

Of the total medicines returned, 21% if items were dispensed within one year (Sept 2008-2009) and a further 6% were dispensed within two years (Sept 2007-2008). The oldest medicine returned was a bottle of morphine that was dispensed in 1958.

The most expensive medicine returned was two injections of adalimumab (Humira) on Special Authority, costing $1799.92 each.

Some of the 11 recommendations are:
• Collaborative approach to reducing medicine wastage, with prescribers and pharmacists educating patients about their medicines, the risk/benefit of treatment and improving compliance. Patient education should focus on addressing the reasons why medicines are wasted in the first place.

• A more “pharmacist-friendly” process for returning unwanted medicines to Nelson Hospital or a central location for analysis. Pharmacists may be more willing to accept returned medicines and ensure appropriate disposal if a more acceptable arrangement is in place. The public will know they can return unused medicines to pharmacy any time, not just during the DUMP campaign.  

• Ongoing analysis of returned medicines to see if the results are repeatable and identify if trends are developing. Also, see if steps taken to reduce wastage are working.

• Future DUMP campaign’s access to pharmacy management systems to aid the identification and pricing of medicines as part if the process.

• The support of MURs by Nelson Marlborough DHB will assist pharmacists to target patients on respiratory inhalers to educate them about and increase their compliance with these medications,
potentially reducing medicine wastage and avoidable hospitalisations.

• Consider extending sharps disposal service to at least some pharmacies to support the safe disposal of sharps.

Nelson Marlborough DHB’s Mark Garisch terms the report an important piece of work that gives the DHB an insight into the kind of medicines being returned by patients in the bays region.

As a result of the report, he says the DHB is considering funding for a limited but ongoing DUMP campaign in the whole of Nelson Marlborough district.

“We may first run the programme through selected pharmacies in the region and see how it goes, before expanding it district wide,” he says.

As for the number of inhalers not being used, he says the DHB is realigning its asthma services to ensure patients know how to use their inhalers properly and seek appropriate help if they have any issues.

NBPH general practice programme coordinator Margaret Gibbs says her PHO has a close relationship with the Nelson Asthma Society and asthma educators will be notified of the results so they may work closely with a pharmacy facilitator to target wastage of inhalers/ their compliance.

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Mark Thursday, July 08, 2010 We have just thrown out over 100kg in approx 16 boxes that were returned between Dec and June. In some cases there were over $5000 worth from 1 customer. We have sent about 50kg to overseas aid and the rest were just dumped. We have taken photos if you ever need evidence of the value people place on medicine. Because they see them as Cheap they are happy to pay $3 just in case they need them. Increase the charges and they will place a value.

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