UK: The Cost Of Unused Medicines In The UK

Last Updated: 3 May 2016
Article by Karen Young

Most Read Contributor in UK, August 2017

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Similar assessments of medicines wastage have been conducted in other parts of the UK.3 In Wales, more than 250 tons of out-of-date, surplus and unused medicines are returned to dispensing General Practitioner (GP) surgeries and pharmacies annually, amounting to a cost of approximately £50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 of unused medicines in South Carolina using a web-based survey with 238 individuals at one health sciences institution and a paper-based survey with 68 individuals at planned drug take-back events at three community pharmacies.4 Although the sample size was relatively small, the findings of the study were startling - two out of three dispensed medications remained unused with the reasons for non-use given as:

  • improved disease or condition - 42 per cent
  • side effects - seven per cent
  • forgetfulness - six per cent.

When projected up to the national level, the estimated cost of unused medicines, borne largely by private medical insurers, were alarming and ranged from $2.4 billion for elderly patients taking five prescription medications, to $5.4 billion for the 52 per cent of the US adult population taking one prescription medication a day. However, there are other risks which potentially outweigh the direct financial cost of unused medicines.

The clinical impact of medicines going unused for patients with chronic conditions requiring long-term, continuous maintenance such as hypertension, diabetes, cholesterol, heart disease and mental health problems are potentially huge. These all require effective management to prevent symptoms from escalating and complications developing. By not taking their medication, patients are compromising the effectiveness of their treatment, which can impede improvement or result in deterioration in health. Some potential knock-on effects for the health care systems are increased demand on hospitals and GP surgeries.

Disappointingly, according to a report published in 2003 by the World Health Organisation (WHO), adherence to long-term therapies for chronic illnesses in developed countries is around 50%.5 In developing countries rates are even lower. In the UK the Aston Medication Adherence Study (AMAS), conducted by Aston Pharmacy School, examined levels of non- or low adherence in patients with dyslipidaemia, type 2 diabetes and or hypothyroidism, living in the Heart of Birmingham.6 The analysis was based on over a million anonymised prescriptions, more than 7,000, mailed patient questionnaires and seven focus groups, plus a literature review. In line with the US study findings, the researchers identified that a quarter to a third of patients were non-adherent. When considering the cost, extrapolating to the national population, they estimated that non-adherence is likely to be costing the NHS more than £500 million a year.

Most compelling of all, a recent US Food and Drug Administration (FDA) announcement highlighted the devastating effects of unused medicines to families and people visiting their homes.7 Over the last 20 years, 12 incidents of hospitalisation and, devastatingly, 12 deaths have been caused by accidental exposure to the powerful pain medications found in fentanyl patches. Most of these occurred in children under two years of age.

Although a US based initiative, National Take Back Day provides an opportunity to reflect on what you can do to help reduce the impact of unused medicines in the UK. There are a number of easy ways to play your part, and I'd encourage you to read the Medicines Waste UK campaign website. But, if you don't have time, here are three simple steps:

  1. Only order the medicines that you need - let your GP or Pharmacist know if you've stopped taking your medicine, hopefully unlike me, this will be straightforward!
  2. Remember that unused medicines cannot be recycled – don't be under the misconception that if you take an unopened box of pills back, they can simply be given to the next patient.
  3. Keep unused medicines out of the way - don't stockpile and keep them away from children.

Footnotes

1 Evaluation of the Scale, Causes and Costs of Waste Medicines, York Health Economics Consortium and School of Pharmacy, University of London, 2010. See: http://discovery.ucl.ac.uk/1350234/1/Evaluation_of_NHS_Medicines_Waste__web_publication_version.pdf

2 Only order what you need, Medicines Waste UK. See: http://www.medicinewaste.com/didyouknow

3 Patient Liaison group: Dispensed but unopened medicines, British Medical Association website, accessed 27 April 2016. See: http://www.bma.org.uk/about-the-bma/how-we-work/professional-activities-and-special-interest/patient-liaison-group/dispensed-but-unopened-medications

4 Taking stock of medication wastage: Unused medications in US households, Anandi V. Law et al, Research in Social and Administrative Pharmacy, vol 11, Issue 4, p571-578, July–August 2015. See: http://www.sciencedirect.com/science/article/pii/S1551741114003337

5 Adherence to long-term therapies: Evidence for action, World Health Organisation, 2003. See: http://www.who.int/chp/knowledge/publications/adherence_introduction.pdf?ua=1

6 Drug non-adherence "costing NHS £500M+ a year", Lynne Taylor, PharmaTimes Digital, February 19 2013. See: http://www.pharmatimes.com/Article/13-02-19/Drug_non-adherence_costing_NHS_£500M_a_year.aspx

7 National Drug Take Back Day: A Great Time to Dispose of Prescription Medications Cluttering Your Cabinets, Douglas C. Throckmorton, M.D, FDA Voice, April 25, 2016. See: http://blogs.fda.gov/fdavoice/index.php/2016/04/national-drug-take-back-day-a-great-time-to-dispose-of-prescription-medications-cluttering-your-cabinets/?source=govdelivery&utm_medium=email&utm_source=govdelivery

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Authors
 
In association with
Up-coming Events Search
Tools
Print
Font Size:
Translation
Channels
Mondaq on Twitter
 
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
 
Email Address
Company Name
Password
Confirm Password
Position
Mondaq Topics -- Select your Interests
 Accounting
 Anti-trust
 Commercial
 Compliance
 Consumer
 Criminal
 Employment
 Energy
 Environment
 Family
 Finance
 Government
 Healthcare
 Immigration
 Insolvency
 Insurance
 International
 IP
 Law Performance
 Law Practice
 Litigation
 Media & IT
 Privacy
 Real Estate
 Strategy
 Tax
 Technology
 Transport
 Wealth Mgt
Regions
Africa
Asia
Asia Pacific
Australasia
Canada
Caribbean
Europe
European Union
Latin America
Middle East
U.K.
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement

Mondaq.com (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of www.mondaq.com

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about Mondaq.com’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.

Disclaimer

Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.

Registration

Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to unsubscribe@mondaq.com with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.

Cookies

A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.

Links

This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.

Mail-A-Friend

If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.

Security

This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to webmaster@mondaq.com.

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to EditorialAdvisor@mondaq.com.

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at enquiries@mondaq.com.

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at problems@mondaq.com and we will use commercially reasonable efforts to determine and correct the problem promptly.