Every year, large quantities of prescribed medicines go unused. As an NHS GP, I sometimes see large stocks of medicines during home visits. The National Pharmacy Association estimates that medicines wasted annually in England amount to around 3,400 tonnes — enough to fill about 75 swimming pools. The cost to the NHS was around £480 million. But the problem is about more than just money.
Medicines have to be manufactured, packaged, transported and eventually disposed of. When these resources are not used, they are wasted. Incorrect disposal can also allow medicines to enter the environment. The scale of the problem may be even greater than these estimates suggest. Some unused medicines remain in people’s homes, while others may be put in household rubbish rather than returned via pharmacies.
Why do medicines go unused?
Medicine waste is not simply the result of patients being careless. Our population is ageing, which means that more people need treatment for long-term health problems. The NHS is also treating conditions such as high blood pressure, heart disease and diabetes more actively.
But people’s health changes. A medicine that was appropriate when it was prescribed may later be stopped or replaced. Some people may also stop taking a medicine because they experience side effects or have concerns about it.
Meanwhile, repeat prescriptions can continue to be ordered, allowing supplies to accumulate. The important principle is that prescribing should reflect what people actually need and take. The aim should be the right medicines, in the right quantities, for as long as they are needed.
What can patients do?
One of the simplest steps is to order only the medicines you need. If you have enough of one of your regular medicines at home, there is generally no need to order another supply simply because it appears on your repeat prescription.
Ordering medicines “just in case” can also increase the likelihood that they will eventually be wasted.
It is important to tell a healthcare professional if you are not taking a prescribed medication. People stop taking medicines for many reasons. You might be experiencing side effects, be unsure why you need the treatment, or simply not want to take it.
Your doctor or pharmacist needs to know this. If a medicine is causing side effects, for example, there may be an alternative. Continuing to issue prescriptions for a medicine that someone is not actually taking benefits nobody.
The NHS has responsibilities too
Reducing waste cannot be left to patients alone. The NHS needs to make it straightforward for people to have their medicines reviewed and to ask questions about them.
People with long-term medical conditions are offered health reviews, which provide an opportunity to discuss their medication and whether treatments are still required. People taking many medicines may also be offered a more detailed, structured medication review.
Doctors and other prescribers can help by explaining why a medicine is being started, what benefit it is expected to provide and what problems to look out for. If patients understand why they are taking a medication and have the opportunity to discuss their concerns, problems can be identified before unused supplies begin to accumulate.
Ask your pharmacist
Community pharmacists are an important source of advice. They can explain why medicines are needed, how best to take them and how much to order. They can also communicate with the patient’s general practice.
So if you find yourself with several unopened boxes at home or are unsure which medicines you should be taking, ask your pharmacist rather than simply ordering the same quantities.
What should you do with medicines you don’t need?
Medicines returned by patients cannot simply be handed out to someone else, even when a packet is unopened, and its seal is intact. They have to be disposed of appropriately.
Nor should unwanted medicines be put into ordinary household waste. They should be returned to a pharmacy for safe disposal. Incorrect disposal can create environmental hazards, including the risk of medicines entering water supplies.
Returning medicines also provides useful information. If you regularly have medicines left over, discussing this with your pharmacist can help identify whether your prescriptions need reviewing.
Safe disposal, however, addresses medicines only after they have been discarded. It is better to prevent unnecessary supplies from accumulating in the first place. That requires action from both patients and the NHS: prescribing carefully, reviewing medicines regularly, making it easy for people to raise concerns, and ordering only what is actually needed.
With hundreds of millions of pounds being spent each year on medicines that are never used, even modest reductions in waste could make a difference to the NHS. The goal is not simply fewer medicines. It is the right medicines, in the right quantities, for as long as they are needed.
- Dr Azeem has been a GP for over 30 years and is also a professor of primary care and public health at Imperial College London’s School of Public Health.
This story originally appeared on Express.co.uk
