The value of unused and out-of-date medicines generated each year in Ireland is estimated at over €37.5 million, according to the findings of new research.
The study by researchers at the Royal College of Surgeons in Ireland, was carried out to quantify the amount of waste medicines generated by both patients and pharmacies.
It estimated the average cost of each item of waste medicine at €20.23 based on wholesale list prices.
The study said its findings highlighted the need to implement the proposed national scheme due to be launched this year to ensure the safe disposal of waste medicine.
“Human health and environmental health are deeply interconnected, and coordinated action is essential to safeguard both,” it added.
The study, which is published in the Irish Journal of Medical Science, noted that only an informal discretionary waste collection service has been provided by some community pharmacies to date.
Researchers based their findings on a clinical waste audit carried out over a four-week period last year of four community pharmacies in Dublin which routinely accepted unwanted, unused or expired medicines returned by patients.
Of the total medication waste recorded, 90% were prescription medicines with 10% over-the-counter products.
More than a quarter of waste medicines was generated from the pharmacies’ own stock.
The study calculated that each pharmacy generated average medication waste of €1,512 over the four-week period.
The death of a patient was the most common reason why medicines were returned by customers, accounting for 21% of all waste medications followed by treatment being discontinued (13%) and non-adherence to medication (12.5%).
Just over 7% of medicines were recorded as out of date, while 4% had been ordered in error.
The most common reason for waste medicines in pharmacies were blister pack amendments following treatment changes (31%) followed by expired medicines (26.5%) and medicines uncollected by patients (16%).
One of the study’s main authors, Aisling O’Leary, said it is a concern that patients may not be adhering to treatment with antibiotics as it could reduce treatment effectiveness and contribute to antimicrobial resistance.
She said it was notable that no liquid antibiotics had been returned during the study period which indicated possible inappropriate disposal by patients.
“Reducing medication waste requires the engagement of multiple stakeholders, including prescribers, pharmacists, patients, and policymakers underpinned by rigorous implementable legislation,” said Dr O’Leary.
Worldwide, it is estimated that up to 50% of medications remain unused with around 40% being preventable.
In Ireland, research has indicated that approximately 29,000kg of medicines remain unused or expire annually.
Improper disposal of medicines can lead to the contamination of water and soil which results in environmental degradation and antimicrobial resistance.
The Environmental Protection Agency has recommended that people should not dispose of their unused medicines by putting them in their general waste household bins.
It was announced earlier this year that an agreement has been reached between the HSE and pharmacists which will provide funding to allow consumers to bring their old pills and medicines to a community pharmacy where they will be disposed of properly.
Formal details of the Dispose of Unused Medicines Properly (DUMP) campaign have still to be announced.
The Irish Pharmacy Union has been calling for such a scheme for several years amid claims that Ireland was out of line with many developed health systems by not having a national programme to limit what the organisation considers “serious health and environmental risks” posed by the inappropriate disposal of medicines.
Research commissioned by the IPU in 2020 showed that a third of all unused medicines are incorrectly disposed of with 6% dangerously flushed down sinks and toilets.