JOURNAL OF THE CZECH PHARMACEUTICAL SOCIETY AND THE SLOVAK PHARMACEUTICAL SOCIETY

Čes. slov. farm. 2018, 67(5):192-199 | DOI: 10.36290/csf.2018.027

Wastage of medicines and its financial impact on the healthcare system in the Czech Republic

Jozef Kolář1,2,*, Jan Kostřiba2, Jana Kotlářová2, Tünde Ambrus1, Lenka Smejkalová1
1 Department of Applied Pharmacy, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
2 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Czech Republic

Background:
Medication wastage is an important factor that contributes to escalating healthcare costs. Medication wastage may be due to poor compliance of patients, excessive and irrational prescribing, or a lack of control of the dispensing of prescription medications in the community pharmacy.

Objective:
To describe and analyze the situation regarding the unused medicines from the quantitative, qualitative and financial point of view, their cost to the public healthcare system, and behaviours regarding medication wastage of the Czech population.

Method:
The analysed material consisted of medicines returned to 66 community pharmacies in the Czech Republic between May 16 and June 29, 2012. Thorough analysis was aimed only at medicinal products.


Main outcome measure:
The analysis of the returned medicines according to the price, amount, therapeutic group, active substance and brand name.

Results:
In the analysed material there were 18,890 items. The number of returned medicines was 16,520 products. The total value of these products was calculated at about Czech crowns (CZK) 2.1 mil., approx. Euro (EUR) 82,000. Reimbursement of health insurance companies was about CZK 1.4 mil. (approx. EUR 55,000). The most frequently returned drugs were medicines acting on the cardiovascular system (17.0%). The most frequent active substance was paracetamol, which recurred 405 times.

Conclusion:
The results about the unused medicines from the quantitative, qualitative and financial perspectives describe the situation not only for medicines policy makers and adjustment of the systems of pricing and reimbursement policies, but also for safer and more effective pharmaceutical care and strengthening of the function of community pharmacies.

Keywords: unused medicines; returned medicines; medication waste; medication wastage; Czech Republic
Grants and funding:

The study was supported by the Charles University PRVOUK project (P40 - Study of Drug Development), which constitutes a framework for the organizational and institutional funding of research activities at the Faculty of Pharmacy, and by a grant of Charles University (SVV 260 417).

Received: October 12, 2018; Accepted: November 8, 2018; Published: May 1, 2018  Show citation

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Kolář J, Kostřiba J, Kotlářová J, Ambrus T, Smejkalová L. Wastage of medicines and its financial impact on the healthcare system in the Czech Republic. Čes. slov. farm. 2018;67(5-6):192-199. doi: 10.36290/csf.2018.027.
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References

  1. World Health Organization. Challenges in expanding access to essential medicines. Geneva 2004; Available from: http://apps.who.int/medicinedocs/en/d/Js5571e/2.html#Js5571e.2 (accessed on 12. 09. 2016).
  2. Malý J., Doseděl M., Kuběna A., Vlček J. Analysis of pharmacists' opinions, attitudes and experiences with generic drugs and generic substitution in the Czech Republic. Acta Pol. Pharm. Drug Res. 2013; 70(5), 923-931.
  3. Abou-Auda H. S. An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries. Clin. Ther. 2003; 25(4), 1276-1292. Go to original source... Go to PubMed...
  4. West L. M., Diack L., Cordina M., Stewart D. A focus group based study of the perspectives of the Maltese population and healthcare professionals on medication wastage. Int. J. Clin. Pharm. 2016; 38(5), 1241-1249. Go to original source... Go to PubMed...
  5. Iuga A. O., McGuire M. J. Adherence and health care costs. Risk Manag. Healthc. Policy 2014; 7, 35-44. Go to original source... Go to PubMed...
  6. James T. H., Helms M. L., Braund R. Analysis of medications returned to community pharmacies. Ann. Pharmacother. 2009; 43(10), 1631-1635. Go to original source... Go to PubMed...
  7. West L. M., Diack L., Cordina M., Stewart D. A systematic review of the literature on 'medication wastage': an exploration of causative factors and effect of interventions. Int. J. Clin. Pharm. 2014; 36(5), 873-881. Go to original source... Go to PubMed...
  8. Czech Republic. Act on Public Health Insurance. Pub. L. No. 48/1997 Coll. (01. 12. 2011).
  9. Institute of Health Information and Statistics of the Czech Republic. Czech health statistics yearbook 2012, Prague 2013; Available from: http://www.uzis.cz/en/system/files/zdrroccz2012.pdf (accessed on 28. 02. 2017).
  10. Institute of Health Information and Statistics of the Czech Republic. Economic information on health care 2012, Prague 2013; Available from: http://www.uzis.cz/system/files/ekinf2012.pdf
  11. Organisation for Economic Co-operation and Development. Health expenditure and financing, 2017; Available from: http://stats.oecd.org/Index.aspx?DataSetCode=SHA
  12. State Institute for Drug Control. Information On Deliveries of Medicinal Products for 2012, Prague 2013; Available from: http://www.sukl.eu/sukl/avizo-k-dodavkam-lecivych-pripravku-za-rok-2012?highlightWords=drug+consumption
  13. Czech Statistical Office. Statistical yearbook of the Czech Republic 2013, Prague 2013; Available from: https://www.czso.cz/csu/czso/statistical-yearbook-of-the-czech-republic-2013-653m9thdn1
  14. Kolář J., Chybová L., Holečko D. Unused drugs returned to pharmacies I. Ces. slov. Farm. 2001; 50(4), 181-187.
  15. State Institute for Drug Control. Real use of medicines in the Czech Republic, Prague 2012; Available from: http://www.sukl.cz/file/73868_1_1 (accessed on 18. 11. 2017).
  16. State institute for Drug Control. Medicinal products database, Prague 2015; Available from: http://www.sukl.eu/modules/medication/search.php (accessed on 03. 03. 2017).
  17. Czech National Bank. Selected exchange rates, 2012; Available from: http://www.cnb.cz/en/financial_markets/foreign_exchange_market/exchange_rate_fixing/daily.jsp (accessed on 18. 02. 2017).
  18. Kolář J., Chybová L., Holečko D. Unused drugs returned to pharmacies II. Čes. slov. Farm. 2001; 50(5), 243-248.
  19. Institute of Health Information and Statistics of the Czech Republic. Economic information on health care 2011, Prague 2012; Available from: http://www.uzis.cz/system/files/ekinf2011.pdf
  20. Braund R., Chuah F., Gilbert R., Gn G., Soh A., Tan L. Y., Tiong H. S., Yuen Y. C. Identification of the Reasons for Medication Returns. NZ Fam. Physician. 2008; 35(4), 248-252.
  21. Coma A., Modamio P., Lastra C. F., Bouvy M. L., Marino E. L. Returned medicines in community pharmacies of Barcelona, Spain. Pharm. World Sci. 2008; 30(3), 272-277. Go to original source... Go to PubMed...
  22. Chien H. Y., Ko J. J., Chen Y. C., Weng S. H., Yang W. C., Chang Y. C., Liuet H. P. Study of Medication Waste in Taiwan. J. Exp. Clin. Med. 2013; 5(2), 69-72. Go to original source...
  23. Ibrahim S. Z., Mamdouh H. M., El-Haddad I. Z. Analysis of medications returned to community pharmacies in Alexandria, Egypt. Life Science J. 2012; 9(2), 746-751.
  24. Vogler S., Leopold C., Zuidberg C., Habl C. Medicines discarded in household garbage: analysis of a pharmaceutical waste sample in Vienna. J. Pharm. Policy Pract. 2014; 7, 6. Go to original source... Go to PubMed...
  25. Barnett-Itzhaki Z., Berman T., Grotto I., Schwartzberg E. Household medical waste disposal policy in Israel. Israel Journal of Health Policy Research 2016; 5: 48. Go to original source... Go to PubMed...




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