The Pharmaceutical Journal
Vol 273 No 7321 p558
16 October 2004

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· Adherence
· Medicines waste
· Community pharmacy
· Brand names
· Tuberculosis
· CPD
· Counterfeit medicines
· Geography

Letters to the Editor

Medicines waste

The root of the problem is in prescribing

From Mr J. Phillips, MRPharmS

The root of the problem with returned medicines is in the initial prescribing, and successive governments have continually avoided the issue. The figure of £500m worth of returned and incinerated medicines is indicative that something is wrong with the system that allows such enormous waste.

Several factors are involved, apart from the carte blanche to prescribe unlimited quantities. The plethora of pack sizes of solid dose medicines presents a nightmare to the average pharmacy: calendar packs, non-calendar packs, pack sizes of almost every whole positive integer, blister packs, caplets, melts, fasttabs, soluble, dispersible. One has to ask if there is any necessity for such a range.

Four groups share joint responsibility for the waste:

· The Government for not limiting prescribing quantities to the minimum necessary for adequate treatment

· Prescribers for failing to implement the above (with the advent of the repeat prescription service there is no need for more than 28 days’ supply of even the most regular medication)

· Pharmacists for having failed, over many years, to present a united front to the other parties when faced with decisions affecting their future, such as demanding equal representation within the NHS

· Manufacturers for failing to consider the needs, as regards packaging at least, of patients, prescribers and pharmacists

Finally, patients must be made aware of their responsibilities as consumers. The prescription charge is a disgrace and should be replaced by a different system by which some cash is returned to the NHS. In addition, all consultations should attract a fee that could be reclaimed in suitable cases.

J. Phillips
Colchester, Essex

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