| • White Paper (4)
• Funding for services
• Prescription charges
• Community pharmacy (2)
• Pharmacist prescribing
• Chlamydia testing
• Pfizer products
• Medicines recycling
• Skill mix
• Retention fees
• Retail pharmacy
Letters to the Editor
|
Medicines recycling
Is the Society’s position on returned medicines evidence-based?
From Dr M. McDonald
Priya Sejpal gives the official Royal Pharmaceutical Society justification
of its Code of Ethics prohibition on using returned medicines for humanitarian
use in Africa (PJ, 3 March p249). The explanation given is that medicines
may have been kept at home “near a radiator or in moist conditions” and
may therefore “no longer be efficacious or stable”.
Might I suggest that this is not a matter for a code of ethics, but rather
a technical issue. For all such science-based assertions one would expect
the Society would offer an evidence-based opinion. In fact the minimum
regulatory requirements for drug stability testing are six months at
40C with 75 per cent humidity,1 which is far in excess of household conditions.
If medicines kept at home are likely to deteriorate within their shelf
life, then surely the initial patient is also at risk. Miss Sejpal also
invokes the World Health Organization, on whose guidelines on drug donation
we collaborated to develop. The primary aim is to ensure no dumping ever
of inappropriate drugs, so the message has to be simplified. In the event,
Inter Care has the most stringent procedures for receiving, screening
and supplying only perfect unused medicines to the developing world,
and over 30 years of unmitigated success (PJ, 17
February, p190).
Increasing numbers of scientific publications are emerging supporting
the reuse of medicines.2 Although there are, undoubtedly, anxieties around
trusting pharmacists not to resell returned drugs for financial reasons,
these should not cloud the issue such that millions of the poorest people
on the planet are prevented from accessing treatment. Moreover, there
are large scale organisations abroad that recycle medicines to Africa,
such as Cyclamed which is supported by the pharmacists professional body
in France.
Access to genuine drugs is even more crucial now that remote parts of
Africa are awash with counterfeit drugs, until such time as policing
can be effective. It is estimated that half of all the pharmaceuticals
in Africa are fakes.3
Many UK pharmacists are in support of our work but are bound by a code
of ethics they do not support. Perhaps A.
Matalia (PJ, 3 March, p245)
has the right message for the future when he says pharmacists should
be bound by law and their own professionalism and conscience and “not
some half-baked code of ethics which a pharmacist might not believe in”.
Margaret Macdonald
Chief Executive Officer,
Inter Care
References
1. Matthews BR. Regulatory aspects of stability testing in Europe.
Drug Development and Industrial Pharmacy 1999;25:831–56.
2. Pomerantz JM. Recycling expensive medication: Why not? Medscape
General Medicine 2004;6:4.
3. Cockburn R, Newton PN, Agyarko EK, Akunyili D, White NJ. The global
threat of counterfeit drugs. PLoS Medicine 2005;2:e100. |
The
Pharmaceutical Journal