Would you throw away a week in the Bahamas?

Image caption Knowing the cost of drugs might prompt different behaviour, Ms Wang suggests

Would you throw away a week in the Bahamas? It is estimated that in England £300m of medicines are wasted each year, and that half of this is avoidable.

In this week's Scrubbing Up, Lin-Nam Wang, community pharmacist and senior contributions editor at The Pharmaceutical Journal, says that current strategies to reduce medicines waste are not enough and explains why she believes NHS patients need to be told how much their medicines cost.

Last month, a man came into my pharmacy and handed me a black bin-bag.

Inside was £2,250.

Ok, so it wasn't in cash, it was in medicines.

Among the stash were 30 unopened boxes of a drug that would have lasted the patient seven months at her prescribed dose. But this was no windfall for the pharmacy - since we can't guarantee how medicines have been stored in patients' homes, they have to be sent for incineration.

Such events make me despair.

And they make me angry that, when we face cuts to services, and over a year since the publication of a Department of Health commissioned report on medicines waste, our system is still letting things like this happen.

'Time to talk'

I admit that in my 15 or so years in pharmacy this "patient return" has taken first prize, but talk to any community pharmacist and he or she will tell you that having to dispose of hundreds of pounds' worth of unwanted medicines is not uncommon.

In this case, the patient, who had died, had been dispensed repeat prescriptions again and again. Some bags had not even been opened.

There are so many holes in the net this patient could have slipped through and the reasons for waste can be complex but in a recent poll of members of the Royal Pharmaceutical Society 57% thought patients are to blame for medicines waste.

Various strategies have been proposed to prevent waste, including limiting prescribing to 28 days (a policy that some primary care trusts have introduced, but which can cause patients inconvenience).

And, since 2006, over 120 campaigns have been run, asking people to "only order what you need". But clearly this is not enough.

It's time to talk about the money

The crux of the problem is that most people don't have a clue how much their medicines cost. I doubt that this patient was aware of the value of what she had been hoarding.

Human nature is such that when no value is attributed to something people take it for granted - when something is free, people behave more irresponsibly.

We're so lucky to have a system that allows free medicines - and long may it continue - but I'm told by colleagues in countries where people have to pay for medicines that they don't see this sort of waste.


The debate on prescription charges will continue but, in the meantime, we need to take a different approach and make individuals aware of exactly how much their medicines cost.

Telling people that saving £300m could pay for 80,906 hip operations is water off a duck's back - the amount is too huge for most people to comprehend and a hip op is something many can't relate to.

Pharmacies could print some extra wording on medicines labels. Something like:

"This box of medicine costs the NHS £XX. Please look after YOUR NHS: don't keep more than two months' worth of medicines."

And perhaps pharmacists should be saying things like: "These tablets need to be taken every day for you to get the best from them. And, just so you know, each box is worth £28".

Will it work? Here is what was in the bin-bag -

Imagine it sitting in your home.

Now picture, instead, the latest 17in, 2.4GHz MacBook Pro, or a Cartier Love ring in pink gold and diamonds, or tickets for a week on Paradise Island in the Bahamas.

Some might class these items as luxuries so let me put it in perspective: we're talking half a years' worth of food and alcohol for the average family of four.

Would you want to hand any of these to your pharmacist for incineration?

We can only truly have "no decision about me without me" in the NHS if people are fully informed. And that includes telling them how much their medicines cost.

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