Pharmaceutical Waste Reduction Strategies

Analyze inventory and modify purchasing

Demand for pharmaceuticals and current inventory is analyzed with usage reports, especially from a computerized inventory management system, which can track use and wastes, among other functions. The analysis is used to determine appropriate dosages to be purchased and to modify orders. A facility may choose to switch to premixed products, which have a longer shelf life than reconstituted products.

Examples of Applying this Strategy

Tri-County hospital in Minnesota found that 157 pharmaceuticals were being purchased in multiple dose containers and were accounting for 3% of the facility's reverse distribution returns, amounting to $1450 per year. For more information: http://www.mntap.umn.edu/health/resources/94FS.PharmWaste.pdf MnTAP 200 Oak Street SE, Sutie 350 Minneapolis, MN, 55455-2008 Phone: (612) 624-1300 Fax: (612) 624-3370

Generic Drug: Agatroban The authors suggest ordering ready-to-use products instead of products that need to be reconstituted. For the 20 patients in their study, this could result in an overall reduction in total cost of waste of approximately $170,000 and an absolute reduction in the percentage of the total drug cost wasted of at least an estimated 29%. If extrapolated to the total number of patients receiving argatroban throughout the year (N = 81), overall total costs would be reduced by approximately $700,000. Proprietary Drug(s): Agatroban Delivery Method(s): Intravenous (IV) For more information: Lose, Jennifer, et al. "Cost Containment for Agratroban Through Reduction in Drug Waste: Experience at a Single Center." Pharmacy Times, Mar. 2013. Web. 10 June 2013. Jennifer Lose, PharmD, BCPS Mayo Clinic, 200 First St SW Rochester, MN 55905 Email: Lose.Jennifer@mayo.edu

The Center for Environmental Information recommends that health care facilities review pharmaceutical use and modify purchasing practices accordingly. Specific recommendations include buying less of pharmaceuticals which commonly expire before use and purchasing a standard size, dose or form for pharmaceuticals which are used by more than one department. For more information: Carl, Ken. "Pharmaceutical Pollution Prevention." Center for Environmental Information, July 2011. Web. 14 June 2013. Center for Environmental Information 249 Highland Avenue Rochester, NY 14620 Phone: (207) 948 - 3131 ext 295

Generic Drug: ALL chemotherapy drugs Inventory control programs can help to minimize the amount of drugs that are allowed to expire and to aid in determining the optimum dosage size(s) of a given medication to be purchased. Falls Memorial Hospital in International Falls Minnesota, performed an inventory analysis in 2006. Changing their order of chemotherapy drugs from once a month to once a week and reducing the number of dosage forms and overall drugs kept in stock, saved the hospital $123,000 per month. See Appendix C of the study. Proprietary Drug(s): ALL chemotherapy drugs For more information: Smith, Charlotte, Pines, Eydie et al. "Managing Pharmaceutical Waste: A 10-Step Blueprint for Healthcare Facilities In the United States." Practice Greenhealth, 2008. Healthcare Environmental Resource Center Phone: (734) 995-7989

Additional Resources

Green Guide for Health Care (GGHC) Pharmaceutical Mangement Technical Brief
http://www.gghc.org/documents/TechBriefs/GGHC_TechBrief_Pharmaceutical.pdf

"In Struggle to Cut Expenses, Hospitals Eye the Pharmacy" --article from Hospital & Health Networks magazine
http://www.hhnmag.com/hhnmag/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/11NOV2011/
1111HHN_FEA_pharmacy&domain=HHNMAG