Intended for healthcare professionals

Practice Sustainable Practice

Reducing drug waste in hospitals

BMJ 2024; 386 doi: https://doi.org/10.1136/bmj-2023-076200 (Published 23 August 2024) Cite this as: BMJ 2024;386:e076200

Linked Editorial

Sustainable practice: what can I do?

  1. Hayley Blackburn, associate professor of pharmacy practice1,
  2. Catherine Forrester, lecturer (Practice)2,
  3. Min Na Eii, advanced pharmacist practitioner3
  1. 1University of Montana Skaggs School of Pharmacy, MT, USA
  2. 2Monash University Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Australia
  3. 3South Tyneside and Sunderland NHS Foundation Trust, UK
  1. Correspondence to H Blackburn hayley.blackburn{at}umontana.edu

What you need to know

  • Drug waste is an important source of financial and environmental waste within healthcare systems

  • Audit and analysis of drug inventory management, hospital policies on medicines, and prescribing and utilisation in clinical practice offer opportunities to reduce medicines waste

  • Engaging in multidisciplinary collaborations and partnering with patients are useful strategies for promoting sustainable medicines use

Any medication which expires or remains unused throughout the whole medicines supply chain is drug waste.1 This waste is associated with unnecessary healthcare spending and environmental harms. In hospitals, it is commonly attributable to suboptimal management of drug inventory and its interplay with drug utilisation. Health professionals can mitigate this waste using a variety of strategies.

Why change is needed

Pharmaceutical manufacturing, packaging, and distribution are carbon intensive processes, accounting for an estimated 12% of healthcare’s global carbon footprint.23 Despite the costs of production and procurement in terms of carbon emissions, considerable financial burden on health systems, and ongoing challenges with drug shortages, some medicines ultimately enter the waste stream as expired or unused products.45 Medicines disposed via landfill and wastewater contribute to pharmaceutical pollution of ecosystems and antimicrobial resistance, while incineration of drug waste generates harmful air pollution, and further carbon emissions associated with waste transport.67 These environmental harms underscore the importance of rational use of medicines and mitigation of waste.

In hospitals, drug waste can occur …

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