From Mr L. A. Goldberg, FRPharmS
I read with interest the conclusion that pharmaceutical recycling can lead to savings for both trusts and the NHS (PJ, 10 March 2012, p321).
I believe the authors have confused recycling with reuse. When unwanted medicines are returned to the pharmacy, the packaging can be recycled, whereas the contents can be reused.
In a situation where large quantities of medicines are returned to the pharmacy unused, it would make much more sense to look at ways to issue medicines more efficiently rather than to handle numerous returns. The “one-stop dispensing system”, which was originally introduced to speed up the discharge process, inevitably generates part-used packs of medicines that are no longer required by patients. These part-packs are returned to the pharmacy and may be reused. The process of reusing returned medicines has an inherent cost because pharmacy personnel have to identify, check integrity and return these items to stock. This cost has to be offset against potential savings.
What is really needed is a critical reappraisal of the way in which medicines are dispensed to hospital inpatients to prevent over-supply.
Most hospital pharmacies have now automated their medicines supply function and are using state-of-the-art IT to monitor the medicines supply chain. Electronic medicine cabinets are also now appearing in many clinical areas. The technology is, therefore, available to trace every dose issued from the pharmacy.
Dispensing for discharge is no longer an issue because robots can handle this efficiently. Outpatient dispensing no longer takes up valuable hospital pharmacy time because, in many cases, it has been contracted out to third parties. Therefore, hospital pharmacies could re-evaluate the supply of medicines to inpatients and devote time to developing a more efficient system that would complement the high quality clinical services now being offered.
Laurence A. Goldberg