Wastage of medicines and its financial impact on the healthcare system in the Czech Republic.

ABSTRACT

BACKGROUND: Medication wastage is an important factor that contributes to escalating healthcare costs. Medication wastage may be due to poor compliance of patients, excessive and irrational prescribing, or a lack of control of the dispensing of prescription medications in the community pharmacy. OBJECTIVE: To describe and analyze the situation regarding the unused medicines from the quantitative, qualitative and financial point of view, their cost to the public healthcare system, and behaviours regarding medication wastage of the Czech population. METHOD: The analysed material consisted of medicines returned to 66 community pharmacies in the Czech Republic between May 16 and June 29, 2012. Thorough analysis was aimed only at medicinal products. MAIN OUTCOME MEASURE: The analysis of the returned medicines according to the price, amount, therapeutic group, active substance and brand name. RESULTS: In the analysed material there were 18,890 items. The number of returned medicines was 16,520 products. The total value of these products was calculated at about Czech crowns (CZK) 2.1 mil., approx. Euro (EUR) 82,000. Reimbursement of health insurance companies was about CZK 1.4 mil. (approx. EUR 55,000). The most frequently returned drugs were medicines acting on the cardiovascular system (17.0%). The most frequent active substance was paracetamol, which recurred 405 times. CONCLUSION: The results about the unused medicines from the quantitative, qualitative and financial perspectives describe the situation not only for medicines policy makers and adjustment of the systems of pricing and reimbursement policies, but also for safer and more effective pharmaceutical care and strengthening of the function of community pharmacies.