Reducing Medication Waste: Strategies for Cost-Effective Prescribing

Medications are essential to healthcare, providing the most common type of intervention when someone experiences a health issue. However, they may also be inefficiently prescribed, or not used correctly by patients, which leads to greater waste and increased costs. This is why working to improve medication optimisation is essential.

What causes medication waste?

Every year, millions of people attempt to manage one or more health conditions with medication, with the assistance of healthcare professionals such as doctors and pharmacists. Sometimes, the medication prescribed may not be the most appropriate choice, and may either fail to treat the underlying condition or cause excess side effects. This can lead to patients not adhering to the prescription and the medication going to waste.

Sometimes, the patient may find it difficult to adhere to an otherwise appropriate prescription for a variety of reasons. They may struggle with memory and organisation and, therefore, struggle to keep to a strict schedule, particularly if they have a hectic life with other responsibilities. There may be mechanical problems that make it hard to open a container or swallow tablets. Psychological issues are also possible, such as fear or embarrassment. Sometimes, they may simply not understand the nature of the prescription or why it is important to follow it. If the medication is prescribed for a certain period of time, but symptoms desist before that, patients may stop taking the medication without realising the risk. Problems can be exacerbated by language or cultural differences.

When medication is wasted, patients do not receive adequate treatment, potentially worsening their condition, costs are increased (both because of the medication itself and in increased dispensing and other use of resources), and there is a risk to people and the environment if unused medication is not disposed of safely.

What do we mean by medication optimisation?

Optimisation is part of medication management. It involves ensuring the best possible outcomes for every patient who uses medication. It is a highly personalised approach that requires doctors, pharmacists and other healthcare professionals to consider the specific needs of each patient. Just because a particular medication can be prescribed for a certain condition does not mean it is appropriate for every individual. It may not work well with other medications they are taking, or be incompatible with their lifestyle. Prescribers need to work with patients, not just informing and educating them but listening to their concerns and giving them an active voice in their own care.

Providers also need to work on their own protocols and practices to reduce prescription errors. Staff need to be adequately trained, communication needs to be clear (particularly when patients are transferring between one provider and another, when there is a particular risk of important information being lost), and systems need to be built with safeguards to identify when things do go wrong and ensure that mistakes cannot be repeated, including referral to external regulators when necessary.

If patients are only given the medication most appropriate not only for their health issue, but also for their lifestyle and other circumstances, and if healthcare professionals listen to and work with patients to ensure their understanding, prescription adherence should improve, which will not just ensure better patient outcomes, but will also reduce costs by increasing efficiency.