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18-02-2025

Millions of euros thrown away: what do pharmaceutical waste statistics show?

Iliustracija

In 2024, a record 35.5 tons of unnecessary medicines were returned to pharmacies. This growing flow of pharmaceutical waste reflects two opposing trends: growing public awareness and a persistent problem of irrational use of medicines. However, this huge amount of unused medicines is not only an environmental challenge, but also a clear example of the waste of both state funds and personal finances.

It is hard to imagine such a large amount of unnecessary medicines, but it is estimated that it could fill around 355 average-sized baths. It is even harder to put a financial figure on such a volume. However, if, say, 1 kg of medicines costs an average of EUR 200 (some medicines are cheaper, others are very expensive), then 35.5 tons of medicines could be worth more than EUR 7 million.

In Lithuania, 78% of medicines prescribed to patients are reimbursed by the Compulsory Health Insurance Fund. This means that some of the medicines returned to pharmacies were paid for by health insurance, as well as by patients’ personal co-payments.

Irma Medžiaušaitė, Senior Advisor of Pharmaceuticals Reimbursement Division of the National Health Insurance Fund (NHIF), is convinced that if patients were to take prescribed medicines as prescribed by their doctors, they would simply consume them and their health would improve and pharmaceutical waste would decrease. By prescribing new medicines as much as needed for a shorter course of treatment, a doctor could assess more accurately how the medicines are working and, if necessary, change the treatment without creating unnecessary pharmaceutical waste. In addition, savings could be used more efficiently, for example, to improve patients’ health, to provide healthcare services and to reimburse new medicines.

Awareness or waste?

Over the last five years, the number of unnecessary medicines has increased dramatically. Pharmacies now collect as much pharmaceutical waste in half a year as they used to collect in a whole year. “On the one hand, this is encouraging because we know that such large quantities of medicines will not end up in household waste but will be specifically disposed of, but on the other hand, it raises the question – were all these medicines really needed by patients? We are convinced that if medicines were purchased and used more responsibly, some of this waste would simply not be generated,” I. Medžiaušaitė says.

A sociological survey initiated by the NHIF in September 2023 showed that 66% of Lithuanian households accumulate medicines that are no longer in use. The most common reasons for accumulating medicines at home are the desire to stock up (60%), stopping treatment without feeling any improvement (23%), or incomplete adherence to the treatment plan (19%), where patients take fewer medicines than recommended to avoid side effects or to save money.

Experts have noticed that some patients lack information about the rules for storing and using medicines and some simply buy more medicines than they need, especially during seasonal waves of illness.

The health insurance funds stress that rational use of medicines means that only the most appropriate medicines are prescribed to the patient, considering his or her individual needs, dosage and duration of treatment. This can only be achieved through close cooperation between a doctor and a patient, with the doctor prescribing and the patient following the recommendations. When a doctor first prescribes a reimbursable medicine, it may be prescribed for only 10 days if the illness is acute, and for a month’s course of treatment otherwise. Only after the doctor is satisfied that the medicine is suitable and safe he can prescribe it for longer periods, up to 3 or 6 months.

Neither in the bin nor in the sewer

Medicines, like other chemicals, can become dangerous if they are misused or mishandled. While these substances often bring significant benefits, improper storage or disposal can cause serious health and environmental problems.

“For example, keeping unwanted or expired medicines at home increases the risk of poisoning, especially for children and animals. In addition, when such medicines are thrown in the trash and end up in the environment and in the soil, they can cause pollution,” the NHIF specialist says, adding that some people mistakenly think that pouring medicines down the drain is a lesser evil, but it is not. – Spilling medicines down the drain can lead to them entering surface water or groundwater and further pollute the environment.”

As Virginija Žilėnaitė-Puodžiuvienė, Head of the Medicines Monitoring and Information Division of the State Medicines Control Agency, states that, according to the international research data, when expired medicines are disposed of in the municipal waste stream, active pharmaceutical ingredients end up in the groundwater of landfills after several years. “Both landfill leachate treatment plants and municipal wastewater treatment plants are not able to completely cleanse wastewater of pharmaceutical active substances, so some of these chemical pollutants end up in rivers and lakes, polluting them, and affecting plants and animals,” the expert says.

It is also important to know that, according to the provisions of the Law on the Control of Narcotic and Psychotropic Substances, a patient can only keep as many narcotic and psychotropic substances as have been dispensed to him/her in the pharmacy on prescription. “This means that if a person who has been prescribed controlled drugs dies, it becomes illegal to continue to possess them. In order to ensure that such medicines are properly disposed of and do not enter into illegal circulation, relatives must bring them to the pharmacy,” V. Žilėnaitė-Puodžiuvienė says.

How to take medicines responsibly?

  • Follow your doctor’s instructions precisely. If treatment is stopped early or if medicines are taken in a different way than recommended, health is at risk and unnecessary medicines accumulate. 
  • Only buy the medicines you really need. Don’t stockpile unnecessarily.
  • Consult your doctor or pharmacist. If you are unsure about the duration or dosage of your medication, it is better to consult a specialist.
  • Proper disposal of unwanted medicines. Take unwanted or expired medicines to the pharmacy.

Where do I put unwanted or expired medicines?

The NHIF, together with pharmacies, continuously encourages people to take proper care of pharmaceutical waste disposal. Pharmacy staff will make sure that returned medicines are safely handed over to specialized waste management companies to ensure environmentally sound disposal.

“Medicines returned to pharmacies are properly disposed of in accordance with strict environmental requirements, so there is no need to worry about their impact on the environment,” emphasizes I. Medžiaušaitė, Senior Adviser of the Pharmaceuticals Reimbursement Division of the NHIF.

IMPORTANT! Returning unwanted or expired medicines to pharmacies is the safest way to protect health and environment. Improperly disposed medicines can cause poisoning or leak into water. If a pharmacy refuses to accept them, contact the State Medicines Control Agency. Mercury thermometers are considered hazardous waste – they are accepted free of charge by municipal waste collection sites, and in Vilnius they are collected by UAB Grinda (phone 1355, email: [email protected]).

This article is part of the pharmacy literacy campaign “Medicines don't speak”, run by the NHIF.

The NHIF invites you:

 

Last updated: 17-03-2025

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