REDUCTION OF UNUSED PRESCRIPTION DRUG PRODUCTS

To recognize that unused prescription drug products contribute to drug misuse, abuse, and diversion; further,

To advocate for staffing, research, education, and best practices to ensure appropriate quantities of prescription drug products are prescribed, reconciled, and dispensed; further,

To advocate that the pharmacy workforce take a leadership role in reducing excess quantities of unused prescription drug products, including the provision of patient and caregiver education, raising public awareness, and supporting and integrating medication take-back programs.

Rationale

According to the Centers for Disease Control and Prevention (CDC), almost 5% of the U.S. population over 12 years old used prescription pain relievers for nonmedical reasons in 2010, resulting in 15,000 overdose deaths. A major source of diversion is unused prescription drug products, such as those left over after a patient has gained relief from temporary pain. Although prescribers and other healthcare providers have long been aware of the dangers of unused prescription drug products, incentives for overprescribing remain. The desire to minimize office visits, concern about undertreatment of pain, and prohibitions against partial fills and refills of controlled substances contribute to overprescribing. In addition to the risk of misuse, abuse, and diversion, research reveals that as many as 10 million prescriptions go unused every year, resulting in up to $5 billion in wasted medication (Lenzer J. BMJ 2014; 349:g7677). There is clearly a need for concentrated effort to minimize medication waste from unused prescription drug products.

ASHP recognizes the need for research on best practices to ensure appropriate quantities of drug products are prescribed, reconciled, and dispensed, which will include study of the effectiveness of partial fills or refills of prescription drug products, among other solutions. ASHP has concerns about quantity and duration limits, because rigid restrictions on treatment options may result in adverse patient outcomes.

Appropriate community return and disposal of excess prescription drug products reduce diversion, accidental poisoning risk, and environmental harm. ASHP advocates for pharmacist pharmacy workforce leadership in reducing excess quantities of unused prescription drug products through appropriate pain management practices and development and implementation of prescription drug product return and disposal programs.