[Description of unused drugs collected in pharmacies in the Puy-de-Dôme region in France].
BACKGROUND
An unused drug (UD) is defined as a drug which is purchased, after prescription or not, but which is not taken. Public health campaigns in France have requested people to return these drugs to their pharmacy. To data, few data have been available concerning the quantity of collected UD and their potential re-use. A study was performed in the pharmacies of the Puy-de-Dôme region in France to describe the UD circuit.


METHODS
A random sample of 1 out of 5 pharmacies in the Puy-de-Dôme region (France) were defined by single level stratified sampling from the list of all pharmacies operating in the region. An exhaustive record of all UD people brought back to these pharmacies was made in 1998 during three 1-week periods. The following data were recorded for each UD: the name of the drug, the pharmaceutical industry code (CIP), the price, the rate of social Security refunding, the mention of "free specimen" on the package, the inscription on the list of poisonous substances and on the list of essential drugs defined by the World Health Organization (WHO), the registration on the list of drugs reserved for hospital use, the packaging notice (opened or not), the therapeutic class, and the formulation.


RESULTS
10,254 US (717kg) were collected during the study period. The therapeutic classes of the UD were similar to those of drugs purchased in France. According to the selling price, these UD had an economic value of 405,845FF (i.e. 3.6% of Social Security refundings paid in the Puy-de-Dôme region during this same period). Only 20% of the UD were potentially reusable for humanitarian purposes. Their estimated economic value was 87,456FF (i.e. 0.78% of the annual Puy-de-Dôme Social Security refunding). Moreover, 43.4% of the reusable drugs were on the WHO list of essential drugs.


CONCLUSIONS
Although the volume of collected UD is high, use by humanitarian associations is on the decline because of the cost of collection and low economic yield. Furthermore, UD must be collected in a systematic manner to preserve the environment and prevent domestic accidents.
Marchiset-Ferlay
N
N
CHU Clermont-Ferrand, Service Epidémiologie, Economie de la Santé et Prévention, Hôtel Dieu, BP69, 63003 Clermont-Ferrand Cedex 1 (Tirés à part: N. Marchiset, Pharmacie, Centre Hospitalier, 28, rue Charlieu, 42300 Roanne).
Gerbaud
L
L
Sauvant
M P
MP
Jaffeux
P
P
Manhes
G
G
Leblanc
N
N
Coste
F
F
Andriollo
O
O
D003625:Data Collection; D005602:France; D006801:Humans; D004364:Pharmaceutical Preparations; D010594:Pharmacies
D004364:Pharmaceutical Preparations