title: Returned medicines: waste or a wasted opportunity?
abstract: BACKGROUND
  Re-use of unused medicines returned from patients is currently considered unethical in the UK and these are usually destroyed by incineration. Previous studies suggest that many of these medicines may be in a condition suitable for re-use.
  
  
  METHODS
  All medicines returned over two months to participating community pharmacies and GP surgeries in Eastern Birmingham PCT were assessed for type, quantity and value. A registered pharmacist assessed packs against set criteria to determine the suitability for possible re-use.
  
  
  RESULTS
  Nine hundred and thirty-four return events were made from 910 patients, comprising 3765 items worth pound 33,608. Cardiovascular drugs (1003, 27%) and those acting on the CNS (884, 24%) were most prevalent. Returned packs had a median of 17 months remaining before expiry and one-quarter of packs (1248 out of 4291) were suitable for possible re-use. One-third of those suitable for re-use (476 out of 1248) contained drugs in the latest WHO Essential Drugs List.
  
  
  CONCLUSIONS
  Unused medicines are returned in substantial quantities and have considerable financial value, with many in a condition suitable for re-use. We consider it appropriate to reopen the debate on the potential for re-using these medicines in developing countries where medicines are not widely available and also within the UK.
authors.affiliation: Pharmacy Practice Research Group, School of Pharmacy and Chemistry, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK. a.mackridge@ljmu.ac.uk
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Mackridge
authors.forename: John F
authors.initials: JF
authors.lastname: Marriott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004355:Drug Stability; D004363:Drug Utilization / Q000191:economics / Q000941:ethics / Q000592:standards*; D004739:England; D017743:Equipment Reuse / Q000191:economics / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005260:Female; D005569:Formularies as Topic / Q000592:standards*; D006801:Humans; D017745:Incineration; D007223:Infant; D008297:Male; D017744:Medical Waste Disposal / Q000191:economics / Q000941:ethics / Q000592:standards*; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000145:classification / Q000191:economics / Q000600:supply & distribution*; D010594:Pharmacies / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*
chemical_list: D017744:Medical Waste Disposal; D004364:Pharmaceutical Preparations