A national survey highlights the significant issue of medical wastage, notes that three out of four households discard unused medicines.
People who were surveyed advocated for the return of unused medicines up to a month after purchase. (IStock)
A recent survey showed that three out of four households discard unused medicine. Indian households are grappling with a significant issue of medicine wastage. A survey by Local Circles, an online platform, showed that participants across several states, including Telangana and Karnataka, agreed that 50-70% of them waste medicines.
People are demanding that the government change the rules to facilitate chemists to sell smaller quantities of medicines and also accept the return of unused medicines within a month of purchase.
Local Circles, in its statement, said that the country needs a stringent monitoring and evaluation framework to ensure compliance in terms of medical waste management. It cited Ecoideaz Ventures, a social enterprise that works with SMEs and NGOs to promote green initiatives.
“Since a majority of Indians throw medicines down the drain, limiting the excess purchase of over-the-counter (OTC) medicines is the first step to being environmentally and financially responsible,” stated the study.
With all the issues around medical waste that has long plagued the healthcare system — with patients often being compelled to purchase entire packets of medicines due to the inability of pharmacists to separate individual doses — Local Circles decided to conduct a national survey to find out how citizens are handling excess and expired medicines in their homes, the real source of the problem, and possible viable solutions.
It recorded responses from citizens located in 322 districts of India from Tier I, II, III, IV cities and rural districts.
The first question asked in the survey is: “On an average basis these last three years, what percentage of the medicines you purchased ended up not getting used, expired, and had to be thrown away?”
The survey report stated that three out of four households have been discarding up to 70 percent of unused medicines purchased in the last three years.
70% of unused medicines are thrown away in 3 out of 4 households. (Wikimedia Commons)
When South First asked a few residents of Bengaluru and Hyderabad, they agreed with the data.
“Majority of the time, I would have used about 1/4th of the syrups purchased and about three to four tablets from the strip. I end up forgetting about it or I am scared to use the same bottle, despite the same prescription and even though it has not expired after a few months. So, I throw them away,” said Sucharitha Bhat, a software engineer and a resident of Bengaluru.
Voicing a similar opinion, Deepesh Reddy from Hyderabad said, “I am very finicky about using already-open bottles. But my father is old and feels insecure about his medicine supply and tends to hoard them, worrying that when he needs them the most, the item might not be available. Now, those tablets tend to go unused and we can’t even return them to the pharmacy.”
Pharmacists say that they have no option but to sell higher minimum quantities. (Wikimedia Commons)
The survey further explored the key reasons behind the accumulation of excess quantities of medicines.
Among the respondents, 47 percent blamed chemists for selling higher minimum quantities than necessary, while 21 percent held e-pharmacies responsible for the same practice. Additionally, 15 percent acknowledged that they discontinued the prescribed medication prematurely or after experiencing initial improvement.
Doctors prescribing more than necessary quantities accounted for 9 percent of the responses, and 8 percent attributed the wastage to other reasons. Surprisingly, none of the participants selected “Can’t Say” as their response to this question.
Speaking to South First, Neelendra Tripathi, a pharmacist from South Bengaluru said, “We are helpless as we don’t have an option but to sell bigger quantities. Also, if the strips are cut, then we can’t return it to the suppliers.”
To tackle medicine wastage effectively, participants were asked to suggest measures that could be implemented at the household level.
A large number of respondents (40 percent) advocated for a system where consumers would be permitted to return any unused or sealed medicine quantities within a month, with pharmaceutical manufacturers being mandated to accept these returns.
Medicine wastage included opened but unfinished syrup bottled. (iStock)
Another significant percentage (28 percent) believed that chemists and e-pharmacies should be compelled to sell medicines in smaller quantities, and manufacturers should also be required to take returns.
A sizeable portion (24 percent) proposed the establishment of district hospitals where people could donate unused medicines.
A small percentage (4 percent) felt that alternative solutions were necessary, while another 4 percent were unsure of the potential remedies.
Balaji S, a pharmacist from Bengaluru’s Chaya Medicals, agreed that the introduction of smaller quantities of medicines (for instance, strips of five instead of 10) could yield several benefits. First and foremost, it would significantly reduce medicine wastage and also enable consumers to better manage their healthcare expenses, as they would only need to purchase the necessary quantity of medicines, he told South First.
However, Balaji cautions that implementing such a change comes with its own set of challenges. Pharmaceutical companies would need to invest in research and development to design packaging that ensures the integrity and efficacy of smaller quantities of medicines.
This may involve developing specialised packaging solutions, such as blister packs or single-dose units, to maintain the potency of the medication while providing the desired quantity.
“Additionally, companies would need to carefully consider the cost implications of producing and packaging smaller quantities of medicines, as economies of scale may be affected,” he added.
Meanwhile, the pharmacists South First spoke to also expressed that introducing smaller quantities of medicines would potentially increase production and packaging costs.
“Pharmaceutical companies operate within a highly-regulated industry and any changes in packaging require compliance with stringent quality control measures. These additional costs could potentially be passed on to consumers, resulting in higher prices for smaller quantity medications,” a pharma manager said, on condition of anonymity.
He explained that to strike a balance, it is essential for pharmaceutical companies to collaborate with regulatory bodies, healthcare providers, and consumer advocacy groups.
“By working together, they can explore innovative packaging solutions that not only reduce wastage but also maintain affordability for consumers. Government support in the form of incentives or subsidies may also help offset the initial costs associated with transitioning to smaller quantity medicines,” he added.
Meanwhile, the Consumer Affairs Ministry, in consultation with the pharmaceutical industry, is taking steps to address the issue of medicine wastage by exploring the implementation of perforated medicine strips with manufacturing and expiry dates on each segment.
This initiative aims to enable patients to purchase the required quantity of medicines.
“It has been proposed to incorporate QR codes on medicine strips or individual tablets. The ministry, in collaboration with the Drug Controller General of India (DCGI) and industry representatives, aims to find cost-effective technologies to reduce wastage,” explained the Local Circles study.
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