Recycling Expensive Medication: Why Not?

Jay M. Pomerantz, MD


Medscape General Medicine. 2004;6(2):4 

In This Article

Supply Sources for a Medicine Recycling Program

Nursing homes and other healthcare facilities are not the only possible sources of recyclable medicines. A more important source may be medication in consumers' homes that is unused. Many prescriptions are frequently switched or simply stopped in midstream by prescribers. Leslie and Rosenheck[18] documented the switching phenomenon in a recent article tracking the prescription of antipsychotic medications within the Department of Veterans Affairs. Of the 21,873 patients with schizophrenia who were on stable 3-month prescriptions of any antipsychotic medication, 25% had their medications switched during the next year.

Patients are also likely to stop medication on their own. Not more than 50% of patients adhere to a chronically prescribed antipsychotic medication, typical or atypical in type, for one year.[19] Antidepressants, another costly and widely used medication class, are discontinued even more frequently.[20] As we move away from the mental health arena, adherence is still a major problem. The cholesterol-lowering statins, which, like atypical antipsychotic medications and antidepressants, are prescribed most often for chronic use, show a similar pattern of premature discontinuation, leaving much unused, expensive medicine in consumer hands.[21] Adherence rates for all medications prescribed for asthma range from 30% to 70%.[22] Mail order prescriptions for 90 days (rather than the 30-day supplies usually available from local pharmacies) have further increased the amount of unused medication in consumers' hands.