Tuesday, April 27, 2010

The whys and wherefores of waste

There is a report in The Press claiming that 50 percent of drugs are being wasted. That wouldn't be happening if they were recreational drugs notice. Try to envisage people turning up to tinnie houses with bags stuffed to bursting with unused cannabis. No. It is too silly.

First, 50 percent seems high when I do a mental check of my own medicine cabinet. 10 or 20 maybe, but then that's just my family.

There are valid reasons why medicines remain unused. Death. Often people are on massive amounts of medication at the point of death.

Recovery. Some medicines should be taken as a whole course but many will do the job and no more is needed.

Over zealous prescribing. Patients can be very passive and let a GP prescribe for them medicines that they have no intention of taking.

Bad reaction. Sometimes the patients rightly or wrongly perceive a bad reaction to a drug and stop using it.

And there are other things that come to mind which lead to waste. The rules around pharmaceuticals and dispensing. Over cautious best-by dates. The non-recyclability of returned medicines.

And of course subsidies. Human nature is such that often people do not value what they do not pay for. There-in lies the paradox. The state makes medicines more accessible so that people's health is preserved and they do not become an economic cost at the secondary level. But by doing so, waste taxpayer's money at the primary level.

In my opening comment I drew a parallel with recreational drugs. Are they comparable? I think so. Genuinely sick people should be just as motivated to take their medicine as people looking for a high. So why, apart from the reasons of death and recovery, aren't they? Because they didn't really need or want it in the first place? If food was subsidised there is no doubt in my mind that the waste of it would be colossal.(I have seen people wasting food from charity parcels - mince, still in the tray, left on the floor for the cats to chomp their way through.)

So the waste of pharmaceuticals is, to some degree, a product of taxpayer subsidy and unnecessary bureaucracy. Death and recovery are immutable factors. Subsidy and over-regulation are not.

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