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Almost half of all returned medicines (43.7%) have not expired according
to an audit of the National Return and Disposal of Unwanted Medicines
The audit report, competed by researchers
from Monash University Institute of
Pharmaceutical Sciences, calls for further
studies to investigate why so many
unexpired medicines are returned and
why some pharmacists failed to correctly
comply with NatRUM protocols on the
correct disposal of Schedule 8 medicines
It concluded that: 'The audit findings
demonstrate that the NatRUM program
is an important and viable public health
initiative safeguarding the health
of consumers in Australia, and the
It also said the program was well utilised
by pharmacists and consumers, and made
a significant contribution to the quality
use of medicines nationally.
The report was launched at Parliament
House, Canberra, by the Assistant
Minister for Health, Senator Fiona Nash in
Senator Nash said that NatRUM was
a partnership between wholesalers,
pharmacies and the government that,
in 2013, had collected 619 tonnes of
unwanted medicines from the community
for safe disposal.
It is Australia's only safe method of
disposing unwanted medicines from the
The report concluded that with an ageing
population with multiple comorbidities
'and the likely resultant polypharmacy,
the need for a safe and environmentally
friendly method of disposal of unwanted
medicines will continue to increase.
Consequently, the importance of safe
disposal of medicines via the NatRUM
program will only increase.'
Researcher Carl Kirkpatrick said that while
funding for NatRUM has doubled over the
years the volume of unwanted medicines
collected had trebled from 200 tonnes to
600 plus tonnes.
'The audit has given us an insight into
what medicines are being collected.
Consumers predominantly returned
scheduled medicines (85.4%),' he said.
The total cost to government of the
31 most frequently discarded medicines
was approximately $2.05 million.
A total of 540 tonnes of returned
medicines from 686 RUM bins which
included more than 700 different
medicines by drug name were audited.
The bins weighing an average 4.2 kg
were from all states and territories except
The report found that of the 85.4% of
returned medicines that were scheduled,
80.9% were Schedule 4, 9.1% Schedule 2,
7.8% Schedule 3 and 2.3% Schedule 8.
The majority (68%) of medicines belonged
to five therapeutic classes: cardiovascular
(17.9%), nervous system (17.5%), alimentary
tract (15.7%), respiratory (8.8%) and anti-
infective (8.1%) which correlated well with
PBS dispensing data.
In the case of medicines dispensed under
the PBS. those discarded in the greatest
proportion relative to the quantities
dispensed were paracetamol/codeine
(500/30 mg tablets) and salbutamol
(100 mcg MDI).
Six of the most commonly discarded
medicines (salbutamol, paracetamol,
atorvastatin, amoxicillin and cephalexin)
were also most frequently dispensed on
The medicines with the highest cost
associated with wastage were tiotropium
($244,000) and paracetamol ($178,000).
Interestingly 1,514 sample packs were
counted across 98 RUM bins and 3,500
dosette boxes or Webster packs were
counted across 333 RUM bins. Most Drug
administration aids were full (n=1488,
42.5%) or partly full (n=1837, 52.5%). Sharps
other than prefilled capped syringes were
found in 83 bins.
In about half of the medicine packaging
(50.3%) a dispensing label was attached to
the packaging. Of these, the drug name on
the dispensing label correctly matched the
drug name on the product (94.8%).
The audit report concluded that the
large quantities of medicines collected
without an significant consumer marketing
suggests that community pharmacy does
promote the program to consumers and
that consumers are 'favourably disposed
It did, however, warn that consumers may
be disposing of a majority of unwanted
and/or expired medicines in general waste
or sewerage with the potential for adverse
health and environmental outcomes.
'Our national QUM strategy must include
an appropriately resourced and funded
NatRUM program in the pursuit of
successful medication management,' the
RUM role in
BY ANDREW DANIELS
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