This site is intended for health professionals only

NHS drug waste "costs £300m a year"

Prescription drug wastage is costing the NHS in England at least £300 million a year, a study commissioned by the Department of Health has shown.

It further stated that about half the waste from unused prescriptions could be prevented.

The sum represents approximately £1 in every £25 spent on primary care and community pharmaceutical and allied products use, and 0.3% of total NHS outlays.

"It includes an estimated £90m worth of unused prescription medicines that are retained in individuals' homes at any one time, £110m returned to community pharmacies over the course of a year, and £50m worth of NHS supplied medicines that are disposed of unused by care homes," the report, based on 2009 figures, stated.

Over-ordering, patients feeling better, side-effects to the medicine and death are some of the reasons why many prescriptions go unused, the report said, but it pointed out some of this waste is inevitable.

Encouraging patients to stick to their prescription guidelines and manage their medicines better could help to make savings as well as improving people's health, thus reducing the strain on the NHS.

Up to £500m could be saved in just five areas - asthma, diabetes, high blood pressure, vascular disease and schizophrenia - if medicines were to be taken in the optimal manner, according to researchers from the York Health Economics Consortium and the School of Pharmacy at the University of London,

Report co-author, Professor Paul Trueman, said: "Many health professionals and members of the public believe that the physical waste of NHS medicines is a major issue.

"We should do everything we can cost-effectively to reduce it.

"But we have not found that the NHS has a systemic problem with drug wastage which marks it out from other health services.

"In value terms there is more to be gained from helping people to take their medicines more effectively, even though this may increase the overall volume of drugs paid for."

The report found the gross annual cost of NHS primary care waste and that occurring in care homes is £300m in England, but this could be an underestimate. However, England is not faring any worse than other countries.

Copyright © Press Association 2010

Department of Health

Your comments (terms and conditions apply):

"There are many excellent comments below and I believe many ways that we all can contribute to reducing prescription drug wastage. I agree a lot of wastage occurs because people have their prescriptions for free, however that is not always the case. My 86 year old uncle amassed a huge amount of drugs over a few months while he was in and out of hospital.
Each time he was discharged he was issued with several weeks supply despite the fact he already had several months supply already at home prescribed by his GP. I took 4 large carrier bags (bag for life size) back to the chemist who told be they would be disposed of despite the fact they were wrapped up and dated. I was furious at this wastage. My Mum too
is prescribed 100 paracetemol a week of which she takes hardly any.  Even if she took 8 a day there would be 43 left yet I am not 'allowed' to buy two packets in the supermarket, how crazy is that!  I hear of similar cases wherever I go now.  My neighbours brother in law died after a long illness. His unused medications and dressings filled the boot of their family car and there was more on the back seat! Though this doesn't get to the root of the problem I would like to bring your attention to a charity called 'INTERCARE'.  Intercare collects unused
drugs from GP surgeries and redistributes them to health centres in Africa. Please access their website and make it your mission to educate your own GP on this initiative and save the criminal wastage ( - Christine Parr, Essex 

"There has always been a massive amount of waste in the NHS and not just drugs. I used to have issue with lack of black bin bags in the clinical room. We would have a bin with a yellow bag but not a black bag. Bins with black bags were usually at the far ends of the ward. Therefore yellow bags would be filled with paper towels and other non-clinical waste. These bags cost twice as much to dispose of. I did mention it several times to my then manager and she did nothing about it" - Lynne Jones, Chester

"There is a huge amount of wastage. If packets are ascertained to be intact and undamaged I cannot see any reason why they cannot be redispensed, patients should also be encouraged to purchase OTC medicines such as paracetamol and Calpol. Patients think they can have everything free on prescription when they are exempt from charges" - Pat Baker, Essex

"Agree there is a lot of wastage of perfectly usable dressings in the community due to a variety of reasons" - Ann Hopper

"A lot of waste can be attributed to those patients who do not pay prescription charges. If every patient had to pay a nominal amount, say £1, for any number of items on a prescription, maybe they would think twice about just ordering as a routine on a monthly basis. I am sure more revenue would be generated on this basis rather than the current system which is unfair and discriminatory. Can't see it happening any time soon
though" - Janet Cunniffe, Lancashire

"I believe that this waste will continue until legislation is changed around return of unused/unwanted prescription items. At present, as soon as a drug is dispensed, it cannot (for safety reasons) be returned to a pharmacy to be reused. I think this was obviously a great safety net when medications were dispensed in open bottles, but now that nearly all drugs are dispensed in blister packs with date of manufacture and date of expiry clearly written on each, there is absolutely no reasonable argument for this policy to continue. There are many instances where prescription items have been dispensed and within a few hours of this the patient dies, and all of these drugs must be destroyed even although the paper package they are wrapped in (by the pharmacy) has been undisturbed. If we could have the legislation changed it could potentially save millions of pounds" - Maureen Duff

"Inevitably, yes, there are some patients who are not compliant with their meds, a good honest relationship with the patient is difficult but worth cultivating. As long as patient understands the risks then the repeat should be stopped. Returned medicines cannot be reused for other patients
once they have been dispensed, the same for dressings due to infection control. This can be difficult as patients have wounds which are sometimes difficult to manage and dressings can be hugely expensive. Yes, medicines should carry the cost on them, hopefully this would save wastage from compliance issues, and also even for those paying prescription fees that the cost of the medicine is much higher than the prescription cost. As with everything else it will take a combined approach, our surgery gives only a minimum of repeats then patients have to see the nurse or doctor for review. DNs must also work with GPs and try to order off formulary for wounds and not order more than necessary as older patients often have boxes full of a variety of dressings stockpiles. An ongoing battle I think!" - Practice nurse, Liverpool

"I have had three people in today who have recently been prescribed meds by the GP who tell me they have not taken them because 'I don't like taking tablets'. Do GPs ascertain if the pt will take the meds before he doles them out? No staff working in the NHS would be in danger of losing their jobs if this mammouth waste of money could be sorted. Yes I did put an alert on for the doctor" - Nurse, Lancs

"The wastage can be avoided if the GP, nurses in both Primary Care and Community Nurses monitor the use of drugs. The patients should be seen regularly and prescriptions should not be longer than 2 weeks. There is too much of repeat prescription which is not monitored regularly and patients
tend to keep them and not use them.They continue to take them if they are not needed and this causes addiction to certain drugs. Education of patients and their family might help. As the comments below point out, some medication that is no longer used should be returned to the pharmacy who can re-use them for other patients if they are still intact in the box and in date, rather then getting rid of them. I am sure there are ways of redistributing this unwanted prescription" - Robert Peumalu, Sandwell

"I have said for ages that if every prescription had the price of the drug on it, people would take notice and not waste so much" - Jane, Cambs

"In the community setting, unopened sterile dressings and bandages are not allowed to be taken from patients' homes once they are discharged, which leads to huge a waste of supplies which could be a valuable resource in the community clinic setting" - Denise Williams, Wolverhampton

"In the community bed unit where I work a lot of wastage is caused by having to dispose of (at substantial cost) perfectly good medicines simply because the pharmacy will not accept them back once they have "left the building" - Elisabeth Burleigh, Leicester