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Unused drugs impact cost, environment
When unused pharmaceuticals associated with phacoemulsification were measured at four surgical sites, the estimated annual cost of the wasted products reached approximately $195,200 per site, according to a study.
“In observing cases and talking with ophthalmologists, pharmaceutical waste was clearly something that irritated many people, but no one had really quantified the problem before. Our study is narrowly focused on just one supply type in one procedure but given the number of cataract surgeries performed nationwide (and globally), addressing this one, seemingly small issue could have a much larger influence on costs and public health impacts of care,” study co-author Cassandra L. Thiel, PhD, told Healio.com/OSN.
Researchers analyzed unused quantities of pharmaceuticals during routine phacoemulsification at a private faculty ambulatory care center, where mean cases performed per month was 73; a private tertiary care center, where mean cases per month was 102; a private outpatient center, where mean cases per month was 112; and a federal medical center for veterans, where mean cases per month was 21.
A member of the study team attended at least 10 routine cataract procedures at each institution to measure unused pharmaceuticals. Emissions were estimated using the economic input-output life cycle assessment model (EIO-LCA) and a free online EIO-LCA tool from Carnegie Mellon University.
Researchers found a cumulative mean of 83,070 mL of 183,304 mL of pharmaceuticals were unused by weight or volume per month across all sites. Eyedrops were the largest unused product at 65.7% by volume compared with 24.8% of injections and 59.9% of systemic medications.
In this study, the range of potential emissions contributing to climate change from unused drugs was equivalent to driving 1,025 miles to 6,120 miles in an average passenger vehicle or burning 47 gallons to 281 gallons of gasoline every month. When applied to an estimate of 1,100 cataract surgeries per 100,000 residents in the U.S. per year, emissions potentially could add carbon dioxide emissions of 23,000 to 105,000 metric tons toward climate change, the same as driving a car from Anchorage to Miami between 4,600 and 51,400 times per year, the authors said.
“Essentially, we are trying to draw attention to the way care is delivered, and how that adds to our cost of care and the environmental footprint of our health care system. Now that we have quantified how much is unused and wasted (at least at these four facilities), we can start to identify pathways for improvement,” Thiel said. - by Robert Linnehan
Disclosures: Thiel reports no relevant financial disclosures. Kahn reports receiving personal fees from Carl Zeiss Meditech. All other authors report no relevant financial disclosures.