5. Monitor and reduce waste
It can be difficult to gauge how much medication goes unused in hospitals, but a report estimating waste from the 2012 Medical Expenditure Panel Survey, by the Agency for Healthcare Research and Quality, found that more than 26 million prescriptions went unfilled that year, and 225 million of those were dispensed but never used, resulting in an estimated $30.4 billion in waste.
Another report in the Tropical Journal of Pharmaceutical Research attempted to estimate wasted intravenous medications in a Saudi Arabian hospital and found that nearly $27,000 in intravenous medications were returned to the pharmacy and almost $14,000 were wasted. The cost of all returned IV medications accounted for 13.65% of the total pharmacy budget, and wasted medication made up 51.77% of the returned medication costs, according to the report. In 45% of the wasted medication instances medication was discontinued after it was dispensed; in 19%, extra medications were dispensed; in 8.4%, patients died; in 8.3%, the dose had changed; and in 7.3%,the medication was held.
Not all of these instances of waste can be prevented or reduced, Hempstead says, but hospitals need to be vigilant in preventing unnecessary medication waste.
"Make sure that you're not dispensing things without making sure patients really need or want them," Hempstead says. "Try and take a real good look at the root cause of wasted medication and look at how often things happen."
Maybe the solution is to work with clinical decision makers to avoid medications being ordered and then orders being changed; maybe it's a dispensing issue. A root cause analysis will help identify where the problem is, and then decision-makers can work on ways to mitigate it, she says.
"You might want to do a study to really break down all the components of waste," Hempstead says.