Waste not, want not in healthcare

Waste not, want not in healthcare

It’s everyone’s responsibility to reduce medicines waste

Better management of medications and reducing waste could save New Zealand healthcare hundreds of millions of dollars, says the latest White Paper from SimplHealth, “Waste Not, Want Not.”

The paper looks at why medication waste occurs, its cost, the issue of non-adherence and the importance of using information more effectively.

It points out that medication has become part of everyday life, resulting in a lack of understanding about its importance and value.

Jodi Mitchell, CEO of SimplHealth, says it’s everyone’s responsibility to reduce medication waste:

“We need to get serious about reducing waste to save money and make sure medication is used as efficiently as possible,” she says.

“We’re all guilty – we all have medicine cabinets or drawers at home with unused out of date medication. For most, it’s probably just that we didn’t finish a prescription, or we just forgot about it. We have all become used to medications being available when we need them.

“But what this hides is a lack of understanding that unused medication, could provide needed medical care elsewhere, help others and in some cases even save lives,” she says.

There are various causes of medication waste including over prescribing and bulk dispensing, for example when a patient leaves hospital with a larger supply of pain medication than is actually needed. This may be convenient but it often results in some being leftover.

It also discusses the complex issue of non-adherence and its significant health and economic consequences.

In New Zealand there is an estimated $40m cost for medication waste, or five per cent of the total $800m total pharmaceutical spend. In addition, there is also the conservatively estimated $700m cost for non-adherence, mostly related to unplanned and avoidable hospitalisation, and expensive secondary care.

Of all the issues relating to medication waste, non-adherence is cited as the most serious and surprisingly common with rates reported of between 25-75%.

There are many reasons for non-adherence such as patient perception of their condition, self-regulation, coping styles, the role of psychology and cultural influences.

“We are not going to eliminate medication waste but we can do a much better job at reducing it,” Jodi Mitchell continues. “If we can address the causes we can improve health outcomes, reduce morbidity and early mortality, and save money.

“The most important thing we need to do is use the information we have now, more effectively, to improve our health in the future - we need to address the causes rather than deal with the outcomes.

“We already have this ability by using non-identifiable information generated by systems like ePrescribing and in the future electronic health records, to help establish how much is prescribed, is it used and how much is wasted,” she says.

The paper goes on to look at what more can be done to reduce waste in the future and bring more efficiency.

It discusses the continued and widespread adoption of information technology as one of the main pathways to improvement but points out patients and healthcare professionals need to change their behaviour for it to reach its potential.

It acknowledges the New Zealand Health Strategy’s “People Powered” theme and highlights the importance of technology and information to drive patients to be co-pilots of their health.

Evolving views about privacy is discussed in order to realise benefits from non-identifiable information.

The paper also emphasises the need for more investment in adherence potentially via public private partnerships and looks at the case for changing the medication delivery system.

“Waste not want not” is a well-known phrase that was first recorded in the late 18th century and means if one is not wasteful then one will not be needy – applying this to healthcare is complex,” Jodi Mitchell continues.

“As a small country, we have the opportunity to create a healthcare system that is the envy of the world, where efficiency is paramount and waste is minimised.

“If we can change our approach to medication, increase our understanding and appreciate its value, we may be able to demonstrate the spirit of waste not, want not,” she says.

The White Paper can be downloaded here.

ENDS

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