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Pharmaceutical Waste Reduction Strategies

Use trial sizes for initial prescriptions

For patients starting new prescriptions, a trial size is issued initially, which can be filled later in full, especially for medications with high rates of discontinuation.

Reduces Amount: Yes
Reduces Toxicity: No

Examples of Applying this Strategy

The Center for Environmental Information recommends that medications with a high incidence of side effects be initially dispensed in a trial size of 7 to 14 day supplies.

For more information:

Carl, Ken. "Pharmaceutical Pollution Prevention." Center for Environmental Information, July 2011. Web. 14 June 2013.

Center for Environmental Information
249 Highland Avenue
Rochester, NY, 14620

Phone: (207) 948 - 3131 ext 295

MaineCare has been using an initial prescription limitation policy since August 2009, limiting initial prescriptions to 15-day supplies for a list of over 60 drugs kept by the Department of Health and Human Services.

For more information:

Fletcher, Sierra. "Strategies to Prevent Pharmaceutical Waste: Addressing Sample Waste." Product Stewardship Institute, Feb 2011.

The Product Stewardship Institute
29 Stanhope Street
Boston, MA 02116

Phone: (617) 236-4886
Email: sierra@productstewardship.us

Additional Resources

The Centers for Medicare & Medicaid Services has adopted rules to encourage trial prescriptions by providing a pro-rated co-pay.  See pp. 22126-22134 of the Federal Register notice, here:  http://www.gpo.gov/fdsys/pkg/FR-2012-04-12/html/2012-8071.htm

Daughton, Christian, Green Pharmacy and PharmEcovigilance: Prescribing and the Planet," Clinical Pharmacology, page 222.

Green Guide for Health Care (GGHC) Pharmaceutical Mangement Technical Brief

©2015 Healthcare Environmental Resource Center