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pharmecology

Pharmaceutical Waste Reduction Strategies

Minimize size of containers

Higher volume containers of medication are replaced with smaller containers to avoid waste from partial use, where appropriate.

Reduces Amount: Yes
Reduces Toxicity: No

Examples of Applying this Strategy
Generic Drug: Propofol

In a 2012 study of eight operating rooms, propofol was found to be the most commonly wasted drug. 50mL and 100mL containers of propofol were removed and replaced with the smaller 20mL size vials. The study reported reduced waste from 29.2 mL/day/bin to 2.8 mL/day/bin.

Proprietary Drug(s): Diprivan, Propofol, Propoven
Delivery Method(s): Intravenous (IV)

For more information:

Mankes, Russell F. "Propofol Wastage in Anesthesia." Anesthesia & Analgesia, 13 March 2012. Web. 13 June 2013.

Russell F. Mankes, PhD.
141 Mohawk Drive
Schenectady, NY, 12303-5732

Email: rmankes@nycap.rr.com


Generic Drug: Agatroban

In a 20 patient study at the University of Michigan Hospitals, use of 50 mg/50 mL and 125 mg/125 mL argatroban products reduced drug waste resulting in projected cost savings to 1% and 2%, respectively, compared to that of the 250 mg/250 mL product.

Proprietary Drug(s): Agatroban
Delivery Method(s): Intravenous (IV)

For more information:

Lose, Jennifer, et al. "Cost Containment for Agratroban Through Reduction in Drug Waste: Experience at a Single Center." Pharmacy Times, Mar. 2013. Web. 10 June 2013.

Jennifer Lose, PharmD, BCPS
Mayo Clinic, 200 First St SW
Rochester, MN 55905
Email: Lose.Jennifer@mayo.edu


Generic Drug: Balanced Salt Solution

Surgery centers should consider purchasing the smallest containers of BSS which will suffice for a given procedure.

Proprietary Drug(s): BSS, Balanced Salt
Delivery Method(s): Ophthalmic Solution


Generic Drug: Dextrose

Hennepin County Medical Center found that two sizes of glutose gel were being ordered, 15 gram for crash boxes and 45 gram for diabetics, although only 30 grams is recommended by the facility's diabetics committee. Purchasing only the 15 gram size tubes saves the facility $345 annually.

Proprietary Drug(s): Glutose
Delivery Method(s): Oral Gel

For more information:

http://www.mntap.umn.edu/health/resources/94FS.PharmWaste.pdf

MnTAP
200 Oak Street SE, Sutie 350
Minneapolis, MN 55455-2008

Phone: (612) 624-1300
Fax: (612) 624-3370


Generic Drug: Epinephrine

The pharmacy and surgery center in a Missouri health care facility have worked with physicians to reduce the bottle sizes of epinephrine from 500 ml to 250 ml per procedure.

Proprietary Drug(s): Epinephrine
Delivery Method(s): Intravenous (IV)


Generic Drug: Iodine povacrylex/Isopropyl alcohol

The University of Minnesota Medical Center - Fairview case study suggested switching from 26 ml sizes of Duraprep to the 10 ml size where appropriate

Proprietary Drug(s): Duraprep, Duraprep
Delivery Method(s): Topical Ointment/Cream

For more information:

"Reducing Waste from the Operating Room." MnTAP, University of Minnesota, April 2011. Web. 13 June 2013.

A.J. Van den Berghe
200 Oak Street SE, Suite 350
Minneapolis, MN 55455

Phone: 612-624-4653
Email: mntap@umn.edu


Generic Drug: Nitroglycerin

Hennepin County Medical Center in Minnesota reduced the size of the nitroglycerin bottle in their crash boxes from 100-count to 25-count.

Proprietary Drug(s): Nitroglycerin, Nitrostat
Delivery Method(s): Oral Tablet

For more information:

Smith, Charlotte, Pines, Eydie et al. "Managing Pharmaceutical Waste: A 10-Step Blueprint for Healthcare Facilities In the United States." Practice Greenhealth, 2008.

Healthcare Environmental Resource Center

Phone: (734) 995-7989


Additional Resources

Daughton, Christian G. Cradle-to-Cradle Stewardship of Drugs for Minimizing Their Environmental Disposition While Promoting Human Health. I. Rationale for and Avenues toward a Green Pharmacy. Environmental Health Perspectives. 2003 May; 111(5):757¿774. http://www.epa.gov/esd/bios/daughton/green1.pdf)

©2015 Healthcare Environmental Resource Center
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