20. Estimates of the extent to which drugs are dispensed and not taken, or not taken correctly, vary widely, and the Department of Health has no recent information. A cautious estimate is £100 million annually; but this figure is based only on unused medicines that are actually returned to pharmacies. There are potentially serious public health and financial implications from drug wastage, as not only do PCTs have to pay for the drugs which are unused, but they also have to pay to dispose of them and for the consequences of patients not taking their medicines correctly.[21]

21. 88% of prescription items are dispensed free to patients and the remainder for a standard charge not directly linked to actual cost. There is a risk that the patients for whom these drugs are prescribed may not be aware of how expensive medicines can be, and consequently do not realise the importance of taking them correctly and returning them for safe disposal if they are not used. The Department has done some research on whether displaying the cost of a drug on the packaging would discourage wastage. The results appeared to be inconclusive, with some patients suggesting that a high price would dissuade them from taking the drug because it was too expensive, and others suggesting that a low price would dissuade them from taking the drug, because they felt it was too cheap.[22]

22. Partly in order to reduce medicines wastage, the Department introduced medicines use reviews (MURs) in the 2005 community pharmacy contract. An accredited pharmacist undertakes a structured review with patients who are on medication for long term conditions, to ensure their medicines are being used correctly and to check if there are any problems. The number of MURs carried out in the first year of the new contract was substantially lower than expected, although it is now increasing, and there were around 60,000 MURs completed in January and February 2007. Most PCTs consider that MURs have considerable potential to reduce wastage, but recognise that progress has been slow.[23]

23. A submission from a member of the public pointed out that generic drugs are manufactured using different tablet sizes, colours and shapes, and come in different types of packaging.[24] This diversity can be confusing, particularly for elderly people who have become used to the appearance of a particular formulation, and for patients taking several different drugs. The Department saw limited scope to encourage the standardisation of appearance of generic drugs prescribed in the UK, because UK drugs sales represent only about 3.5% of the global medicines market.[25] Greater standardisation should however bring benefits wherever in the world the drugs are used.

22   Qq 2-3 Back

23   C&AG's Report, paras 4.9-4.11; Q 39 Back

24   Ev 17 Back

25   Qq 82-83  Back