The medical waste mountain is growing over our heads. But there is hope, also for the environment. If recycling doesn’t work, you can at least save money.
Prescribing pills smarter
5 percent of the annual amount of prescribed medicines is returned unused to the pharmacy or chemokar. That seems to be not too bad, but medicines are also thrown in the trash or flushed down the toilet. A waste of nearly $100 million worth of pills. There is no other way, thought Erik Muller, internist-oncologist from the Slingeland Hospital in Doetinchem. He has long been annoyed by the large-scale destruction of untapped medicines. So he asked his patients to hand in their remaining medicines. He then passed them on to other patients, after rummaging through the label with the name of the package.
In a cry from the heart in the medical journal Medisch Contact, he called on colleagues to do the same. In a year’s time he had saved €16,000 in (expensive) medicines in this way. If everyone followed his example, Muller calculated that this could result in savings of millions of euros.
Muller’s patients thought it was an excellent idea. “Sometimes I gratefully accepted sixty expensive pills during a consultation, to be able to hand them out again at the next,” says the doctor.
But not everyone was so enthusiastic. The hospital whistled Muller back because his action was against the law. It is unsafe to reuse medicines, because you are not sure whether patients have stored them properly. Even though half of it is in principle still usable, as pharmacist Marcel Bouvy researched.
How can the percentage of throwaways go down? By prescribing smarter. Bouvy gives an example: “For prostate cancer, some men receive a hormone injection once every three months. As a doctor, you can give a new prescription immediately after the injection. The patient often picks up the syringe directly from the pharmacy, while after three months it may turn out that he does not respond well to the injection. The injection is then discarded. Way 800 euros.”
As a patient you can also contribute. Does a doctor at the hospital prescribe a type of medicine that you still have at home? Then report that. Are you the carer of someone who uses a lot of medicines? In that case, do not ask too easily for repeat prescriptions, but consult with your doctor or pharmacist which medicines are still usable.
Bouvy: “Sometimes the family returns two plastic bags full of medicines to the pharmacy after someone’s death. A shame, of course.”
Free to collect: medical equipment
An old MRI scanner, worn-out heart monitoring equipment, an X-ray machine that no longer works: often it does not disappear in a garbage can, but is shipped to countries where they can still use the equipment. It’s not always about ‘cast-offs’. In a developed, rich country such as the Netherlands, medical developments are moving fast and new equipment is sometimes purchased purely because of the better options. There is nothing wrong with the old one, so it would be a shame not to make a hospital elsewhere in the world happy with it.
Dosing medication better
Cancer drugs are often contained in ampoules. If there is any leftover, the doctor should throw it away. Re-use by another patient is not possible, partly because the medication often has a very short shelf life. A shame, they thought in the Rotterdam Ikazia hospital. Research has shown that if a little more thought is given to the dosage, this could save 8.6 percent in costs.
How does that work? Oncologist Felix de Jongh: “The medication dose of patients with cancer is always precisely adjusted to their body weight. Suppose you have a patient who needs 51 milligrams of a drug based on his body weight. If the pharmacy works with ampoules of 50 milligrams, we therefore have to break open two ampoules and throw away 49 milligrams. We have now investigated that patients can also be helped with a little more or less medication. We argue for a safe margin of 10 percent. The patient in the example will then have enough with 50 milligrams and we only need to use one ampoule. This is a cost saving for the hospital, because it pays 20 percent of the medicine costs. This makes a big difference, especially with expensive cancer drugs. One ampoule costs 600 euros, so count your profit.”
Rollators on the boat
Rollators that are written off in the Netherlands go en masse on the boat to all corners of the world. Jolanda Beumer, owner of an Amsterdam care store that depreciates a few hundred rollators every year: “Rollators are taken out of circulation here if the white wheels can no longer be cleaned properly or if they have paint damage or a dent. They are always replaced after five years. But in other countries the requirements are often much lower than in the Netherlands and our old rollators are still usable there. Sometimes they can also make one good one out of two rollators. So we ship them to Suriname, Turkey, Morocco and Poland, among others.”
Pacemakers to chemical waste
A pacemaker lasts about six to eight years. After that time, the battery is depleted, and then the entire pacemaker is replaced. The old pacemaker, just like a pacemaker from someone who has died, goes into chemical waste. Because of those batteries!
Sources):
- Plus Magazine
