To find this stockpiling of medications really annoying?

[MindSweeper]

'This medicine was returned by a patient today. Once medicine has left a pharmacy it cannot be reused for safety reasons. All of the inhalers are full. The purple ones alone (all 42 of them) are worth £60 each. That is £2520 worth of medicines that the NHS could be using for something useful'

Medication wastage currently costs the NHS £300,000,000 per year.

It's shocking how much we have to waste in hospitals too, I see how much is destroyed and it makes me think how much good that could do for people in countries who don't have access to meds.

What solutions can you think of?

People are shifting the blame on pharmacists and doctors, but a lot of the time this stockpiling is people just not telling their doctors they're not taking medications, and still ticking the box to receive the med.

Pacific...I hope you don't think I was dissing all pharmacists! 😁
Sadly the one in my village isn't great (overly complicated computer system to blame if you ask me!) but I've had some really great service from pharmacists over the years...once or twice sending me straight to ooh dr as I had no idea how poorly I was! 😖
The system here is a bit silly IMHO.
I signed up to the "paperless" px service....this means that if the dr px something it goes straight to the pharmacy and the dr doesn't give you a script.
So off I trot happy that it's all going to be quicker and easier....
To be met with blind panic and to be told they need to print out the px to dispense it....HOW is this quicker!?
Am I missing something?
I couldn't be a dr or pharmacist...I couldn't cope with the people who knowingly and happily waste ££millions of tax payers money simply because they can.
Another thing that concerns me (as a parent and as a child of an elderly frail Mother) is the ease with which people can either not bother reading instructions

Reuse the stuff that's not out of date. It doesn't need to be thrown away.

CF isn't exempt!?
What!?
Madness!
😳😡
Footle...oh I've tried believe me! She's so determined it's causing me a bit of worry actually. I'm concerned she is actually getting a bit addicted to surgeries 😖 She's had a few in the past 2 years.
I hope the hcp she sees has the sense to say no. Unless she lies to them of course....sigh.
She can afford to have it done privately if she feels that strongly about it!

Actually my MIL had that with her glaucoma medication, with the result that it didn't work and her eye-sight continued to deteriorate. It was only when DH quizzed her on it he read the info and found out. Bizarrely the instructions are not provided in large print and either it wasn't explained properly at the clinic or she didn't take it all in.

Oh my goodness, this is shocking! And the cost of that wasted medication that has to be thrown is eye opening. Has anyone in the field thought about raising it as an issue using a similar examples through their local MP? That way the national press might pick up the wastage to NHS and make it a live discussion that gathers momentum & attention.

I definitely think telling people the actual cost to NHS of each item of medication they receive would go a way towards helping people change their behaviour if reordering unnecessarily.

It would be good to raise awareness amongst pharmacies and GP surgeries about intercare: medical aid for Africa that oxcat1 shared in her post today at 15:39.

Are there any pharmacists, GPs or nurses on here, that could raise this issue (with all the necc confidentially that is required not to breach professional ethics) with their local MP to be tabled as a discussion in House of Commons?

I think it's very, very common tbh.
I always go through with mum each new med and explain. But nit everyone has someone who can/will do that.
I'll never forget the night my mum asked my late dad to go and get her something from the co op.
She had a nasty chesty cough and it was keeping her up.
He did and came back with bronchial mixture.
Now...you need to dilute this stuff. It's something like half a teaspoon full in a large glass of hot water.
She necked it from the bottle neat 🙄😳😁
After dad and I had stopped laughing at her histrionics we ended up having to call the dr out (yes the days of home visits!!)
She couldn't get her breath and went a very odd colour.
Anyway, she was fine, but people do do silly things, especially if they are poorly and not thinking straight.

Whereismymumhiding, this is a well known issue and is often discussed.

Within my health board we are to save £42 million in this financial year. On medication alone.

So if you prefer paracetamol capsules over tablets, you have to buy them yourself. Or at least this is what GPs are being told we are to see when asked. However, if a patient complains to the HB prescribing advisor, they are being told 'it's up to your GP' .

Either, or - but if we are to crack down more on inefficient prescribing then it needs to be a joined up and consistent approach with ALL agencies singing off the same hymn sheet.

Unfortunately, there are many and competing interests at play, of course.

A Swedish friend told me that in Sweden everybody pays for prescriptions - even her dad who was over 90 and not well off. There is however an annual cap of a certain amount - not an awful lot - for those who need a lot of medication. And this is Sweden, which is popularly supposed to be a socialist Utopia. She told me that everyone pays for visits to the GP and A &E, too - maybe children are exempt, I forget.

Yes in Sweden you have to pay for healthcare - it really does make you think about the cost of things in a way that I never did in the UK

You have to pay the full cost of your medications up until £100 (per year) then you get increasing levels of discount between 50-90% and the max you can pay in any one year is £200 (you get a free card once you reach it)

The amount you pay for your healthcare appointments depends on where you live but the max in any one year is £100 - each health authority has its own price list
On average

GP visit - £15-20
Specialist/consultant £30-40
A&E £35-50 (but often 50% discount if sent by GP first)
Other (physio/district nurse/MH outreach etc) £10-15

Inpatient hospital (per day) £8-10
Crutches - £10 (but you can keep them)
Loan of other equipment £10-15

In most counties children are free but a couple charge ½ price

Dosette boxes (compliance packs round here!) still won't make people take their meds, though will they? It will help people who either can't manage the blister packs, or who get confused about when and which, but has nothing to do with whether or not!

I had a problem keeping up with my prescriptions for a while - meds changing completely, doses in flux etc - and once I'd got it all sorted it was embarrassing how much extra I had of some things. I can understand how it happens, when you're maybe getting confused anyway and you're feeling like shit, and tiredness and worry chucked on top. Add to that the insecurity of having run out of a pill once and having had to wait a few days before you get it - it takes quite a while to feel secure again.

I check my meds before I leave the chemist so I can hand anything back straightaway, a result of my gp retiring and no one quite sure who my new gp is and what I'm supposed to be taking. They keep adding the wrong statin, or giving me twice as much pregabalin, or half as much propranolol etc.

Perhaps if people had to check through their prescription every time before they leave the chemist that would help?

How about anyone shocked by this raises it with their local MP? I.e. Asking them as a concerned constituent member to check this out with their local pharmacies to get a sense from them of scale of wastage? We could start a campaign from grassroots via a number of MPs....!
Is that a reasonable idea? Or am I the only one that thinks that?

The thing is, most medications could be prescribed in a small dose. There are very few that come in special containers that cannot be split. If a doctor prescribed 1 paracetamol tablet then a pharmacy could easily dispense that. Sure its annoying to split packs and it takes a bit longer to dispense a split pack, so I see why its not done in a practical sense. However for really expensive medications which may not suit a patient, I think it could easily be done.

Drifting, slightly, I think the way exemptions are implemented is bizarre to be charitable, and bonkers, to be blunt. Especially since, generally, they don't seem to have any medical basis.

Diabetic ? Great. Free prescriptions. For everything.

Glaucoma on lifelong medication (like me ?). Get fucked.

So a Glaucoma suffered who doesn't want to go blind (is there any other sort) is paying a tax on their illness if they are working.

Why not make the Glaucoma meds exempt, but all else (e.g. a course of antibiotics) chargeable ? It certainly can't be for lack of systems spending - the NHS has swallowed enough IT to get us to the Moon and back. Twenty times.

I have asked to take a few items to try and I always get told no, I either take the lot or none they can't give half a prescription.

I have also asked the dietician to prescribe less but she says it's a standard script.

BTW. I don't mean turn it into a witch hunt of 'who is to blame' by suggesting people raise it with their MPs, but that it could become (I hope) a constructive national debate of different strategies that can be used to help reduce wastage like OP posted. ( My only worry would be it could get derailed into a blaming exercise rather than a fixing exercise)

anecdotally - I am only ever given 2 months worth of thyroxine and have to renew and get Dr approval for the repeat prescription when ordered online
I was prescribed Statins - did not agree with me so I never asked for more
Why on earth would someone keep asking and taking a repeat prescription for something they do not use.
IMO I feel all prescription drugs should be charged for (for all ages and health conditions) with the option to take out an annual (all meds) charge which would cover most people's needs.

I don't think all should be charged tbh.

There were times when I was a student that I couldn't get my medications because (to stop me going manic) I couldn't afford them and wasn't exempt from paying, I even applied for the low income thing but wasn't entitled.

I think we would be punishing people

Meanwhile I'm not ordering my prescriptions for inhalers because it costs too much.

There is also a massive issue with pharmacies dispensing incorrectly.
My friend has taken over sorting her mothers meds, and every time (except for 2) she has gone to collect over the last 18 months there has been something wrong, collections are at least monthly and more if there has been changes of meds or different illnesses, not all of these have resulted in meds being given that have been returned (wrong dosages and wrong tablets), but at least 30% (that's also being generous)- how does this happen?
Its not a one off- has also happened with my family (different pharmacy)- some of these are controlled drugs, the price and risk is huge.

From the patient side I think people being aware of what meds actually cost is a good idea.
Oh and send me the purple inhalers

One time I got a prescription for 100 pills.
I calculated that I really needed at very most maximum of 21.
I crossed 100 out & wrote down 30.
It took me 3+ yrs to use up the 30 & I never needed a renewal.

Earlier this yr I rang GP for a muscle relaxant prescription (sudden bad back). DH picked up the prescription. So I now have 90 pills in a bottle I don't need, may never need. :( I suppose may be handy for next time DH's back goes.

I think I need in future to stress to GPs exactly how many pills I really will need, I can do the maths even when I'm unwell.

Paracetamol: why can't doctors issue, not a prescription, but a 'please allow to buy in the following quantities' notice?

I completely agree. My Mum takes paracetamol regularly for her arthritis. Up until this week she has been asking us to get it for her which is fine but as you can only buy 32 at a time it's not practical. She didn't want to ask for a prescription as it didn't feel right to her (she doesn't pay) but I persuaded her to do it and she's now got a repeat prescription of 100. If she could get that quantity over the counter it would make sense

And to think I felt bad about the 12 tins of baby milk we get a month!

Sorry I haven't RTFT but years back when I worked in pharmaceutical sales I had to take the industry exam and I was really shocked when I learnt that 87% of prescriptions are exempt from payment.

I am very lucky in that I have always been in a position to pay for the prescriptions I have been given, but I do feel that if even a nominal charge was made, it would give the medicine a value to the recipient.
If everyone was asked to pay say a 50p charge for a complete prescription regardless of the number of items would this end up generating more money for the NHS than the current £8.40 per item paid by 13% of prescription users? What if the non exempt still paid the per item higher charge?

I just think no cost = no value to some people

Not all meds are controlled by GP, though they may well be writing the prescription. Not sure I would be keen on my GP deciding how much warfarin I need.

Why does everyone in Wales and Scotland get free prescriptions but in England we have to pay?

I pay for my inhalers so there is no way I would tick both boxes when I only needed say the preventer not a reliever.
My GP will always ask if I pay, then will tell me if I can get it cheaper over the counter.

Maybe things like very basic painkillers that are dirt cheap shouldn't be available on prescription.

Unfortunately I think most of the waste will be either from people who don't realise, like the elderly who are on auto repeats, or those who just don't give a shit as long as it's free.