Like all industries, the pharmaceutical industry undeniably has an impact on the environment. Medicines alone contribute to the global harm caused by the healthcare sector with residues from pharmaceuticals found in the environment from formulation, manufacture, distribution, patient use and improper disposal. Pharmacists and pharmacies around the world are using their knowledge of medicines to try and reduce this impact.
What Are Pharmacies Doing To Be Sustainable?
- Pharmacists try to decrease medicine waste by managing stock closely, monitoring how much stock is kept on the shelves, and checking medicine expiry dates to try and keep the disposal of expired or unused medicines at a minimum.
- Unused medicines are collected from patients – this removes unwanted, unused and expired medicines from homes to increase the safety of those living there and potentially as suicide prevention as some stockpiled medicines can be used in overdose.
- Medicines are disposed of safely. Medicines contribute to water contamination and disrupt ecosystems if they are not properly disposed of.
- Pharmacists undertake medicine reviews on patient’s prescribed medicines to check for overprescribed or unneeded medicines. Potential medicine waste is identified and a patient’s compliance often improves after a review. This can avoid the significant environmental cost from medicines that are prescribed but not taken – from the waste of the medicine itself as well as the wasted resources used to produce and supply the medicine.
- Pharmacists work with prescribers to deprescribe unwanted or unneeded medicines, to prevent them going into landfill.
- Pharmacies are decreasing paper usage with the use of electronic technology – medical records are now electronic, e-prescribing sends prescriptions to pharmacies via email, essential documentation is digitally stored and online resources are used for medicine information, treatment guidelines and legislation.
- Pharmacies are switching to energy-efficient practices – using efficient lighting like LED, low energy appliances and equipment, smart systems for heating/cooling/air conditioning, motion sensor lights and energy efficient gadgets.1
- Sustainable packaging is used.
- Recycling of glass, paper, cardboard and plastic minimises waste. Storage bins from wholesalers that are used to pack medicines are returned and used again.
- Natural lighting, light-coloured paint used on interiors and transparent display shelves are used to decrease the need for overhead lighting.
- Pressurised Metered Dose asthma inhalers (MDIs) contain propellants that are potent greenhouse gases. Sometimes it is possible to switch to ones with lower propellant levels, and pharmacists encourage patients to keep track of their inhaler doses so they don’t throw out half-used ones.
What Happens To My Medicines After I Return Them To The Pharmacy?
In New Zealand the waste from community and hospital pharmacies is collectively taken to a treatment facility in South Auckland where it is autoclaved (sterilised using steam) then disposed of into a landfill that has been protected against leakage (lined with a plastic liner, topped with clay soil then gravel is added before it is safe to use for medical waste).2
Unfortunately for legal reasons in New Zealand, part pack or unused medicines (even if they are still in date) that are returned by patients to the pharmacy cannot be reused. This is because the pharmacist cannot guarantee how the medicines have been stored or whether they have been tampered with.
Sometimes appropriate medicines are reused where possible and sent to the Pacific Islands via Medical Aid Abroad. These would be short-dated medicines or medical devices no longer needed in the pharmacy that had not been dispensed to patients.
The Future
- There is ongoing research looking at the carbon footprint and environmental risk of medicines, so prescribers and patients will be able to make environmentally informed choices.
- There is actually no ‘one-size-fits-all’ when it comes to medicine and there is great variation between people leading to different responses to treatments. The developing field of pharmacogenomics (the study of how genes affect a person’s response to drugs) will allow medicines to be tailored to a patient’s specific genetic profile. This will result in a more effective treatment, less side effects and less pharmaceutical waste.3
- Of all medicines in use, inhalers and medical gases have the biggest environmental impact. It is likely that in the future, pharmacies will collect back used inhalers so the propellant gas can be removed and the metal components recycled.
- Medication blister packing can be recycled by chopping it up and turning it into pellets which is then used in outdoor furniture, bins and fencing, however this facility is not yet available in New Zealand.
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