Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy

C. L. Bekker; E. J. Melis; A. C. G. Egberts; M. L. Bouvy; H. Gardarsdottir; B. J. F. van den Bemt

doi:10.1016/j.sapharm.2018.03.064

Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy

C. L. Bekker, E. J. Melis, A. C. G. Egberts, M. L. Bouvy, H. Gardarsdottir, B. J. F. van den Bemt^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Patients sometimes discontinue the use of expensive oral anti-cancer drug (OACD) or biological disease-modifying anti-rheumatic drug (bDMARD) therapies early, leading to medication waste if the patient has not used all dispensed medication.

Objective: To determine the proportion of patients who have unused OACDs or bDMARDs after therapy discontinuation, and the quantity and economic value of these unused medications. Furthermore, patients' reasons for therapy discontinuation and their disposal method for unused medications were determined.

Methods: In a retrospective follow-up study using a Dutch outpatient pharmacy database, patients (>= 18 years) who did not refill an OACD or bDMARD prescription, dispensed between November 2015 and February 2016, within two weeks of the prescription end date were contacted by phone and asked about their unused medication and reasons thereof. The economic value was calculated using Dutch medication prices. Data were descriptively analyzed in STATA13.

Results: The database included 1173 patients, of whom 159 likely had discontinued therapy and were contacted. Of these, 88 patients were excluded (39 refilled, 47 missing, and 2 other). Of the 71 patients who had discontinued therapy, 39 (54.9%) had unused medications, comprising 22 OACD users (mean age 63.0 (SD +/- 15.9) years, 50.0% female) and 17 bDMARD users (mean age 50.7 (SD +/- 13.5) years, 47.1% female). A total of 59 packages were unused, with a total value of (sic)60,341. Unused OACD packages and bDMARD packages had median values of (sic)179 (IQR (sic)24-2487) and (sic)992 (IQR (sic)681-1093), respectively. Patients primarily discontinued therapy due to adverse or insufficient effects.

Conclusions: This study illustrates that more than half of patients discontinuing OACD or bDMARD therapies have unused medication. This emphasizes the need for waste-reducing interventions.

Original language	English
Pages (from-to)	100-105
Number of pages	6
Journal	Research in Social & Administrative Pharmacy
Volume	15
Issue number	1
DOIs	https://doi.org/10.1016/j.sapharm.2018.03.064
Publication status	Published - Jan 2019

Keywords

Medication waste
Unused medications
Therapy discontinuation
Health economics
RETURNED MEDICINES
RHEUMATIC-DISEASES
MEDICATIONS
ADHERENCE
COSTS

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10.1016/j.sapharm.2018.03.064

Cite this

Bekker, C. L., Melis, E. J., Egberts, A. C. G., Bouvy, M. L., Gardarsdottir, H., & van den Bemt, B. J. F. (2019). Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy. Research in Social & Administrative Pharmacy, 15(1), 100-105. https://doi.org/10.1016/j.sapharm.2018.03.064

@article{c5e41e9172b64667ac19a1e262bf08cc,

title = "Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy",

abstract = "Background: Patients sometimes discontinue the use of expensive oral anti-cancer drug (OACD) or biological disease-modifying anti-rheumatic drug (bDMARD) therapies early, leading to medication waste if the patient has not used all dispensed medication.Objective: To determine the proportion of patients who have unused OACDs or bDMARDs after therapy discontinuation, and the quantity and economic value of these unused medications. Furthermore, patients' reasons for therapy discontinuation and their disposal method for unused medications were determined.Methods: In a retrospective follow-up study using a Dutch outpatient pharmacy database, patients (>= 18 years) who did not refill an OACD or bDMARD prescription, dispensed between November 2015 and February 2016, within two weeks of the prescription end date were contacted by phone and asked about their unused medication and reasons thereof. The economic value was calculated using Dutch medication prices. Data were descriptively analyzed in STATA13.Results: The database included 1173 patients, of whom 159 likely had discontinued therapy and were contacted. Of these, 88 patients were excluded (39 refilled, 47 missing, and 2 other). Of the 71 patients who had discontinued therapy, 39 (54.9%) had unused medications, comprising 22 OACD users (mean age 63.0 (SD +/- 15.9) years, 50.0% female) and 17 bDMARD users (mean age 50.7 (SD +/- 13.5) years, 47.1% female). A total of 59 packages were unused, with a total value of (sic)60,341. Unused OACD packages and bDMARD packages had median values of (sic)179 (IQR (sic)24-2487) and (sic)992 (IQR (sic)681-1093), respectively. Patients primarily discontinued therapy due to adverse or insufficient effects.Conclusions: This study illustrates that more than half of patients discontinuing OACD or bDMARD therapies have unused medication. This emphasizes the need for waste-reducing interventions.",

keywords = "Medication waste, Unused medications, Therapy discontinuation, Health economics, RETURNED MEDICINES, RHEUMATIC-DISEASES, MEDICATIONS, ADHERENCE, COSTS",

author = "Bekker, {C. L.} and Melis, {E. J.} and Egberts, {A. C. G.} and Bouvy, {M. L.} and H. Gardarsdottir and {van den Bemt}, {B. J. F.}",

note = "Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",

year = "2019",

month = jan,

doi = "10.1016/j.sapharm.2018.03.064",

language = "English",

volume = "15",

pages = "100--105",

journal = "Research in Social & Administrative Pharmacy",

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Bekker, CL, Melis, EJ, Egberts, ACG, Bouvy, ML, Gardarsdottir, H & van den Bemt, BJF 2019, 'Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy', Research in Social & Administrative Pharmacy, vol. 15, no. 1, pp. 100-105. https://doi.org/10.1016/j.sapharm.2018.03.064

Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy. / Bekker, C. L.; Melis, E. J.; Egberts, A. C. G. et al.
In: Research in Social & Administrative Pharmacy, Vol. 15, No. 1, 01.2019, p. 100-105.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy

AU - Bekker, C. L.

AU - Melis, E. J.

AU - Egberts, A. C. G.

AU - Bouvy, M. L.

AU - Gardarsdottir, H.

AU - van den Bemt, B. J. F.

PY - 2019/1

Y1 - 2019/1

N2 - Background: Patients sometimes discontinue the use of expensive oral anti-cancer drug (OACD) or biological disease-modifying anti-rheumatic drug (bDMARD) therapies early, leading to medication waste if the patient has not used all dispensed medication.Objective: To determine the proportion of patients who have unused OACDs or bDMARDs after therapy discontinuation, and the quantity and economic value of these unused medications. Furthermore, patients' reasons for therapy discontinuation and their disposal method for unused medications were determined.Methods: In a retrospective follow-up study using a Dutch outpatient pharmacy database, patients (>= 18 years) who did not refill an OACD or bDMARD prescription, dispensed between November 2015 and February 2016, within two weeks of the prescription end date were contacted by phone and asked about their unused medication and reasons thereof. The economic value was calculated using Dutch medication prices. Data were descriptively analyzed in STATA13.Results: The database included 1173 patients, of whom 159 likely had discontinued therapy and were contacted. Of these, 88 patients were excluded (39 refilled, 47 missing, and 2 other). Of the 71 patients who had discontinued therapy, 39 (54.9%) had unused medications, comprising 22 OACD users (mean age 63.0 (SD +/- 15.9) years, 50.0% female) and 17 bDMARD users (mean age 50.7 (SD +/- 13.5) years, 47.1% female). A total of 59 packages were unused, with a total value of (sic)60,341. Unused OACD packages and bDMARD packages had median values of (sic)179 (IQR (sic)24-2487) and (sic)992 (IQR (sic)681-1093), respectively. Patients primarily discontinued therapy due to adverse or insufficient effects.Conclusions: This study illustrates that more than half of patients discontinuing OACD or bDMARD therapies have unused medication. This emphasizes the need for waste-reducing interventions.

AB - Background: Patients sometimes discontinue the use of expensive oral anti-cancer drug (OACD) or biological disease-modifying anti-rheumatic drug (bDMARD) therapies early, leading to medication waste if the patient has not used all dispensed medication.Objective: To determine the proportion of patients who have unused OACDs or bDMARDs after therapy discontinuation, and the quantity and economic value of these unused medications. Furthermore, patients' reasons for therapy discontinuation and their disposal method for unused medications were determined.Methods: In a retrospective follow-up study using a Dutch outpatient pharmacy database, patients (>= 18 years) who did not refill an OACD or bDMARD prescription, dispensed between November 2015 and February 2016, within two weeks of the prescription end date were contacted by phone and asked about their unused medication and reasons thereof. The economic value was calculated using Dutch medication prices. Data were descriptively analyzed in STATA13.Results: The database included 1173 patients, of whom 159 likely had discontinued therapy and were contacted. Of these, 88 patients were excluded (39 refilled, 47 missing, and 2 other). Of the 71 patients who had discontinued therapy, 39 (54.9%) had unused medications, comprising 22 OACD users (mean age 63.0 (SD +/- 15.9) years, 50.0% female) and 17 bDMARD users (mean age 50.7 (SD +/- 13.5) years, 47.1% female). A total of 59 packages were unused, with a total value of (sic)60,341. Unused OACD packages and bDMARD packages had median values of (sic)179 (IQR (sic)24-2487) and (sic)992 (IQR (sic)681-1093), respectively. Patients primarily discontinued therapy due to adverse or insufficient effects.Conclusions: This study illustrates that more than half of patients discontinuing OACD or bDMARD therapies have unused medication. This emphasizes the need for waste-reducing interventions.

KW - Medication waste

KW - Unused medications

KW - Therapy discontinuation

KW - Health economics

KW - RETURNED MEDICINES

KW - RHEUMATIC-DISEASES

KW - MEDICATIONS

KW - ADHERENCE

KW - COSTS

U2 - 10.1016/j.sapharm.2018.03.064

DO - 10.1016/j.sapharm.2018.03.064

M3 - Article

C2 - 29610051

SN - 1551-7411

VL - 15

SP - 100

EP - 105

JO - Research in Social & Administrative Pharmacy

JF - Research in Social & Administrative Pharmacy

IS - 1

ER -