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2.5 Deputy G.C.L. Baudains of the Minister for Social Security regarding return of unwanted prescription drugs:
Are details of unwanted prescription drugs, which are returned to dispensing
pharmacies, reported to the Department, and if so, what is the percentage and value of
those returns, not including prescriptions returned for disposal after the expiry date? Senator P.F. Routier (The Minister for Social Security):
The simple answer to the question is no: details of medicines returned through the pharmacies are not reported to the Department. However pharmacies do notify the Department of medicines returned in exceptional quantities, which in turn helps the Department to emphasise the need when discussing with general practitioners to review medication on a regular basis with their patients. The Department also benefits from the advice of a pharmaceutical advisor who helps G.P.s review their prescribing habits and associated costs. Although wastage is an issue, fortunately Jersey's limit of 30 days supply on prescription helps to control that because we just do not have the same issues that other jurisdictions have.
- Deputy G.C.L. Baudains:
I wonder if the Minister would consider attempting at least to gain some idea of the scale of the issue, because my understanding is that some medicines are heavily subsidised by the taxpayer when they are paid for at the normal prescription rate, and if there was any significant amount of return of drugs that could conceivably be used again, surely there could be considerable savings for the taxpayer. Would the Minister consider attempting to get some view as to the volume and monetary value involved?
Senator P.F. Routier:
Firstly, I am amazed at the suggestion that prescription drugs which have been prescribed for an individual could be considered to be re-issued to somebody else. There is no knowing of how those drugs have been stored or used and it would be totally inappropriate to consider to re-issue those drugs to another patient. In fact my understanding from the Minister of Health is that if a pharmacist was to attempt to do that he would be struck-off. So, I do not think it would be appropriate to take that line of action. With regard to the value of drugs which may not be used, the Rotary Club run a Dump' campaign quite regularly and I think at the last time they carried that out it was estimated that about 10 per cent of drugs for the Island are probably not used, and a value to that would be about £1 million. So, there is wastage, there is no doubt about it, but ethically and sensibly and reasonably it is not appropriate to re- issue drugs to other people.
- Deputy A.D. Lewis of St. John :
The Minister just mentioned the Dump' campaign, that is what my supplementary
was going to be about. Would the Minister consider that in conjunction with the Health Department a campaign could be set up to dispense safely unused and expired products? I believe the last national campaign was back in the 1980s, and of course this resulted in quite a large decline of incidents of the likes of children inadvertently accessing prescription drugs. Would the Minister consider some kind of campaign to encourage people to dispose of their excess drugs?
Senator P.F. Routier:
Yes, certainly, I believe from Dump' campaigns that when it has been carried out before in previous years it has been very successful. What I would encourage people to do when they are prescribed drugs is firstly to use them in the way they are prescribed, because there is not even confidence that people take the drugs at the right time and there is national information being gathered which does indicate that if people do not use the drugs in the way that they are prescribed them, it could even be that the drugs are not being effective, so there is even more wastage. So, there is that side of it, but with regard to Dump' I would certainly recommend that a similar campaign is carried out and encourage the population to dispose of their drugs very carefully.
- Deputy J.A. Martin of St. Helier :
The Minister has already stated that nobody reports pharmacies do not report the return of drugs. He has also stated we over-prescribe, and under the Dump' issue about £1 million of drugs a year are disposed of. Now, that is quite a lot of money. Who polices this? The Minister, Sir, also mentioned that if a pharmacist was doing this he would be struck-off immediately, but as far as I can ascertain from the answers so far, nobody knows and there seems to be a lot of money and a lot of drugs involved in this question. Thank you, Sir.
Senator P.F. Routier:
It is quite a wide-ranging question, but certainly the mechanism for people receiving drugs from the pharmacies is fairly straight-forward and we have to be sure and encourage people to use their drugs wisely. There are people and we know, personally, you probably get prescribed an amount of drugs for a particular month's series, or 30 days, and do not use them all. That is quite possible. It is possible that you feel better within the 30 days, so there is an amount of drugs that does get wasted, and as far as monitoring what the pharmacists do if they were to re-issue them, the pharmacists are licensed pharmacists who have a strict code of conduct which they have to abide by, and we have to rely on their professionalism to ensure that they do maintain high standards.
- Deputy J.A. Martin:
So, can I take the answer is no one is policing this, Sir? Thank you. Senator P.F. Routier:
You can, yes, but their licences ensure that they have to continue in a proper manner.
- Deputy G.C.L. Baudains:
Yes, clearly there are circumstances where a pharmacy might find it inappropriate to
re-use drugs that had been returned because they did not know about the condition of
them, so the Minister gave us a couple of reasons why they could not be re-used. Could he tell me, for example, medicines which have not even left the pharmacy premises - why they should not be reused? He also stated that of course one could not be sure of how they had been stored. Can he guarantee that between the manufacture of the drug and the actual receipt of it by the pharmacy that it has been properly stored all the way?
Senator P.F. Routier:
I am sorry, I have forgotten the first part of the question. Can you repeat the first part?
Deputy G.C.L. Baudains:
Drugs that had not left the pharmacy. Senator P.F. Routier:
Yes, sorry. Certainly if a drug has not been prescribed to somebody, if it has not left
the pharmacy it would not have been prescribed out, so the conditions that they had been stored in would be correct and in a correct manner.
Deputy G.C.L. Baudains:
I think perhaps if I could assist the Minister he may have misunderstood me, if I could perhaps give a very quick example? Were I to be prescribed a drug and I go to the pharmacy to collect it, and I receive the packet of drug, I look at the thing and say: "No, I do not want to take those" and give them back, they are immediately thrown in the dustbin. Surely that is not a wise use of taxpayers money.
Senator P.F. Routier:
I am sorry, Sir, but that is quite a wild example, which I think the Deputy has If somebody has been prescribed a drug I would hope that they would recognise that was a drug that their G.P. recommended for them and that they would take the drug. The decision not to take that drug would have been perhaps better made when the G.P. was prescribing them in the surgery.