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Community pharmacists should be allowed to reuse unopened medicines, says BMA


By Isabel Shaw
Reporter

22 Oct 2020

Community pharmacies should be allowed to supply patients with medicines that have been returned in unused packaging to help reduce medicines waste, the BMA has proposed.

In an open letter to junior minister Jo Churchill, the BMA suggested several ways general practice can reduce its carbon footprint, including an extension of the recent relaxation of medicines reuse rules to community pharmacy and primary care.

In April, the Government introduced a standard operating procedure that allowed care homes and hospices to reuse certain unused medicines during the Covid-19 pandemic, providing strict criteria were met.

The BMA letter said: ‘The current pandemic saw us work together in the relaxation of rules in secondary care and care homes which dictate that any medicines that have left the pharmacy cannot be given to another patient, even if they are unopened.

‘Following a review of existing regulations, this relaxation could be extended to primary care and community pharmacy, allowing pharmacists and clinicians to make us of medicines that are returned in unused packaging and providing a significant reduction in medicines waste.’

Under the Human Medicines Regulations 2012, pharmacists are not currently permitted to re-use or recycle another patient’s medicine, even if returned to the pharmacy unopened.

Patient safety not guaranteed

Sandra Gidley, president of the RPS, said she did not support the BMA’s proposal.

She said: ‘Medicines returned to the pharmacy cannot be re-used primarily due to patient safety issues. The quality and efficacy of a medicine is difficult to assess when the medicine is returned to the pharmacy, so patient safety cannot be guaranteed.

‘Some medicines could have been inappropriately stored and have degraded, causing a loss of potency or the development of toxic breakdown products.’

She added: ‘The real answer is for pharmacists, doctors and nurses to work together to ensure patients understand their medicines, what they are for, how to take them and manage side-effects so that people don’t waste medicines by discarding or stockpiling the ones they no longer need or benefit from.

‘Care homes work to standards of medicines storage so there is minimal risk to patients in the reuse of medicines. The situation in households up and down the country is much more variable.’

Carbon footprint labels

The BMA also proposed that all medicines be labelled with their carbon footprint, after estimating that between 65% and 90% of general practice’s carbon footprint comes from pharmaceutical prescribing.

By putting the carbon footprint of the medicine on the label ‘GPs and other clinicians can make informed decisions about the carbon footprint of the medicines they prescribe,’ the body said.

The BMA’s letter follows the recent publication of the NHS’s plan to tackle climate change by reducing its emissions to ‘net zero’.

According to ‘Delivering a ‘Net Zero’ National Health Service’, published earlier this month, 20% of all carbon emissions within the NHS come from the manufacturing of medicines.

Interventions being considered to reduce these emissions include optimising prescribing, substituting high carbon products for low-carbon alternatives, and improvements in production and waste processes.

The report said that the NHS is working with patients, clinicians and industry to reduce emissions, and will continue to ‘work with pharmaceutical companies to encourage carbon transparency reporting’.

‘Further work will include the active consideration of compulsory reporting from suppliers, and the inclusion of carbon accounting in the metric by which suppliers are assessed during procurement exercises,’ it added.


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