Drugs up in smoke: a study of caseated drugs in Sweden

Design: Cross-sectional survey Setting: The county of Malmohus, with 817,000 inhabitants, in the far south of Sweden. All drugs handed in for destruction to the 65 pharmacies during one week in March 1996 were analysed. Results: 92% of the packages were prescription drugs for human use, 7% were over-the-counter drugs, and 1% were for veterinary use. Slightly less than half (48%) had expired when they were handed in for destruction. 36% were unbroken when returned and another 18% of the packages were nearly full. A comparison between the drugs sent in for destruction and the drugs sold in the county gave a ratio of 0.030. Antineoplastic and immunosuppressive drug s, drugs for the respiratory system, antiparasitic products, and cardiovasc ular drugs were returned to a greater extent than other types of drugs. Dru gs for the genito-urinary tract, sex hormones, and drugs for the alimentary tract were returned to a lesser extent. Extrapolated to a whole year the v alue of caseated drugs was estimated to 60 SEK (5.83 Br ,) per person. The value of unbroken packages was 20 SEK (1.94 Br ,) per person per year. Conclusion: Although not all of the drugs handed in for destruction could h ave been unnecessarily prescribed or obtained by the patient, a more cautio us approach to prescribing of drugs would likely yield significant savings.