Introduction: Although the increasing costs in the health system in Germany
is a frequently discussed topic, the amount of the so-called unused drugs
which patients and customers bring back to pharmacies does not seem to dimi
nish. In 1988, the authors conducted a study to document this problem. Ten
years later, in 1998, a second study with the same design was done. The new
data are compared with the results of the first study. Methods: The study
was carried out in a public pharmacy in Berlin, Germany, 1998. All drugs re
turned unused were documented during a period of 12 months. The drugs were
counted and classified according to therapeutic groups and to prescription
or OTC status. The remaining amount in each package was determined in relat
ion to the package size. The prices of the drugs were obtained from the "Ro
te Liste 1997". Results: 10,603 unused drug-packages were collected (1988:
n = 5,164). The 10 most frequent indication groups showed nearly the same r
anking as the German annual report of prescribed drugs (GKV-Index 1988, sam
e result). Only 17% of the returned drugs were for self-medication (1988: 1
2%). The value of the original medicines amounted to approximately DM 232,9
20 (1988: DM 100,000), therefore,, the average drug price was DM 22 (1988:
DM 19). On an average, packages contained 65% (1988: 70%). 24% of the drug
packages returned contained the original content, i.e. were unused (1988: 3
1%). 39% of the returned packages contained 51-99% of the original contents
(1988: 35%) and 37% contained up to 50% of the original contents (1988: 34
%). Conclusions: Although patients in Germany had to pay a higher prescript
ion charge in 1998 than in 1988, the amount of unused drugs has increased.
The reasons for this non-compliant behavior have not yet been analyzed. The
results of this study suggest the need for further research for the reason
s of non-compliance.