Minimize Waste in Your Pharmacy’s Budget

Billions of dollars’ worth of meds go to waste in hospitals each year...due to discontinuation, dose changes, expiration, etc.

But you’re in a prime position to help minimize med waste.

Start by getting familiar with common meds that are very costly.

Think “ABC” to remember the biggies...some antimicrobials (cefiderocol, isavuconazonium, etc)...biologics (bevacizumab, rituximab, etc)...and chemo meds (erlotinib, paclitaxel, etc).

Take note of whether meds added to formulary are high in cost.

Don’t assume older meds are inexpensive...sometimes they’re not. For example, vasopressin can cost around $200/vial...and IV vitamin K can cost almost $50/amp or vial.

If unused meds are routinely disposed of, try to find out why.

For instance, prepping short-stability meds, such as ertapenem or rifampin, too early means that doses may expire before they’re given.

Or ordering too much of a specialty or other rarely used med means it could expire before it’s needed.

Check with a pharmacist before prepping odd doses that require wasting a partial vial...or won’t likely be reissued if not used.

It may be possible to switch to a more common dose...or to a whole vial...without impacting patient care. And the pharmacist can get the ball rolling on a dose-rounding protocol, if needed.

For instance, dispensing a fixed Kcentra dose of 1,500 or 2,000 units instead of a weight-based dose could save hundreds of dollars.

Consider whether alternative package sizes could reduce waste. Work with admin to check availability and add to stock.

Be aware, some prepped but unused doses can be refunded or replaced...such as alteplase for stroke.

Identify these meds and use shelf tags or other reminders to follow proper procedures.

Look into additional ways to reduce waste. For instance, you may be able to prep and freeze individual doses from leftover alteplase.

Keep in mind, med waste doesn’t just hit hospitals in the pocketbook. It causes other problems, such as worsening shortages.

Get our resource, The Ins and Outs of Pharmacy Inventory, for more useful strategies to properly manage stock.

Key References

  • J Pediatr Pharmacol Ther. 2014 Apr;19(2):111-7
  • Pharmacy (Basel). 2018 Aug 29;6(3):94
Hospital Pharmacy Technician's Letter. August 2022, No. 380819



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