Almost 460 tons of unused and expired prescription drugs were collected nationwide during the October 2018 “National Take Back Day,” an initiative by the Drug Enforcement Agency to encourage people to rid themselves of unwanted or outdated medications. Through the “Takeback” program, pharmacies, police stations, health facilities and other designated locations serve as drop-off locations for individuals to safely and anonymously discard their medications.
The success of the Takeback program, which recently marked its 17th event in April 2019, highlights the large volume of prescription medications Americans have in their households – and the fact that most people fail to regularly clean out their medicine cabinets of expired and unused medicines.
But what sort of steps are in place to ensure that pharmacies themselves are rid of expired medications, and not inadvertently adding to the problem by dispensing expired drugs to their patients? Is it time to implement a national “Pharmacy Takeback Day” as well?
Expired medications are a concern to pharmacy managers for many reasons. For one thing, it is illegal to dispense expired medications, and any pharmacy that inadvertently does so, risks significant penalties. Both CVS and Walgreen’s faced steepfines in recent years, following allegations that expired drugs were sold to customers. In addition to these monetary fines, the companies faced negative media attention, and the potential for lost trust among its consumers.
Expired medications can also impose significant costs on a pharmacy’s bottom line. According to research by NPR and ProPublica, expired drugs can cost a hospital in excess of $200,000 annually, And when expired drugs discarded by pharmacies and consumers are factored in, the cost exceeds $1 billion annually.
While technicians and pharmacists serve as the first line of defense by regularly checking inventory and removing expired – or nearly-expired – medications, pharmacists have an added tool at their disposal in their technology management systems. A comprehensive system allows pharmacies to manage inventory and ordering processes, but used effectively, the system can help guard against drugs remaining on the shelves past their expiration dates. Key technology capabilities include:
Inventory Management. The easiest way to prevent your pharmacy from being saddled with expired medications, is through proper inventory management. This includes only keeping enough medications on-hand for short-term needs, and by order higher-priced, less-often prescribed drugs on an as-needed basis.
An integrated technology system will link directly to a pharmacy’s wholesalers and distributors so that reorders can be transmitted automatically when the supply of a particular drug reaches a pre-determined level. For fast-moving drugs, a reorder “trigger” can be set at a much higher level than for a slower-moving drug. This ensures that inventory replenishment keeps pace with patient demand.
Real-time expiration tracking. In addition to tracking the volume of drugs on hand, the system can also monitor expiration dates for supplies of each drug. The expiration date for each unit in a pharmacy’s supply of EpiPens, for example, can be scanned into the system and flagged as the expiration date approaches. Pharmacy staff can then remove the expired unit from inventory, and place it in the pharmacy’s “do not dispense” area for proper disposal.
Verification of Patient Demand for Expensive Drugs. Abandoned prescriptions are a common cause of a pharmacy finding itself with expired medications. Abandoned prescriptions generally refer to expensive or seldom-requested medications a pharmacy acquires to meet the needs of specific patients. If a patient ultimately fails to pick up that prescription, the pharmacy is often forced to carry the medication in its inventory. Pharmacies can minimize the risk of prescription abandonment by using its technology system to proactively confirm a patient’s intentions. An electronically generated text or email can ask patients to confirm whether or not they would like their prescriptions filled. This simple step can help pharmacies minimize the risk of holding costly medications in their inventories – medications that stand a good chance of expiring on the shelf.
The PrimeRx™ pharmacy management system is a good example of how technology can help a pharmacy manage expiration dates. The system’s user-friendly navigation fields allow pharmacy staff to easily enter expiration information, and can automatically generate an alert whenever an expiration date draws near – or when an expiration date has passed. In addition, a pharmacy manager can generate reports on a range of topics including inventory flows, scheduled expiration dates, and pending refills for expensive or rare drugs.
No reputable pharmacy would knowingly dispense expired medications to a patient. And with an integrated technology system working as an added layer of internal control, pharmacy managers can have peace of mind that “just enough” inventory levels are continually updated, with expired and nearly-expired medications flagged and removed.