Expanding the war on waste: recycling cancer drugs

Background: Cancer drug expenditure is enormous and rising rapidly. There is potential for the waste of parenteral cancer drugs, ordered from external compounding companies, if patients are delayed or have treatment discontinued. Unused drugs can be orphaned and potentially reused in the future, for the same or other patients, up to their expiry date. Aim: This study evaluated the amount and cost of waste that could occur from orphaned cancer drugs having to be discarded, determined the amount and cost of waste that can be prevented by reuse, and identified strategies to prevent waste and optimise recycling. Methods: A prospective study over 6 months was undertaken to document information on all drugs orphaned. Doses, expiry dates, purchase costs, reasons for orphaning, how drugs were reused and why drugs were discarded were recorded. Results: Of 3379 drugs purchased, 412 were orphaned (12.2%), with 357 of these recycled (86.7%). The potential cost of orphaned drugs that could have been wasted was A$334,111. Of this, A$303,951 (91%) was saved via recycling, equating to 9.8% of the total expenditure on cancer drug products over 6 months. Conclusion: This study has important consequences for the health sector, demonstrating that significant cost savings can be realised by recycling cancer drugs. This directly affects the budgets of Australian hospitals using external compounding companies, and reduces claims on the Pharmaceutical Benefits Scheme. The study highlights the amount of wastage that can occur, and identifies strategies to prevent and reduce waste