E Bronder1, A Klimpel. 1. Institute for Pharmacoepidemiology und Technology Assessment, Berlin, Germany. bronder@ipta-berlin.de
Abstract
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 diminish. 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 returned 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 relation to the package size. The prices of the drugs were obtained from the "Rote Liste 1997". RESULTS: 10,603 unused drug-packages were collected (1988: n = 5,164). The 10 most frequent indication groups showed nearly the same ranking as the German annual report of prescribed drugs (GKV-Index 1988, same result). Only 17% of the returned drugs were for self-medication (1988: 12%). The value of the original medicines amounted to approximately DM 232,920 (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: 31%). 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 prescription 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 reasons of non-compliance.
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 diminish. 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 returned 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 relation to the package size. The prices of the drugs were obtained from the "Rote Liste 1997". RESULTS: 10,603 unused drug-packages were collected (1988: n = 5,164). The 10 most frequent indication groups showed nearly the same ranking as the German annual report of prescribed drugs (GKV-Index 1988, same result). Only 17% of the returned drugs were for self-medication (1988: 12%). The value of the original medicines amounted to approximately DM 232,920 (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: 31%). 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 prescription 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 reasons of non-compliance.