Measurement of unused medication in Medicare Part D residents in skilled nursing facilities

Abstract

Objective: To determine the cost of unused medication dispensed to Medicare Part D residents in nursing facilities in the United States and to describe the distribution of unused medication based on dispensed prescription cost and unit medication cost.

Design: A prospective study in which dispensed and returned prescription data for Medicare Part D residents encompassing the first six months of 2010 were provided by eight long-term care pharmacies servicing approximately 33,700 residents in 425 facilities.

Setting: Nursing facilities.

Patients: Residents covered by Medicare Part D.

Main outcome measures: Unused medication as a percentage of dispensed prescriptions was calculated based on the number of returned prescriptions and the cost of unused medication for all dosage forms and for solid oral forms.

Results: For all dosage forms, 6.8% of dispensed prescriptions were returned partially used, representing 3.5% of dispensed cost. For solid oral dosage forms, 6.1% of all dispensed prescriptions were returned partially used, representing 2.9% ± 1% of total dispensed cost. For returned oral solid prescriptions, 24% had a dispensed cost of $50 or more but accounted for 84% of the cost of returned medications; 26% had a unit cost of $1 of more, but accounted for 83% of the cost. The total amount of unconsumed solid oral medication for Medicare Part D residents in skilled nursing facilities was estimated at $125 million annually.

Conclusion: The estimated cost of unconsumed medications dispensed to Medicare Part D residents in nursing facilities is approximately 3% of dispensed cost, amounting to approximately $125 million across all U.S. nursing facilities.