Quantification and composition of pharmaceutical waste in New Zealand

Abstract

This study aimed to quantify the amount of pharmaceutical waste produced in New Zealand, and determine the composition of pharmaceutical waste from community pharmacies in Auckland, New Zealand. Pharmaceutical waste collected in New Zealand is increasing, peaking at 542 tonne in 2019. Pharmaceutical waste collected from hospitals and pharmacies in Auckland increased by more than fourfold from 2016 to 2020. An audit of the types of pharmaceutical waste collected from community pharmacies revealed that the most common classes of drugs identified in this waste stream belonged to the nervous system, cardiovascular system and alimentary tract, and metabolism. Following examination of the contents of 12 pharmaceutical waste bins, 475 different pharmaceutical products were identified, highlighting the breadth of drugs in this waste stream. A range of dosage forms and hence materials were identified, which could present challenges for future waste treatment approaches. Hazardous drugs were identified including cytotoxic compounds, which should go into a separate waste stream for incineration. There is a need for similar data to be collected from multiple sites to fully appreciate the magnitude and composition of pharmaceutical waste. This will allow for the suitability of current practices for managing this hazardous waste stream to be evaluated.

Keywords: Pharmaceutical waste; Waste production; Waste stream composition.

Fig. 1

Overview of the pharmaceutical waste disposal process in New Zealand. Pharmaceutical waste from hospitals and pharmacies comprises expired medicines as well as unwanted medicines, particularly those returned from patients. Cytotoxic waste is sent off-shore for incineration, whereas other pharmaceutical waste is autoclaved before being sent to landfill. Individual images obtained from Pixabay

Fig. 2

Changes in the total weight of pharmaceutical waste being produced in DHB-contracted pharmacies (black line) and hospitals (grey line) in Auckland by month between January 2016 and 2021

Fig. 3

Distribution of the waste items into different therapeutic classes of drugs. A alimentary tract and metabolism, B blood and blood forming organs, C cardiovascular system, D dermatologicals, G genito urinary system and sex hormones, H systemic hormonal preparations, excluding sex hormones, J general antiinfectives for systemic use, L antineoplastic and immunomodulating agents, M musculoskeletal system, N nervous system, P antiparasitic products, insecticides and repellents, R respiratory system, S sensory organs, V various, including diagnostic agents and non-therapeutic products