Unused medication among outpatients receiving cost-free medication from a community pharmacy in the Region of Southern Denmark

Abstract

Objective: To evaluate the extent and nature of unused medication dispensed from the hospital as cost-free medication (CFM), sent to and collected from the community pharmacy (St Thomas Pharmacy) in the Region of Southern Denmark.

Methods: This observational study was conducted over 6 months. In the first 2 months, patients collecting CFM were invited to participate in an unused medication monitoring programme by completing an inclusion questionnaire. Those who consented were followed for four additional months and asked to report on unused medication during subsequent visits. Data on dispensed medication and patient-reported unused medication were collected using structured survey forms and analysed using descriptive statistics.

Results: Thirteen per cent of patients reported unused medication from approximately 100 enrolled participants. Collecting CFM for themselves, the unused medication rate was 15%, compared with 8% among those collecting on behalf of others. No unused medication was reported by first-time collectors. Reported reasons included clinical changes (eg, dose adjustments, treatment discontinuation, adverse effects) and administrative errors (eg, excess quantities, incorrect formulations). The total value of unused medication was estimated at 83 000 Kr (€11 100). Extrapolated to the annual distribution volume at the St Thomas Pharmacy, the annual loss from unused medication would be 900 000 Kr (€120 000).

Conclusion: The small sample size in this project is a limitation and associated with an uncertain outcome. Unused medication related to CFM is a measurable and economically significant issue, primarily driven by clinical and administrative factors. While reducing pack sizes could help mitigate unused medication, this may increase logistical burdens on patients and healthcare providers. A larger distribution model, such as dispensing through all local community pharmacies under hospital tender agreements, may offer a more efficient solution but would require legislative reform. Broader, multi-site studies are needed to validate findings and inform future policy interventions.

Keywords: ECONOMICS, PHARMACEUTICAL; Health Care Economics and Organizations; Hospital Distribution Systems; PRIMARY HEALTH CARE; Quality of Health Care.