Drug Wastage: Hospital & Outpatient

Drug wastage is defined as the portion of a medication bottle, syringe, or vial that is not given to a patient. Drug wastage has been found to contribute at least an additional two percent cost to total spending across all pharmaceutical lines. There are effects not only on patients due to the cost, but also to insurance companies, hospitals and other healthcare centers, and the patient’s or insured’s employers, especially when it is a smaller company.

Nursing Home Drug Waste

It should come as no surprise that nursing home residents consume a large amount of prescription drugs. It has been shown that 25% of patients 65-69 take at least 5 medications for chronic conditions and in the patients who are 70-76 that numbers jumps to 46%. When patients move to a different facility, have their medications changed, or pass away, the nursing home is left with their remaining medication. These excess drugs that have already been paid for by Medicare are typically thrown away by nursing home staff.

Outpatient Drug Waste

While the exact cost of outpatient medication waste is not known a study conducted at a retirement community in New Hampshire has helped to give an idea of the cost. The study used 73 residents over the age of 65 who conducted in-home pill counts and answered questionnaires to determine how medication is wasted each year. The average amount of wasted medication was $30.47, which represented 2.3% of the total costs of the drugs.

While $30 is a relatively small amount per person, it does add up. Using this as a low estimate of average annual waste per person, the national cost for adults 65 years and older would be more than $1 billion annually. This is an outrageous amount of wasted money that could be saved by insurance companies, patients, and employers. The most common wasted medication types Were antibiotics, benzodiazepines, antidepressants, and antihypertensives, which accounted for a third of the cost.

Medication Switching Drug Waste

Another contributing issue in drug wastage is switching medications. Approximately $269.4 billion was spent on medical costs due to patients not staying on the medications that they were prescribed. Frequently, new prescriptions are given for recently released medications when more affordable medications could have been prescribed, saving some $55.8 billion. Drug companies are great at advertising their new medications and influencing patients to believe they need them, even when older medications are much less expensive and work just as well.

Self-Injectable Syringe Drug Waste

Syringe dead space is the residual fluid or medication that is left after the plunger is fully depressed while the medication is injected. One study found that of 24 self-injectable medications that they looked at, the median cost of waste for a single dose was as high as $2300 per year. Though it isn’t an exorbitant amount, that cost would be better applied to medication that’s being used, rather than medication that is left in a syringe and thrown away.

What Can Be Done to Prevent Drug Waste?

There are several different approaches being taken to help combat drug wastage in the US. In Iowa, there is a program that receives the excess medications from nursing homes and redistributes them to uninsured or underinsured patients at no cost to the patient. The program was on pace to redistribute $6 million worth of medications in 2017. While it is important to ensure that safety protocols are strictly adhered to,  programs like these could have a great impact on reducing medication wastage if adopted in more states.


Curus is  acutely aware of how wasted prescriptions increase drug costs and affect the environment. One of the main tenants of Curus Complex Care is a review by a Clinical Pharmacist. This ensures that Curus Members aren’t being over-prescribed. Less prescriptions means less waste on an individual basis.