THE Health Ministry should introduce policies for Malaysians to return unused, unwanted or excess drugs to combat the shortage of medicine in the country, health organisations said.

Exact figures on the value of medicine wasted each year are unavailable, but previous news reports have estimated it to be tens of millions of ringgit worth in terms of the medicine dispensed by government health facilities.

For a variety of reasons, patients don’t complete their course of drugs and either dump them or return them to hospitals or clinics.

If the government has a policy that allows consumable but unused medication to be reused, this will reduce wastage, save healthcare costs and help other patients, said National Cancer Society Malaysia (NCSM) managing director Dr Murallitharan Munisamy.

“Our system is quite ill-equipped to deal with returning medicine or collecting and reusing medicine,” he told The Malaysian Insight.

He said a lot of medicines go to waste because there is no policy on reusing them or educating patients to return unused drugs.

There is more awareness about reusing medicine for others among cancer patients and their caregivers, as cancer drugs can be expensive.

Hospis Malaysia, for one, accepts donations of medicine including morphine left behind after a cancer patient dies.

NCSM does the same, Dr Murallitharan said. When a cancer patient dies, the family members will sometimes bring boxes of medicine to NCSM to be distributed to other patients who need them.

“We need to see more of this happening widely. We need to educate people on this and have a visible system for them to bring in unused medicine.

“We first of all need a national policy,” he said.

In 2010, the Health Ministry introduced the Return Your Medicine programme to encourage patients to return their unused or excess medicine kept at home for safe disposal by the ministry. 

The ministry said medicine that is no longer needed can be returned to pharmacy counters or medicine return boxes provided at all pharmacy facilities at ministry hospitals and health clinics.

However, this programme is only for disposal and not for reuse, noted Assisi Palliative Care Bhd (Aspac) manager Malliga Perumal.

This, she stressed, is wasteful.

“When the medications are returned to the government facilities, what do they do with it?

“If it is expired, then it has to be disposed but if it is not and still can be used, why dispose of it?” she asked.

Malliga said the government could give the unexpired medication to patients who cannot afford to pay for drugs.

Aspac accepts donations of medications new or unused, she said.

Their in-house pharmacist vets the donated medicine before dispensing it to other patients.

“Our pharmacist will ensure they are not expired and that the medications are not opened.

“It is a tedious job but we have to do it first as we can’t just give it out to patients. But at least we are not throwing away medications that still can be used,” she said.

Malliga said Aspac has been doing this despite there being no policy from the government, as the practice helps patients in their care.

“We are a charitable, not-for-profit organisation established to provide hospice-at-home care to patients with life-limiting illnesses at no charge.

“We have about 500 patients currently. We do not look at whether the patients are rich or poor.

“We give our care to all patients and our service is free. We also provide medications for free,” she said.

Public healthcare services are heavily subsidised by the government with Malaysians only needing to pay RM1 to see a medical officer or RM5 to see a specialist at any government health facility.

The fees also cover the drugs prescribed to the patients.

To reduce wastage, the Health Ministry in 2018 introduced the Patient’s Own Medicines programme to ensure optimal use of prescriptions. This is not a return and reuse programme, but involves patients bringing along the medicine they had purchased themselves or obtained from government clinics along when they are warded. – June 29, 2022.