Stakeholders' views on and their minimal requirements for redispensing unused medicines: A qualitative study

Background and objective: Medication wastage has undesirable consequences both economic and environmental. Wastage is partly unavoidable, but could be reduced by redispensing unused medicines that are returned to the pharmacy. However, scientific and practical information on the minimal requirements for redispensing medicines is lacking. Stakeholders can provide insights into the feasibility of a redispensing system. The objective of this study is therefore to identify stakeholders' views on and their minimal requirements for redispensing unused medicines. Setting and method: Semi-structured interviews were conducted with 19 Dutch key stakeholders (healthcare professionals, health insurance companies, patient and consumer organisations, health authorities and manufacturers' representative organisations). The interview guide included two core themes: medication wastage and redispensing unused medicines. The latter contained in depth the subthemes quality, legal and business aspects and patient communication. Interview transcripts were subjected to thematic content analysis by open, axial and selective coding. Main outcome measures: Stakeholders' reported minimal requirements for redispensing unused medicines. Results: All stakeholders recognized medication wastage as undesirable and wasteful. Stakeholders' views on redispensing unused medicines were positive. All stakeholders stated that several requirements should be met for the safe redispensing of unused medicines. Most frequently mentioned was that the quality of redispensed medicines should be guaranteed, for instance, by monitoring patients' home storage conditions. In addition, responsibilities for the redispensing system should be integrated into guidelines. Stakeholders addressed that the redispensing system's benefits have to outweigh the costs, and a cut-off price value of medicines suitable for redispensing should be determined. Stakeholders stated that transparent communication towards patients is essential, as patients have to trust the redispensing system and be willing to participate. Moreover, stakeholder involvement can contribute to the success of the system, and their roles should be established. Conclusion: According to stakeholders, unused medicines can be redispensed if several requirements are fulfilled. This strengthens the idea of decreasing medication wastage by redispensing unused medicines.