The Commonwealth fund rankings place the UK’s National Health Service (NHS) as number one in the world. But these are complex and challenging times for the UK’s most trusted and respected social institution. The NHS has been under budgetary pressure for many years now. In 2017-2018, the total deficit stood at a staggering £991M. National Audit Office (NAO), has recently reported that extra funding to NHS has mostly been used to manage current demand instead of being used to develop a strong foundation for the transformation of the health service. Additionally, due to the imminent EU Exit, Pharmacists have warned of delays and price increase for widely prescribed medicines for depression, pain and high blood pressure.
Despite all these pressures, £300m worth of unused medicines is being thrown away in England each year. Overprescribing, lack of adherence, a change of treatment, or the patient dying are the most common reasons why we have such a huge medication wastage. Medication waste is not only a substantial financial impact but also a serious cause of environmental pollution. Medicines which are not used are either flushed/disposed of as rubbish or returned to a hospital or pharmacy. Flushing medicines adds them directly to the water supply and harms our environment. Most medicines cannot be removed by water treatment plants. Medicines disposed of as rubbish can still find their way into soil and ultimately into the water. The Department of Health (DH), guidelines mandate that medicines returned to pharmacies cannot be reissued to other patients. Therefore, medicines returned to the pharmacist are not re-dispensed even though 90% of these medicines are within their expiry date. The reasons for not reusing medicines are:
- There is no mechanism to validate drugs handed back to a pharmacy or hospital. This could lead to counterfeit drugs entering the health system. Drug authentication is almost impossible because currently, it is not easy to identify and track drugs by a product code, serial number, batch and expiration date.
- Once the medicine has left the hospital or pharmacy, storage conditions cannot be guaranteed. Some medicines are sensitive to heat, light or moisture and can become less effective if not stored properly.
Latest packing techniques can be very effective in safe guarding against poor storage conditions and hence there is potential to re-use medicines which need special storage conditions. For medicines which do not need special storage conditions, if there is a way to validate drugs and establish their authenticity, they could be safe for reuse. From the patients’ perspective, according to a survey by Ipsos Mori survey, 52% of respondents in England are likely to accept re-issued medicines.
Disruptive technology, blockchain has a good use case in this scenario. Most of us understand blockchain in the context of Cryptocurrencies like Bitcoin. But, blockchain is spreading across many industries because of attributes of blockchain, such as providing provenance, traceability, security and transparency of transactions.
SAP has partnered with top life sciences companies like GlaxoSmithKline, Boehringer Ingelheim and Merck Sharp & Dohme and developed software which plays a vital role in the process of drug validation. If we apply this innovation to the drugs dispensed by the NHS, it will allow hospitals (or whoever has the right authorisation) to validate drugs sent back to hospitals and pharmacies using the blockchain powered supply chain tracking system. This, in turn, will establish a trustworthy way of tracking and authentication of drugs. Once this is done, repeat dispensing is a possibility. Repeat dispensing offers potential benefits to practices, pharmacists and patients for the safe and efficient continued supply and management of medicines. It will also save money for the NHS and reduce the environmental pollution created by the addition of unused drugs into the waste supply chain
Learn more about SAP Healthcare here.
Watch a video about how pharmaceuticals giant Boehringer Ingelheim co-innovated with SAP to establish a digital network to track its products at every stage of the supply chain.