Study Finds Re-dispensing Unused Cancer Drugs Can Save Money and the Environment Interview with:
Lisa-Marie Smale, PharmD
PhD Candidate Clinical Pharmacy
Radboud University Medical Center
Department of Pharmacy
Nijmegen, the Netherlands

Lisa-Marie Smale, PharmDPhD Candidate Clinical PharmacyRadboud University Medical CenterDepartment of PharmacyNijmegen, the Netherlands What is the background for this study?

Response: Cancer drugs are not always fully used by patients, while these drugs are mostly expensive and environmentally damaging, both in production and (waste) disposal. Therefore we investigated whether unused drugs of patients can be collected, verified of quality by a pharmacy, to be redispensed to other patients instead of being disposed of. We were interested whether such an approach ultimately leads to lower environmental impacts and costs. What are the main findings? Is there any additional liability? Does cost savings include pharmacy labor involved in re-packaging medications?

Response: Of all wasted drug packages, two-thirds could be redispensed. We showed that the approach is cost-effective for expensive cancer drugs, even after correcting for the costs of the labor and materials required for quality verification of the drugs. The investment of the method, such as packaging with a temperature sensor, amounts up to 37 euros per patient per year. This is offset by savings of 613 euros. Annually, this results in a net saving per patient of 576 euros. Cost-savings could even be increased up to 1,348 euros ($1591) per patient per year by optimizing the procedures and targeting patients at risk. In the Netherlands, we have relatively low drug prices. If you look at the U.S., where the price of new drugs is over 300 percent higher, thus potentially even more money could be saved there. What are the main findings?

Response:  That we can safely redispense unused (cancer) drugs and in that way contribute to better affordability and sustainability of (cancer) treatment. What recommendations do you have for future research as a results of this study?

Response: The study will be expanded to 14 hospitals because of the successful results so far, again looking at the redispensing of cancer drugs, but we hope that the approach can eventually be used nationwide, as well as for other drugs. Is there anything else you would like to add? Any disclosures?

Response: The practice of redispensing unused drugs is currently limited due to legal restrictions, at least in Europe. These legal restrictions arose from concerns about drug quality and safety as the drugs have been previously stored in patients’ homes and can have been exposed to incorrect storage conditions. However, we showed that pharmacies could easily verify storage conditions by using temperature-sensoring technologies and sealed packaging, which is cost-beneficial for these expensive drugs. We also showed the potential benefits that could be achieved by redispensing unused drugs. Therefore we hope that the results of this study will open the political debate!


Smale EM, van den Bemt BJF, Heerdink ER, et al. Cost Savings and Waste Reduction Through Redispensing Unused Oral Anticancer Drugs: The ROAD Study. JAMA Oncol. Published online November 16, 2023. doi:10.1001/jamaoncol.2023.4865

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Last Updated on November 17, 2023 by Marie Benz