ATC/DDD analysis of expired and unused medicines collected through separate collection

IntroductionIrrational use and improper disposal of medicines lead to environmental pollution. There is compelling evidence of the negative impact of medications on biological systems. In Russia, there is no legislation regarding the disposal of expired medications at home. Expired medications generated at home are considered household waste.ObjectiveTo study the effectiveness of separate collection of medicines and analyze unused medicines discarded by patients.MethodsWe organized separate collection of expired and unused medicines in two polyclinics in Kazan. An ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose) analysis was conducted to estimate how many drugs are not consumed by people and are thrown away in the general waste.ResultsFrom November 2022 to April 2024, a total of 4737 trade names of medicines or 707 INNs (International Nonproprietary Names) and 195 dietary supplements were collected, totaling 243 kg of medicines and supplements that were subsequently sent for proper disposal. The ATC/DDD analysis showed that the largest number of DDDs collected were medicines for treating cardiovascular system disorders, digestive system and metabolism disorders, and blood and hematopoietic system disorders.ConclusionsTo assess the rationality of medicine use, it is important to conduct qualitative and quantitative evaluation of disposed medicines. Such analysis can be part of actual consumption analysis, as not all medicines dispensed to patients in pharmacies are actually consumed by them.