Quantifying Pharmaceutical Waste Burden and Management Costs: Implications for Healthcare Risk Management and Governance
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Angga Prawira Kautsar1, Mochammad Ihsan Ramadhan2, Falerina Puspita3
1Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, West Java, 45363, Indonesia.
Background:
Pharmaceutical waste represents an emerging operational, financial, and governance challenge within healthcare systems, particularly in resource-limited settings where routine waste monitoring remains limited. Evidence regarding pharmaceutical waste burden and its associated management costs is still scarce, especially in low- and middle-income countries.
Methods:
This study assessed pharmaceutical waste burden and management costs using routinely collected hazardous medical waste data from a regional referral hospital in Indonesia between 2023 and 2024. Because pharmaceutical waste was not routinely segregated or directly quantified, pharmaceutical waste quantities were estimated using a model-based proportional approach rather than direct measurement, assuming a base-case proportion of 5% of total hazardous medical waste. Management costs were estimated using an outsourced treatment tariff of USD 0.44/kg. Sensitivity analyses were conducted using alternative assumptions ranging from 3% to 6%.
Results:
During the 24-month observation period, total hazardous medical waste generation reached 182,428.32 kg, with a mean monthly generation of 7601.18 kg. Under the base-case scenario, estimated pharmaceutical waste generation was 380.06 kg/month, equivalent to approximately 53 g/bed/day. The estimated pharmaceutical waste management cost was USD 166.28/month (USD 1995.36 annually). Sensitivity analyses demonstrated monthly costs ranging from USD 99.77 to USD 199.54 across alternative scenarios.
Conclusion:
Pharmaceutical waste contributes a measurable and recurrent operational and financial burden within hospital waste management systems and may serve as an indicator of healthcare operational efficiency and governance performance. Routine waste segregation, direct quantification, and systematic monitoring may support risk-informed decision-making, resource optimization, and sustainable healthcare waste management.
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