A recent article in the Chinese-language Liberty Times (the Taipei Times’ sister paper) said flushing old medicines down the toilet pollutes the environment. In actual fact, recycling medicines does not only pollute the environment, it is also a waste of health insurance resources.
Speaking from my own experience, the hospital where I work receives medicines that patients do no want each day. Many expensive medicines are returned unopened to pharmacies, where they are all destroyed. These medicines are just the tip of the iceberg, as even more are never returned but just thrown away by patients themselves.
The medicines that are thrown away are funded by the health insurance fees that each citizen pays. I get upset every time I see this waste, which has been helped along by low-priced health insurance policies. It is a problem that has been upsetting pharmacists for a long time.
For example, the hospital where I work is very busy on Saturdays, sometimes even more so than weekdays, because on Saturdays, Taiwanese people doing business in China come to our hospital to get their medicine before they go back to China. Each time they come, they take two months worth of medication. Why don’t they see doctors and get medicine in China? While China’s national income is lower than Taiwan’s, it costs more than in Taiwan to see a doctor there and the quality of its medicine is inferior to ours. When chatting with other pharmacists recently, someone told me that overseas Chinese from the US and Canada try to use personal connections to join Taiwan’s health insurance system because it has given Taiwan the cheapest medical care environment in the world. I have even heard that there are people who get the same medicine from many different hospitals here and then sell them in China.
The Department of Health handles this by demanding that municipal hospitals and local healthcare centers countrywide set up medicine return sites for unwanted medicines or by asking local pharmacies to help collect unwanted medicine, but these are only temporary solutions. To really solve the problem we must encourage citizens to keep a record of the medicines they are taking and to remind their doctors of how much they have taken to avoid situations where doctors repeatedly prescribe the same medicine when it is not needed.
We should teach Taiwanese to get into the habit of telling their doctors not to fill prescriptions if they have leftover medicine. This can help save some of the costs of medicine. Starting by focusing on the interests of our citizens and spreading the message around is the only way to stop wasting medical resources. Even more importantly, we should look at the overall health insurance system and put an end to the systemic waste of resources, for this is the only way to protect the medical rights and interests of Taiwanese citizens.
Chen Honyi is a pharmacist.
TRANSLATED BY DREW CAMERON
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