Creative solutions for unused medicines

Piet Berkers works on business case for redistribution

He is a business engineer, company lawyer, the owner of a pharmacy and former manager of a pharmaceutical wholesale business. Not the most obvious choice for a speaker during CWF2019, you might think. Still, engineer and Master of Laws Piet Berkers will be there because he is seeking creative solutions for unused medicines. In the Netherlands, a large part of these medicines are thrown away or incinerated. That really needs to change, Berkers thinks.

What is Piet Berkers’ connection to creativity? The answer is: two things. Firstly, his view on the way unused medicines are handled in the Netherlands is different from the common view up to now. He considers this alarming and he will tell about this subject during the first part of his workshop. Secondly, he is very curious to find out what creative solutions the participants of the second part of the workshop (which is led by three students) will come up with in order to redirect medicine return flows. “Research by Utrecht University has shown that it is possible to reuse 40% of all medicines.”

‘It is possible to reuse 40% of all medicines’

Down the toilet

What people do with unused medicines, such as those of deceased family members, is a question that greatly fascinates Berkers. Much is still unknown about this subject, but what is known worries him. “We know that one third of people returns unused medicines to the pharmacy. This means that two thirds of the population throws them away with the household waste or even flushes them down the toilet. A terrible waste.”

And that’s not even all. Do you know what the pharmacy does with returned medicines? They are taken to the recycling centre and are incinerated there. “In the Netherlands, an estimated 100 million euros worth of medicines is incinerated every year,” knows Berkers.

Medicines management

And there are other things going on that Berkers finds hard to stomach. The municipality of Breda, which has twenty pharmacies, distributes 15,000 kilos of medicines each year by its own account. Berkers thinks the actual amount is twice as high. And one in five GPs in the Netherlands stocks up on returned medicines for the benefit of people who have a hard time making ends meet. “This is a nice gesture in itself and, of course, has a noble intention,” says Berkers, “but it does away with the medicine management step and that involves risks.”

Berkers tipped over four waste containers at pharmacies to view the contents

Berkers also did an experiment of his own recently. On a small scale, admittedly, but still: he asked a pharmacy to keep all its waste for an entire month. The result was four full containers. Berkers tipped them all over and viewed their contents. He was shocked. “We came across large amounts of unused medicines. What stood out was a package of hormone preparations worth €2,200. Half of the medicines was still in there.” The experiment gave Berkers an idea: during the workshop at CWF2019 he will once again tip over the waste container of a pharmacy. “I have no idea what we will run into, but it’s bound to be interesting.”

Collecting and redistributing

Berkers does not only delve into the issue of used medicines, he also works on possible solutions. In that sense it comes in handy that he is a lecturer at Breda University of Applied Sciences (BUas). He is leading a project that aims to increase people’s willingness to return medicines and to collect, inspect and redistribute used medicines. “We intend to build a business case for the redistribution of medicines,” he says. “This is necessary because we do realise that our project is nibbling away at the existing medicines chain of industry, wholesaler and pharmacy. Every per cent of medicines that we will be able to reuse means one per cent less for the chain.” Still, the chain doesn’t have much of a choice, thinks Berkers. “They cannot afford to take a stand against reuse because that would harm their image.”

‘The medicine chain cannot take a stand against reuse because that would harm their image’

Horror scenario

Berkers claims he is ‘not a sustainability guru’. But he is worried by the fact that we have no idea how the incineration of medicines affects our air quality, or how throwing them away affects the groundwater quality. “Imagine if this were to cause certain bacteria to become resistant to certain antibiotics! We don’t know if this is happening, but it would certainly be a horror scenario. Apart from the financial and health consequences, I am worried about the effects of throwing away unused medicines. Take a look at microplastics and nanoplastics, for example: we are doing a fair job of ruining our planet. The problem we address is familiar: it could well be your pharmacy that contributes to pollution. I can’t wait to find out if we can inspire the participants of our workshop to come up with creative solutions.”

Meet Piet Berkers at day 2 in Breda >

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