Drug Waste

Drug waste significantly increases the cost and carbon footprint of ophthalmic surgery. Find resources and solutions for drug waste reduction.

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Overview of Surgical Drug Waste

The healthcare sector accounts for 10% of greenhouse gas emissions every year. Medications in the operating room represent a sizable portion of the waste generated, estimated at $560 million in waste annually. David Palmer, MD, provides an overview of a study of medication waste from cataract surgery at several facilities in Illinois.

Reducing Topical Drug Waste in Ophthalmic Surgery

Surgical facilities should be permitted to use topical drugs in multidose containers on multiple patients until the labeled date of expiration following proper infection control and storage guidelines. Some states may need to modify their pharmacy practice regulations to allow eyedrop multidosing. Surgical patients receiving dedicated topically applied medications should be allowed to bring their partially used medication home with them if needed for continued postoperative care.


Inappropriate Disposal of Multi-use Ophthalmic Solutions Can Lead to Drug Shortages

Visit the American Society of Health-System Pharmacists website for up-to-date information about ophthalmic drug shortages.

Reduction of Eyedrop Volume for Topical Ophthalmic Medications with the Nanodropper Bottle Adaptor

The Nanodropper (Nanodropper, Inc.) is an FDA-listed adaptor that can be placed onto most eyedrop bottles to reduce drop volume with each administration and thereby reduce waste. A study by Dr. Seibold and colleagues found that the Nanodropper delivered drops that were 62.1% smaller than standard bottles, resulting in a 2.6-fold increase in the number of drops dispensed per bottle. This reduction in eyedrop volume was significant for solutions, suspensions, and emulsions. Volume reducing bottle adaptors have potential benefits of reducing medication waste as well as minimizing systemic side effects and improving patient compliance with eye drops.