Management of Pharmaceutical Household Waste

Annex A. List of pharmaceutical waste management systems in OECD countries

 

Country	National drug collection programme	Legislation	Collection method	Funding	Source
Australia	State-funded national programme (NatRUM)		Collection at community pharmacies (voluntary participation)	Government (Australian Health Department)	(NatRUM, 2020[111])
Austria	Voluntary collection by pharmacies		Unused medicine should be returned to pharmacies or to public collection points	Collaborative funding by local governments and pharmacies	(Oesterreich.gv.at, 2022[138]; Stadt Wien, 2022[139])
Belgium	National EPR scheme, infrastructure and costs negotiated by region (Wallonia, Flanders, Brussels)	Mandatory legislation in place		Funded by pharmaceutical industry and wholesalers
Canada	Four provincial EPR programs	Provincial legislation in place	Retail pharmacies commonly act as collection sites	Industry
Chile		No legislation and drug take-back system in place. Recommendations to safely dispose in sealed package in household waste			(Vargas, 2018[140])
Czech Republic	Pharmacies are required to take back unused medicine	National legislation issued by the State Institute of Drug Control	Pharmacies	Funded by the state through regional authorities	(State Institute For Drug Control, 2007[141])
Denmark	Locally organised collection programs	Mandatory legislation in place	Pharmacies or designated municipal collection points	Local government	(Methonen et al., 2020[87])
Estonia	Mandatory take back collection systems via pharmacies and municipal collection points	Waste Act, and municipal waste handling rules	Pharmacies and hazardous waste collection points	Pharmacies finance the waste collection process, municipalities partially finance local collection	(Methonen et al., 2020[87])
Finland	Collection systems via pharmacies and collection points. Municipalities are responsible for collection, transportation and disposal of UEM	Pharmaceutical waste produced by households is classified as hazardous waste and must be collected separately (Waste Act)	Community pharmacies and municipal collection points	Local municipality	(Methonen et al., 2020[87])
France	National EPR scheme (Cyclamed)	Article 32 of the law n°2007-248	Mandatory EPR-scheme, Retail pharmacies act as collection sites	Industry
Germany	Some voluntary take-back schemes on local level	Generally, it is recommended to dispose pharmaceutical waste via the household bin, as MSW is incinerated			(RiSKWa, 2016[142])
Hungary	National EPR scheme (Recyclomed)	National system for the collection and disposal of household pharmaceuticals since 2005 (20/2005. [VI.10])	Collection bins at pharmacies and other medicine outlets (e.g. petrol stations)	EPR, financed by the pharmaceutical industry, as a percentage of sales proportion of the previous year	(Health Care Without Harm, 2013[143])
Iceland	National level programme	Mandatory obligation of pharmacies to participate in the take-back scheme	Pharmacies
Ireland	Pharmacies are expected to accept any medicines returned	Retail Pharmacy Businesses Regulations 2008	Via pharmacies and take back initiatives (DUMP - Dispose of Unused Medicine Properly)	Largely by pharmacies	(Pharmaceutical Society Ireland, 2017[144])
Israel		No legislation for pharmaceutical waste in place	Pharmacies are expected to accept medicines from the public.	Government (Israeli Ministry of Health)	(Barnett-Itzhaki et al., 2016[86])
Italy	National EPR scheme (Assinde)	Decree D.P.R. 254/2003 specifies that expired drugs, as well as cytotoxic and cytostatic drugs must be collected and incinerated, financed by producers	Collection bins are available in pharmacies, healthcare centres, on streets or at hazardous waste collection sites	Pharmaceutical industry. In addition, some municipalities organise their own collection systems	(PGEU, 2021[145])
Japan	Some voluntary take-back schemes on local level or within businesses
Korea	National voluntary programme		Voluntary take-back by some pharmacies	Self-funded by pharmacies
Latvia	Voluntary collection by pharmacies	No legislation in place	Pharmacies and hazardous waste collection centres		(Methonen et al., 2020[87])
Lithuania	Collection by Pharmacies	Community pharmacies are obliged to accept UEM and send them for safe disposal (Farmacijos istatymas nustato 2006/6/22 d. No. X 709, Official Gazette, 2006, Number: 78-3056)	Pharmacies	Pharmacies cover costs of collection. Government responsible for financing disposal.	(Methonen et al., 2020[87])
Luxembourg	“Superdreckskëscht”: collection system in co-operation with pharmacies		Waste can be returned to community pharmacies, to mobile collection centres from the Ministry of Environment, or to recycling centres directly	Government funded treatment facilities	(SuperDrecksKëscht, 2020[146])
Mexico	"SNGREM" take-back scheme in 25 out of 32 states	Article 28 of waste prevention law (LGPGIR – 2006) requires the pharmaceutical industry to define and execute a waste management plan for UEM		Organised and financed by the National Chamber of the Pharmaceutical Industry (CANIFARMA)	(Singrem, 2018[130])
New Zealand	Voluntary programme by community pharmacies			Pharmacies, sometimes compensated by district health boards	(Anthony Roberts, 2015[147])
Norway	National drug take-back system	Mandatory legislation for pharmacies to receive drugs at no costs to the consumer			(Helsenorge, n.d.[148])
Poland	Voluntary collection points in some pharmacies, otherwise municipal offices and health care centres	Act on Maintaining Municipalities Clean and in Order of 13 September 1996, i.e. (Journal of Laws of 2020 item 1439, as amended)	Waste can be returned to waste collection points or pharmacies	Municipalities are required to collect UEM at least in civic amenity sites	(Rogowska et al., 2019[110])
Portugal	National collection system (SIGREM)	National legislation since 2001	Pharmacies	Funded through an EPR by the pharmaceutical industry	(Health Care Without Harm, 2013[143])
Slovakia	Mandatory legislation in place		Pharmacies are required to take back unused medicine and hand it to the State Institute for Drug Control, which deals with its proper treatment and disposal. Municipalities need to provide information on the system	Financed by the State Institute for Drug Control	(State institute for drug control, 2020[149])
Slovenia	Compulsory take back system	Decree on the management of waste medicine (Official Gazette RS, Nos. 105/08 and 84/18 - ZIURKOE)	UEM can be returned to municipal collection centres for hazardous waste, pharmacies or during collection campaigns	Medicine wholesaler is liable to fund treatment of UEM	(Official Gazzette of the Republic of Slovenia, 2008[150])
Spain	National EPR scheme (SIGRE)		Pharmacies	PRO funded by pharmaceutical companies.	(SIGRE, 2018[151])
Sweden	National EPR scheme (financed and organised individually by retail pharmacies)		Mandatory EPR-scheme, retail pharmacies commonly act as collection sites and organise collection independently	Pharmacies are considered the “producer” in the Swedish EPR
Switzerland	Return scheme in place (depending on Canton)	Pharmaceutical waste shall be collected separately	Pharmacies or designated disposal points	In some Cantons the system is government-funded, in others pharmacies bear the cost	(Federal Office for the Environment, 2021[152])
The Netherlands	Locally organised voluntary collection by pharmacies	Environmental Management Act: declares that municipalities are responsible for the collection and processing of medical waste	Collection points in pharmacies	Municipalities generally cover the cost of disposal, though in 19 out of 355 municipalities (6%) pharmacies still bear the costs	(KNMP, 2020[109])
Turkey	Voluntary collection by pharmacies (through ÇEKOOP)	No legislation in place
United States	25 local EPR laws in the US; 3 at state-level, 18 at county-level and 4 at city-level		Either voluntary programs by firms or governments, or mandatory programs through EPR	Governmental, firms or by industry
United Kingdom	Pharmacies are obliged to take back and sort unused medicine and return them to National Health Services	The National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations, 2013	Collection in Pharmacies and through local collection events	Local government funds the treatment process	(Paut Kusturica, Tomas and Sabo, 2016[96])