Reducing Repackaged Medication Waste in the Pharmacy Department

Objectives

Discuss a process for decreasing repackaged wasteDescribe methods to streamline the distribution of repackaged medications

Project Charter • Project Name: Reducing Repackaged Medication Waste

in Pharmacy• Problem Statement : Waste is defined as the Total Units

Ordered minus Total Units Charged to the Patient. It has been identified that 34% of the Top 25 Repackaged Brand Medications ordered annually by the pharmacy department ends up as waste. Repackaged Branded Medication waste cost the Pharmacy department over $10,000 in 2010 .

• Project Objective: The objective of the project is to decrease the percentage of repackaged medications wasted by 10% .

• Scope: To look at the processes of the repackaged solid medications (start point: when ordered to end point: drug expires)

By identifying how to prevent repackaged oral solid medication waste in the Pharmacy Department the potential benefits:

• Save the department/facility $5,000 +annually• Change processes to minimize repackaged waste• Manage inventory in automated dispensing

cabinets

Justification

Process Steps• Determine Top 25 Medications

• Create Par Levels

• Ordering

• Repackaging

1

2

3

4

5• Stocking

Determine Top 25 Medications

1

• Review formulary • Run reports:80/20 wholesaler report by dollars• Perform a physical inventory on the Branded bulk solid oral medications• Review waste records (if available)• Run reports of usage from automated dispensing machines• Run charge reports for 25 medications identified

Generic Name % of WasteVORICONAZOLE 24%TENOFOVIR DISOPROXIL FUMARATE 14%RITONAVIR 14%EMTRICITABINE 11%PREGABALIN 9%NELFINAVIR MESYLATE 5%VITAMIN K (PHYTONADIONE) 5%ACETAZOLAMIDE 5%LOPINAVIR/RITONAVIR 4%MESALAMINE 4%CINACALCET HCL 3%EFAVIRENZ 3%COLESEVELAM HCL 3%PARICALCITOL 3%RALOXIFENE HCL 2%DIPYRIDAMOLE/ASPIRIN 2%RANOLAZINE 1%MONTELUKAST SODIUM 1%ENTACAPONE 0%FLUCYTOSINE 0%DOXERCALCIFEROL 0.5MCG -2%SEVELAMER HCL -3%OLANZAPINE -3%PROPAFENONE HCL 225MG -3%LANTHANUM CARBONATE -4%

Generic Name % of Waste

VORICONAZOLE 24%

TENOFOVIR DISOPROXIL FUMARATE 14%

RITONAVIR 14%

EMTRICITABINE 11%

PREGABALIN 9%

DDefine

MMeasure

AAnalyze

IImprove

CControl

Create Par Levels

2

• Run a report on products ordered in the last quarter• Classify par levels based on history or how many days of inventory on hand you desire • Create your definition of slow medium or fast moving products

Ordering

3

• Review order for high dollar solid oral medications• Run report for current orders• Do an inventory count in RX and Cabinets• Only order if you have less that 3 days worth of medication

Repackaging

4• Only repackage slow moving items for 2-3 days quantity needed• Repack medium and fast movers based upon Par levels

Stocking

5• Determine if product should be stocked outside Pharmacy• If stocking in automated machine set PAR levels for 2 days

Conclusion Create Par levels for all bulk oral solid productsCreate ordering system that includes total inventory levels and chargesUnused stock outside the Pharmacy should be returned to Pharmacy on a routine basisStock outside the Pharmacy should be rotated in machinesCreate guidelines for repackaging to reduce waste