Measurement of unused medication in Medicare Part D residents in skilled nursing facilities.

OBJECTIVE

To determine the cost of unused medication dispensed to Medicare Part D residents in nursing facilities in the United States and to describe the distribution of unused medication based on dispensed prescription cost and unit medication cost.

DESIGN

A prospective study in which dispensed and returned prescription data for Medicare Part D residents encompassing the first six months of 2010 were provided by eight long-term care pharmacies servicing approximately 33,700 residents in 425 facilities.

SETTING

Nursing facilities.

PATIENTS

Residents covered by Medicare Part D.

MAIN OUTCOME MEASURES

Unused medication as a percentage of dispensed prescriptions was calculated based on the number of returned prescriptions and the cost of unused medication for all dosage forms and for solid oral forms.

RESULTS

For all dosage forms, 6.8% of dispensed prescriptions were returned partially used, representing 3.5% of dispensed cost. For solid oral dosage forms, 6.1% of all dispensed prescriptions were returned partially used, representing 2.9% ± 1% of total dispensed cost. For returned oral solid prescriptions, 24% had a dispensed cost of $50 or more but accounted for 84% of the cost of returned medications; 26% had a unit cost of $1 of more, but accounted for 83% of the cost. The total amount of unconsumed solid oral medication for Medicare Part D residents in skilled nursing facilities was estimated at $125 million annually.

CONCLUSION

The estimated cost of unconsumed medications dispensed to Medicare Part D residents in nursing facilities is approximately 3% of dispensed cost, amounting to approximately $125 million across all U.S. nursing facilities.