What literature is available that reviews strategies health-systems have used to effectively use data from reverse drug distributors to improve medication use practices and reduce medication waste?

Comment by InpharmD Researcher

There appears to be limited published literature describing how health systems use reverse drug distributor data to improve medication use practices and reduce medication waste. ASHP guidelines and review articles primarily focus on the operational, regulatory, and logistical aspects of reverse distribution, such as inventory control, documentation, traceability, disposal, and regulatory compliance, rather than using reverse distributor reports to drive quality improvement initiatives. ASHP guidelines recommend reviewing reverse distributor reports to identify trends in expired medications, quantify associated costs, identify opportunities to reduce waste, and ensure manufacturer credits are received, while more recent studies have demonstrated the value of using internal medication waste and inventory analytics to identify waste trends and implement targeted interventions, including inventory optimization, redistribution of short-dated medications, and enhanced inventory management systems. These approaches have been associated with reductions in expired medications, reverse distributor costs, and medication waste; however, they did not specifically evaluate the use of reverse drug distributor data.

Background

The 2008 ASHP Guidelines on Medication Cost Management Strategies for Hospitals and Health Systems and the 2022 ASHP Guidelines on Controlled Substance Diversion Prevention provide very limited guidance regarding the use of reverse drug distributor data to improve medication use practices. The 2008 guideline recommends that pharmacy managers and buyers routinely review reverse distributor reports to identify trends in expired and wasted medications, quantify associated costs, identify opportunities to reduce waste, and ensure manufacturer credits are received. The 2022 guideline focuses on maintaining accurate inventories, chain of custody, reconciliation of reverse distributor documentation with pharmacy records, and timely disposition of expired controlled substances, emphasizing accountability and regulatory compliance rather than the use of reverse distributor data for quality improvement initiatives. [1], [2]

Review articles primarily focus on the operational, regulatory, and sustainability aspects of reverse logistics and medication returns rather than the use of reverse distributor data to improve medication use practices. The literature largely describes strategies related to medication collection, segregation, traceability, inventory control, disposal, and regulatory compliance, with limited discussion of using reverse distributor reports to identify medication use trends or implement waste reduction initiatives. Although some publications propose leveraging information systems to quantify expected versus actual medication returns to improve reverse logistics processes and support policy development, these approaches are intended to strengthen return programs and supply chain management rather than optimize prescribing, inventory management, or medication utilization. [3], [4], [5], [6]

Literature Review

A search of the published medical literature revealed 3 studies investigating the researchable question: