Analysis of medication returns to the pharmacy in a high-complexity hospital in Rio de Janeiro

Abstract

Objective: Analysis the profile and costs related to return of medication to a large hospital pharmacy. Methods: This retrospective observational study collected monthly data on medication returns from June 2023 to May 2024. Data were recorded in spreadsheets upon receipt of returns. Medications that were not reintegrated into pharmacy stock for various reasons were categorized using Microsoft Excel® and categorized by pharmaceutical form, pharmacological class, quantity, and unit value. Financial impact analyses were conducted to assess these losses for the hospital. Results: Of the average monthly total of US$7170,88 in medications returned to the hospital pharmacy, US$507,73 represented losses — medications that could not be reintroduced into the pharmacy stock. The substantial value of reused items emphasizes the importance of monitoring the return process. Additionally, it was observed that a majority of medications reintegrated into pharmacy stock were antimicrobials. Although this practice has provided financial benefits to the institution due to the high cost of these medications, it raises an important concern regarding potential treatment failures. The return of antimicrobials may be related to prescription errors, changes in the patient’s clinical condition, or misdiagnoses. As a result, these factors significantly contribute to the non-administration of the medications and, consequently, their return to pharmacy stock. Conclusion: The results demonstrate the critical need for improving the hospital’s medication return process to reduce losses and ensure greater medication safety for patients.