Unused pharmaceutical products during phacoemulsification result in relatively high financial and environmental costs; according to a study published online in JAMA Ophthalmology. Pharmaceutical products, including unused portions; may contribute to financial and environmental costs in the United States. Because cataract surgery, performed millions of times each year in the United States and throughout the rest of the world; understanding these financial and environmental costs associated with cataract surgery warranted.
Jenna Tauber, M.D., from the New York University School of Medicine in New York City; and colleagues assessed the financial and environmental costs of unused pharmaceutical products after routine phacoemulsification surgery; at four surgical sites in the northeastern United States (a private ambulatory care center, private tertiary care center, private outpatient center; and federally run medical center for veterans). However, the evaluation included 116 unique drugs.
Medications remaining after cataract surgery
However, this descriptive qualitative study included 4 surgical sites in the northeastern United States. Prices and data for use of services and pharmaceuticals obtained for the tertiary care and outpatient centers from January 1 through April 30, 2016; for the ambulatory care center from June 1, 2017, through March 31, 2018; and the federal medical center from November 1, 2017, through February 28, 2018.
Data collected from routine phacoemulsification surgical procedures; without vitreous loss or other complications. However, volume or weight of medications remaining after cataract surgery measured. Total and mean costs of medications per case and month calculated. But environmental effects estimated using economic input-output life cycle assessment methods. Data, analyzed from December 1, 2017, through June 30, 2018.
Cost of unused pharmaceutical products (in US dollars); and kilogram equivalents of carbon emissions (carbon dioxide [CO2-e]), air pollution (fine particulate matter emissions of ≤10 μm in diameter [PM10-e]); and eutrophication potential (nitrogen [N-e]). But the researchers found that a cumulative mean 83,070 of 183,304 mL per month (45.3 %) of pharmaceuticals were unused by weight or volume across all sites.
Unused pharmaceutical products
However, cost estimates for the annual unused product reached approximately $195,200 per site. Eye drops (65.7 % by volume), more often unused compared with injections (24.8 % or systemic medications (59.9 %). Monthly unused quantities at the ambulatory care center (65.9 % by volume); tertiary care center (21.3 %), federal medical center (38.5 %), and outpatient center (56.8 %) resulted in unnecessary potential emissions at each location of 2,135, 2,498, 418, and 711 kg carbon dioxide equivalents per month, respectively.
However, the investigators observed variance in unnecessary potential air pollution and unnecessary eutrophication potential between sites. “If these findings can be substantiated and shown to be generalizable in the United States or elsewhere, reducing these costs may be of value,” the authors write. This study suggests that unused pharmaceutical products during phacoemulsification result in relatively high financial and environmental costs. But if these findings can be substantiated and shown to be generalizable in the United States or elsewhere, reducing these costs may be of value.