Ophthalmic drop wastage due to artificial expiration dates
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Reviewed by Gareth Lema, MD, PhD, John Tan, BA
A new study found that artificial expiration dates for eye drops can lead to significant medication, plastic, and cost wastage. The investigators recommended establishing practices that use ophthalmic drops until the manufacturer's labeled expiration date to reduce wastage. John Tan, BA, presented the results on behalf of the research team at the 2024 American Academy of Ophthalmology annual meeting, in Chicago.
The study’s corresponding author, Gareth Lema, MD, PhD, is Associate Professor of Ophthalmology at the Icahn School of Medicine at Mount SinaiDepartment of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, and the Department of Ophthalmology, JJ Peters VA Medical Center, Bronx, NY.
Eye drops in ophthalmology clinics have self-imposed use cessation dates (SUCDs) that are arbitrarily assigned, and not based on FDA regulations or testing, the investigators explained. They are often significantly earlier than the FDA-regulated expiration date (FRED), which is printed on the bottle. Because of this, the researchers undertook a 6-week study of multiuse ophthalmic drops that were going to be discarded at 3 ophthalmology clinics across the Mount Sinai Health System. The drops were collected over 3three 14-day study periods to mimic the 14- and 28-day SUCDs used within the health system. The investigators measured the residual medication volume and extrapolated medication, plastic and cost waste out to 1 year.
The outcomes were the number of discarded bottles, the volume left in the bottles, the cost associated with drop waste (based on the average of list prices from 3 national distributors), the time from disposal to the FDA expiration date, the total encounters worth of medication wasted, and the optimal use defined as the number of bottles that would be used if the FDA-regulated expiration dates were followed.
Waste identified
Over the 6 weeks of the study, which has been published in Ophthalmology,1 the investigators reported that 297 bottles were discarded. They found that an average of 71.9% of the medications remained in the bottles, and the bottles were discarded an average of 494 days before the manufacturers’ expiration dates. If the manufacturers’ expiration date had been adhered to, the investigators reported that 91% of bottles would have been used completely based on the use frequency.
Over 1 year’s time, they estimated that the total waste cost was an extra $80,997.00, and 1,850 bottles were discarded. Thus, using ophthalmic eye drops until the FDA labeled expiration date can help reduce healthcare’s carbon footprint and clinic costs without adversely affecting patient care, the investigators concluded.
