DISPOSAL OF EXPIRED OR UNUSED MEDICINES IN FEDERAL DISTRICT –
BRAZIL: AN ANALYSIS OF REVERSE LOGISTICS
1
DESCARTE DE MEDICAMENTOS EXPIRADOS OU NÃO UTILIZADOS NO
DISTRITO FEDERAL – BRASIL: UMA ANÁLISE DA LOGÍSTICA REVERSA
VANESSA CABRAL GOMES
Universidade de Brasília (UnB)
E-mail: vanessacabral@unb.br
CINTHIA BANDEIRA CHAVARRI GOMES
Universidade de Brasília (UnB)
E-mail: cinthiabchavarri@gmail.com
EDILENE SAMPAIO
Universidade de Brasília (UnB)
E-mail: edilenesampaio@gmail.com
ANDRÉ VALLE MAGALHÃES
Universidade de Brasília (UnB)
E-mail: andrevalle@gmail.com
ABSTRACT
This study aims to analyze part of the Reverse Logistics chain of expired or unused medicines in
the Federal District (FD) - Brazil, namely, the disposal by users and receipt by pharmacies and
drugstores. As for the method, this is applied research, and primary and secondary data were
collected. The application of the questionnaire resulted in 158 responses from residents of the
Federal District and 65 companies were interviewed. The result with the residents shows that most
of the population disposes of their medicines incorrectly; they never received information about the
correct disposal of medicines; but residents who tried to deliver the medicines to pharmacies had
no difficulty. The result of the research with drugstores shows that most of them receive expired or
disused drugs; that dispensing containers are not available to customers, but that there are
containers for primary storage within the pharmacies themselves. Thus, it is concluded that the
main problem is in the first link of the chain that is, in consumers who do not dispose of waste
correctly, since the next link in the chain, pharmacies, and drugstores, are not showing resistance
when receiving the medicines, that is, they comply with their legal responsibility.
Keywords: Reverse logistics, Reverse logistics of medicines, Expired medicines, Unused
medicines.
RESUMO
Este estudo tem como objetivo analisar parte da cadeia de Logística Reversa de medicamentos
vencidos ou em desuso no Distrito Federal (DF) - Brasil, a saber, o descarte pelos usuários e o
recebimento pelas farmácias e drogarias. Quanto ao método, trata-se de uma pesquisa aplicada, e
foram coletados dados primários e secundários. A aplicação do questionário resultou em 158
respostas de moradores do Distrito Federal e foram entrevistadas 65 empresas. O resultado com
os moradores mostra que grande parte da população descarta seus medicamentos de forma
incorreta; nunca receberam informações sobre o descarte correto de medicamentos; mas os
moradores que tentaram entregar os medicamentos nas farmácias não tiveram dificuldade. O
resultado da pesquisa com drogarias mostra que a maioria delas recebe medicamentos vencidos
ou em desuso; que os recipientes dispensadores não estão à disposição dos clientes, mas que
existem recipientes para armazenamento primário nas próprias farmácias. Assim, conclui-se que o
principal problema está no primeiro elo da cadeia ou seja, nos consumidores que não descartam
os resíduos corretamente, já que o elo seguinte da cadeia, farmácias e drogarias, não estão
1 DOI: https://doi.org/10.5935/2763-9673.20230008
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demonstrando resistência ao receber o lixo. medicamentos, ou seja, cumprem sua
responsabilidade legal.
Palavras-Chave: Logística reversa, Logística reversa de medicamentos, Medicamentos vencidos,
Medicamentos não utilizados.
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1. INTRODUCTION
The consumption of medicines has increased due to technological
advances and social development, which, despite being beneficial to society,
raises concerns about the impact of these wastes (BUENO, 2016). In addition,
self-medication is a common practice among Brazilians more than 10 thousand
tons of waste in this category are generated per year by the Brazilian population,
making Brazil the seventh country with the highest consumption of medicines in
the world (SILVA et al., 2014).
Pharmaceutical residues fall into Group B according to the resolution of
the National Council for the Environment (CONAMA) Nº 358 of 2005, because
they have corrosive characteristics, and because their incorrect disposal poses
risks to the environment such as soil contamination, groundwater, animals,
vegetation, and man (CONSELHO NACIONAL DO MEIO AMBIENTE – CONAMA,
2005). In this way, with a large amount of manufacture and consumption of
medicines, Policies, Laws, and Decrees of Reverse Logistics (RL) of expired or
unused medicines were implemented so that the impact of this waste was reduced
(DOS SANTOS; FRIZON, 2019).
The Federal Government determines at the national level, through the
National Policy and Solid Waste (NPSW) (Lei N
o
12.305BRASIL, 2010) that the life
cycle of products must be a shared responsibility, that is, from manufacturers to
consumers and holders of public services for urban cleaning and solid waste
management, to minimize the volume of solid waste and rejects generated, as well
as to reduce the impacts caused to human health and environmental quality
resulting from the life cycle of products (Lei N
o
12.305, de 2 de agosto de
2010.BRASIL, 2010). In short, all actors must play their part in the reverse logistics
chain.
Reverse Logistics can be defined as the process of planning,
implementing, and controlling reverse flows of raw materials, packaging, final
manufacturing, and distribution products (LEITE, 2009). In the case of drugs, it is
concerned with residues after their expiration date, discontinuity of use, or proper
disposal of these elements (DE BRITO; DEKKER, 2004).
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Despite the significant impact that the incorrect disposal of solid waste
from medicines can cause to the environment and society, only in the year 2020
will the RL of expired or disused home medicines, for human use, industrialized
and manipulated, and their packaging after disposal by consumers was sanctioned
by Decree No. 10,388 (BRASIL, 2020).
On the other hand, in the scope of the Federal District, since 2013, with
Law Nº 5,092 of 2013, pharmacies are obliged to receive from the consumer
medicines with an expired expiration date or in disuse. These must return the
medicines to their respective manufacturers so that they can dispose of them
properly, as provided for in the National Policy on Solid Waste (DISTRITO
FEDERAL, 2013).
It is important to emphasize that, for the reverse logistics chain of
medicines to work, it is necessary that all actors - supplier, industry, and consumer
- play their role within it (ZAJAC et al., 2016), as non-compliance can have
negative consequences to the environment and society (BILA; DEZOTTI, 2003;
PINTO et al., 2014; ZAPPAROLI I.D., CAMARA M.R.G., BECK, 2011)
However, the study by Ramos et al. (RAMOS, 2017) in the Federal
District, revealed that in 2017 around 73.7% of the population declared having
household inventory and 75.2% stated having the habit of checking expiration
dates. Regarding the proper form of disposal, 80.7% stated that they had never
received information about this procedure and 45% had never thought about this
matter, whether they were disposing of it inappropriately or not (RAMOS, 2017).
As for the practice of improper disposal, 87% of the interviewees stated that they
had disposed of their medicines incorrectly, with 71.3% of the interviewees stating
that they had disposed of them in a trash can for common waste, 8.7% in a sink
and 7% in a toilet (RAMOS, 2017).
Results such as those presented by Ramos et al. (RAMOS, 2017) shows
the relevance of research corresponding to the reverse logistics chain of
medicines because when the product is disposed of incorrectly, it becomes
impracticable to reuse or correctly conduct this waste, since each material has its
specific form of disposal, which has consequences for the environment and human
beings, in addition, when companies do not accept disposal, despite being
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mandatory, the correct destination of products and preservation of the
environment is unfeasible (RAMOS, 2017).
Therefore, it is necessary to research the knowledge and practice of the
population concerning waste disposal, to avoid inappropriate disposal, as well as
verify whether companies and industries are fulfilling their role in the chain,
especially the drug chain, which according to Silva (2014), the practice of reverse
logistics in expired or disused domestic medicines is a recent topic and little known
by society, given the scarcity of disclosure on this subject. Given the above, the
objective of this article is to analyze part of the Reverse Logistics chain of expired
or unused medicines in the Federal District, namely, disposal by users and receipt
by pharmacies and drugstores.
2. LITERATURE REVIEW
2.1. Reverse Logistics and Medicine Disposal
Reverse logistics is understood as the logistics area responsible for
planning, operating, and controlling the flow of materials after consumption and
sale. and sustainable (LEITE, 2009). It emerged as a way to reduce damage to the
environment and make all actors in the chain responsible for the correct
destination of the consumed product, from manufacturing to the final consumer. In
this sense, the commercial, business, social, and environmental objectives of
companies must be considered in a synchronized way (COHEN; SMITH;
MITCHELL, 2008).
The stages of reverse logistics are similar to those of direct logistics,
however, the flow is reversed, that is, the practice of reverse logistics makes it
possible to reuse inputs or, if reuse is not feasible, the product will have a correct
final destination without impact. to the environment (LAMBERT; RIOPEL; ABDUL-
KADER, 2011; SRIVASTAVA, 2008; ZHANG; HUANG; HE, 2011). Reverse
logistics must be part of the life cycle of products that are used or consumed daily.
In addition, expired, damaged, or unusable products must be returned to their
point of origin for correct disposal or reuse (LACERDA, 2002). For Lacerda
(LACERDA, 2002) the reverse flow has three stages: disposal, collection and
recycling, reuse, or correct final destination. The disposal stage, as it is the first, is
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fundamental for the reverse logistics chain (LACERDA, 2002). Thus, if there is no
awareness of the proper disposal of medicines, it becomes impractical to reduce
risks to the environment and humans. Improper disposal can affect waste pickers
and recyclable material collection workers, as when searching the garbage, they
can become contaminated by consuming medicines that were disposed of
incorrectly (PINTO et al., 2014).
Figure 1 depicts the flowchart of expired or consumed medications, and
the first activity is carried out by the consumer, who becomes the first link in the
chain, in whose responsibility is limited to storing the medication and discarding it
at the pharmacy or point of sale. nearest collection point. In the next step, which
refers to the industry, in this context, the pharmacy has the responsibility of
collecting the medicine, storing it, and then returning it to the supplier, the latter will
give the final destination appropriate to the product.
Figure 1 - Reverse logistics of medicine
Data Source: (PATELLA, 2011)
In Brazil, the Reverse Logistics of medicines is an eminent need.
According to the Federal Council of Pharmacy (CFF, 2016), Brazil ranked sixth in
the largest pharmaceutical market in 2016, according to data from the Federal
Council of Pharmacy (CFF). In 2013, it was estimated that around 10.3 and 19.8
thousand tons of medicines are discarded annually in Brazil (CFF, 2016). In
addition, self-medication is a constant practice in Brazil, the Brazilian population
has the habit of having a "pharmacy" in their homes, keeping excess medicines
that are usually expired, this practice is aggravated by the distribution of free
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samples by pharmacies and the sale of medicines with a greater amount than will
be consumed by the individual, in addition to excessive drug advertisements,
which are reproduced on television, usually starring artists (RAMOS, 2017).
Drugs have chemical substances that are capable of seriously affecting
human health, and may alter the endocrine system, which is related to several
factors, such as, for example, a drop in sperm count, breast cancer, and may also
cause dysfunction. of the thyroid and it is possible to suffer from changes in the
neurological system (CARVALHO et al., 2009).
Among the possible impacts that the substances present in incorrectly
discarded medicines can generate, there are some species of fish that, when
exposed to the substances and hormones present in contraceptives, can undergo
feminization (GHISELLI; JARDIM, 2007).
In the state of Rio Grande do Sul, fifty pharmacies were selected for the
research sample and then they were asked if they made any kind of disclosure
regarding the correct disposal of medicines, 48% said they did not collect the
medicines and that they did not disclose the correct way of disposing of them.
disposal, 32% reported that they inform customers only when they ask, 12% have
totems in the establishment and 4% through radio advertisements (SILVA et al.,
2014). In addition, still, according to Silva (SILVA et al., 2014), part of the state's
population is not aware of the practice of reverse logistics, despite the existence of
regulations, as a result, the waste is disposed of in common garbage or the sewer.
2.2. Main Rules of Reverse Logistics of Medicines
Since 2013, all pharmacies and drugstores in the Federal District are
obliged to receive medicines from their consumers, a fact determined by Law No.
5092 of May 4, 2013 (DISTRITO FEDERAL, 2013), of the Federal District. This
Law enacts the obligation of pharmacies and drugstores in the Federal District to
receive any expired or unused medicine for correct disposal, therefore, it becomes
the responsibility of the productive chain of the pharmaceutical industry, to the
correct destination of the medicines delivered by the consumer (DISTRITO
FEDERAL, 2013).
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In 2020, Decree No. 10.388, of June 5, 2020 (BRASIL, 2020), was
created, which regulates § 1 of the caput of art. 33 of Law No. 12,305, of August 2,
2010 (Lei N
o
12.305, BRASIL, 2010), and establishes: “the reverse logistics
system for expired or disused home medicines, for human use, industrialized and
manipulated, and their packaging after disposal by consumers”.
This Decree determines the responsibility of all agents in the production
chain, from the consumer to the industries. The correct packaging of medicines is
defined, consumers must pack them in bags or containers so that leakage does
not occur. The next stage is primary storage carried out by pharmacies,
drugstores, and collection points, while secondary storage is carried out by
distributors until the external collection stage of the containers containing the
medicines discarded by consumers occurs. In the external collection activity,
household drug residues are transported to the proper treatment and final disposal
site. As of this Decree, consumers now have greater legal responsibility for the
duty to dispose of unused or expired medications (BRASIL, 2020).
As provided for in the National Solid Waste Policy (Lei N
o
12.305, BRASIL,
2010) RL is applied in pharmacies and drugstores within the Federal District, to
return expired medication to the manufacturer so that it can be disposed of
correctly (DISTRITO FEDERAL, 2013). In this way, the responsibility for storing,
packaging, and sending the waste back to its point of origin is established by one
of the actors in the chain, the pharmacy (DISTRITO FEDERAL, 2013). In addition,
the FD State Department of Health, through notes, suggests that health units also
receive domestic medicines from the population, so that they have the correct
destination, despite the responsibility of pharmacies (RAMOS, 2017). Thus, the
population of the FD can deliver unused or expired medicines to pharmacies and
drugstores in the FD, which are responsible for sending them to the manufacturer,
since the population does not know what to do with the waste (AGUIAR, 2017).
For Ramos et al. (RAMOS, 2017) the importance of information on the
reverse flow and final destination of medicines is clear, with population awareness
being a fundamental means to avoid inappropriate disposal and, consequently,
risks to society (RAMOS, 2017).
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3. MATERIALS AND METHODS
Through applied research, whose methodological framework is
characterized as descriptive-exploratory, primary and secondary data were
collected using a mixed approach (quanti-quali). Primary data were obtained using
two research instruments: a questionnaire and a semi-structured interview, while
secondary information was collected through a literature review. The application of
the questionnaire resulted in 158 responses from residents of the Federal District
and 65 companies (pharmacies and drugstores) were interviewed.
As for the procedures, the research was divided into two stages: Research
with residents of the FD; and Research with Pharmacies in the Federal District.
The first stage of the research verified the citizens' knowledge about the correct
disposal of medicines and investigated whether people correctly dispose of
medicines in the FD. While the second stage of the research investigated the
collection of expired or unused medicines by pharmacies in the Federal District.
The stipulated number of drugstores was based on the 33 Administrative Regions
(ARs) existing in the FD, with two pharmacies being selected per AR, totaling 66
pharmacies and drugstores. The selection of drugstores was made from searches
on Google, with the term: "Pharmacies and AR". Pharmacies were selected in
order of appearance and contacted by telephone. A total of 65 pharmacies were
surveyed, and only one drugstore in the SIA Region could not be contacted
because they did not answer the phone. Data collection was carried out from
December 2021 to February 2022 and lasted, on average, five minutes (5').
Finally, the quantitative data were analyzed using descriptive statistics
and, in a complementary way, the qualitative information was submitted to
discourse analysis which, according to Bardin (BARDIN, 1977) belongs to the field
of content analysis having the word as its object (BARDIN; RETO; PINHEIRO,
2009).
4. ANALYSIS RESULTS
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This section is divided as follows: 4.1 Analysis of data collected through
the questionnaire answered by residents of the FD; and 4.2 Analysis of information
obtained through interviews carried out in pharmacies and drugstores.
4.1. Survey With Residents of The Fd
The primary agent of Reverse Logistics for expired or disused medications
is consumers since they are responsible for giving the first correct destination to
this waste. In this way, what will be analyzed below is whether the residents of the
FD correctly dispose of the waste generated by them and whether they have this
knowledge.
These two questions were asked since even if the individual knows the
correct form, he may not perform it. With the National Policy on Social Waste
(NPSW) in 2010 and Decree No. 10,388, the responsibility of consumers
regarding the reverse logistics system for expired or unused medicines is required
and regulated.
So that incorrect disposal does not occur, the consumer must be aware
and carry out all the steps - separate, pack and dispose of correctly - that he is
responsible for, in this way, the environment will be preserved, as the impact
generated by the consumption of medicine will be reduced (ZAJAC et al., 2016).
65,8%
0,6%
7,0%
14,6%
11,4%
0,6%
Trash Can
Sink
Toilet
Farmacies/drugstores
Nerver discarded the waste
Take it to the nearest health
center
Figure 2 - The main way of discarding expired or unused medicines
Source: Research data.
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As can be seen in Figure 2, most respondents (74.4%) stated that they
dispose of medications incorrectly, with 67.1% in the trash can sink and toilet
(sewage), receiving, respectively, 6.7 % and 0.6%. The result obtained converges
with the statement by Melo and Rodrigues (MELO et al., 2009) on the importance
of reverse logistics for the disposal of medicines since most people dispose of
medicines in the trash or public sewage system. Silva (2014) pointed out that even
though there are laws and regulations in Brazil, the final destination of drug waste
is usually common waste or sewage.
Given the results obtained, 74.4% of respondents incorrectly dispose of
expired or unused medication, even if they know the correct way to dispose of it.
This can damage the soil, lakes, and rivers and contaminate garbage collectors
who have direct contact with the waste discarded in the dump (BILA; DEZOTTI,
2003; PINTO et al., 2014; ZAPPAROLI I.D., CAMARA M.R.G., BECK, 2011).
According to Ghiselli (GHISELLI; JARDIM, 2007), with the excess of medicines,
such as contraceptives, discarded incorrectly, through the toilet or sink, fish
species suffered feminization when they encountered the substances and
hormones contained in this medicine. However, 14.6% responded that they
discarded it in pharmacies and drugstores and 0.6% took it to the nearest health
center, and 11.5% stated that they never discarded the waste.
Even if most respondents dispose of it incorrectly, it does not mean that
they do not know the correct way, as 66.1% state that drugstore pharmacies are
among the correct forms of disposal (Figure 3).
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Trash Can
Sink
Toilet
Farmacies/
drugstores
Do Not
know the
correct way
0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% 70,0%
12,7%
5,2%
8,9%
64,6%
32,3%
Figure 3 - Correct way(s) to dispose of expired or unused medications
Source: Research data.
The trash can for common waste, the sink and the toilet are stated as the
correct way to dispose of medicines by 13.9%, 4.8%, and 8.5% respectively.
These data show that, despite most affirming the correct way of disposal, there is
a part that still thinks it is correct to dispose of medicines by other means.
Another point that should be highlighted is that, according to Figure 3,
32.30% of people claim not to know the correct way to dispose of it. That is, this
demonstrates the lack of disclosure on the subject and that waste is not currently
being well managed by the population, which generates a negative impact on the
environment and corroborates the research developed by Silva (SILVA et al.,
2014).
As for the attempt to dispose of medicines in pharmacies and drugstores,
79.7% never tried to discard medicine in pharmacies or drugstores. On the other
hand, of the 16.5% who tried to discard it, they were successful, while 3.8% tried
but failed (Figure 4).
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80%
17%
4%
Never tried
Tried to discard and were
successful
Tried to discard, but failed
Figure 4 - Attempted disposal of medicines in pharmacies and drugstores
Source: Research data.
Still, regarding the disposal of medications, most respondents (98.8%)
indicated that they were not informed about the correct disposal of expired or
unused medications at the time of sale and only two respondents claim to have
received information about the correct disposal of medicines.
As the consumer is the primary agent in the reverse logistics chain for
disposing of expired or unused medications, they must know the correct way to
dispose of them. the pharmacy supplies the drug for consumption. These data
converge with the research carried out in the Federal District by Ramos and
Pimentel (RAMOS, 2017) in which 80.7% declared never having received
information about this procedure. Therefore, in the FD scenario, there has not yet
been a significant change regarding the dissemination of information on the
correct disposal of medicines in these establishments.
In this context, and based on the data collected, what can be concluded is
that most of the population of the FD still dispose of their medicines incorrectly,
either in the common trash or in the sewer. Another problem is related to the lack
of information on the subject since although most respondents consider
pharmacies to be one of the correct ways to dispose of them, there is a part that
believes that disposing of medicines by other means is correct. Another point that
should be highlighted is that 32.30% stated that they did not know the correct way
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to dispose of it, that is, this demonstrates the lack of dissemination on the subject
and that waste is not currently being well managed by the population, agreeing
with the study by Silva (SILVA et al., 2014).
It can be seen in Figure 4 that more than 80% never tried to dispose of
them in pharmacies and drugstores, even though most respondents indicated that
pharmacies and drugstores are the correct destinations for disposing of medicines.
This fact allows us to infer that the lack of incentive and awareness of the
population about the consequences to the environment and society is one of the
factors why the consumer does not dispose of it in the appropriate place. In
addition, another corroborating factor is the lack of disclosure by pharmacies,
since, according to data from this survey, most respondents did not receive
information on correct disposal by pharmacies or drugstores until the time of the
survey.
Therefore, the lack of information and awareness of the population,
aggravates and enhances the accumulation of waste, in addition to the excessive
distribution of "free samples", medicines with pills above the amount that will be
consumed by the patient, interruption or change in treatment (JOÃO, 2011). For
Reverse Logistics to be fulfilled and ensure its purpose, which is to cause the least
possible damage to the environment, unused medicines need to be properly
disposed of, and all agents, from the manufacturer to the collectors, must be
committed to campaigns to promote the correct disposal of medicines (SOUZA et
al., 2021). Only when the primary agent fulfills its role in the chain will it be
possible for other agents to do their part, such as pharmacies and drugstores.
4.2. Research With Pharmacies and Drugstores
With society's awareness, the Government implemented Laws and
Decrees for the management of pharmaceutical waste generated by pharmacies,
worrying about the environment and the impacts generated by the incorrect
direction of medicines (GUARNIERI, 2013). Thus, in 2013, Law 5,092/2013 was
sanctioned, in which pharmacies and drugstores in the Federal District are obliged
to receive expired or unused medicines for disposal (MCT, 2010) (AGUIAR, 2017).
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In this context, to investigate compliance with Law 5092/2013 by
pharmacies, it was asked whether pharmacies collected or received medications
from consumers. Among 65 pharmacies researched in the FD, 96.9% answered
that they receive the medicines from the users, showing that the organizations
adhere to the district law. These findings converge with Leite (LEITE, 2009), who
stated that responsibility for the waste generated has been transferred from the
Government to companies or their industrial chains. Despite being a minority, it is
worth mentioning that two pharmacies (3.1%) stated that they did not receive the
medication for users, with the justification for non-compliance being the high cost
associated with receiving it. Still in this question, Interviewee 34 stated that, if the
user tries to discard it at his pharmacy, he advises him to take it to a health center.
Thus, although it does not comply with the regulation, it directs the individual user
of home medications to the correct form of disposal.
The second question asked to the 63 pharmacies that receive medication,
sought to verify whether there are any containers exposed to dispose of
medications, which could be a way of disclosing correct disposal (Souza, 2021). In
this sense, only 29.2% of drugstores answered yes, that they have the container
exposed, which shows that this type of advertising is still little explored in
pharmacies in the FD. In particular, Interviewee 59 reported that the box comes
from the "conscious disposal" program which is among the largest programs in
Brazil for collecting expired or unused medicines (BHS, [s. d.]).
Most drugstores (70.8%), however, stated that they do not have
containers exposed to the consumer, which can be a barrier to correct disposal,
due to lack of disclosure (SOUZA et al., 2021). On the other hand, among the
alleged reasons for not exposing the containers, there is the issue of safety.
According to Interviewee 25, the lack of exposure of the container dispenser to
consumers is justified by the impossibility of filtering the objects that are placed in
the box. Still, according to Interviewee 25, the sharp object box has already been
placed, being unsuitable for this collection point, which caused an incident. Since
that episode, the pharmacy has withdrawn exposure to customers to avoid this
circumstance. Although pharmacies are responsible for receiving unused or
expired medications, they are not among the establishments that are responsible
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for collecting sharps, according to Law No. 6,656/2020 (DISTRITO FEDERAL,
2020).
After receiving medicines, the next step in the chain, primary storage is
also the responsibility of pharmacies, which is considered as temporary storage of
medicines in sealed packages with identification, which prevent leakage until
collection and transport to the environmentally friendly final destination. adequate
as determined by Decree No. 10,388/2020 (BRASIL, 2020). Thus, the
interviewees were asked how the medicines were stored. Among the 65
pharmacies surveyed, most respondents (86.2%) responded that they store them
in the pharmacy's warehouse, using bottles provided by the companies
responsible for collecting these medications, see Figure 5.
86%
9%
3%
2%
Pharmacy's warehouse
Container visible to the
consumer
Do not have the appropriate
place
Do not have any container
Figure 5 - Storage of medicines in pharmacies and drugstores
Source: Research data.
Pharmacies and drugstores can also be called logistics operators, this
term is defined as a "company with operating authorization and special
authorization, when applicable, qualified to provide transport or storage services"
(BRASIL, 2020). According to Figure 5, while 9.2% of pharmacies reported that
the medicines are stored in a container visible to the consumer, and; only two
stated that they did not have the appropriate place, Pharmacy 35 revealed to
separate them in specific boxes to be collected later, while at Drugstore 36 the
medicines are removed from the store's hall and placed in white disposal bags and
taken to the garbage location identified as infectious waste. Only Pharmacy 56
does not have primary storage. Because of the result, it is worth mentioning that of
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the 65 pharmacies surveyed, 64 have medication storage, only one does not, and
of the 65 pharmacies, two claim not to receive the medications, however, one of
these has primary storage for its stock.
Finally, the last question was whether the pharmacy disclosed and
encouraged the population to participate in the disposal of unused medicines and
how (Figure 6). Among the responses obtained, more than 75% of pharmacies
claim to disclose, in different ways, the correct way of disposal, although
disclosure at the time of sale of the medicine is carried out by only 15.4%. Thus,
although only 24.6% claim that they do not disclose the information, the other
ways have not had an effect, since residents claim that they do not receive this
information.
15,4%
1,5%
10,8%
43,1%
3,1%
1,5%
24,6%
Yes, at the time of sale of the
medicine
Yes, through TV advertising and
informational posters
Yes, when requested by the cus-
tomer
Yes, through information boards
Yes, through social media
Yes, by the box visible in the sto-
re
Do not disclose the information
Figure 6 - Disclosure of the correct way to dispose of medicines
Source: Research data.
Given the above, it is important to highlight that the action taken by an
organization can impact the environment and people's lives, therefore, the theme
of reverse logistics of expired or disused medicines should have more space in
television media and social networks. Considering that medication advertisements
on television are frequent, and, comparing them with RL campaigns, it can be
stated that the correct disposal of medication is almost non-existent (SOUZA et al.,
2021). Finally, when verifying the results obtained by the research in pharmacies
and drugstores, most receive unused or expired medicines, acting correctly,
however, for the medicine to have its correct destination, it is necessary that the
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primary actor of the waste, the final consumer, know your role in the chain and
play it assertively and effectively.
5. CONCLUSIONS
Part of the reverse logistics system for expired or unused medicines in the
Federal District was analyzed through two stages: the disposal of medicines by
residents of the FD; and the receipt of this waste by pharmacies and drugstores in
the FD. Because of the data obtained, it is observed that in the Federal District,
residents still dispose of their medicines incorrectly, either in the common trash or
in the sewer. In addition, there is a lack of information on the correct disposal of
this waste, since a portion of residents said they did not know how it should be
done, while another believes that sewage and common garbage are the correct
forms of disposal.
Another point to be highlighted is that, among residents who tried to
dispose of medications in pharmacies, few encountered resistance. But, on the
other hand, most respondents stated that they never received information about
the correct disposal of medicines at the time of purchase. Once again, this shows
the lack of awareness campaigns on the topic.
Concerning the next stage of the RL, that is, the receipt of this waste by
pharmacies and drugstores in the FD, the data showed that there is little
resistance from these establishments to receive expired or unused medicines from
consumers. This may be a reflection of District Law 5,092/2013 (DISTRITO
FEDERAL, 2013), which requires the receipt of "any expired medication for
disposal purposes" since non-compliance with this law can lead to sanctions for
these establishments. On the other hand, these establishments are not very
concerned with disclosing the correct way to dispose of medicines, which may be
among the reasons for this lack of information reported by residents at the time of
purchase, the cost of storing and hiring a specialized company to collect and
dispose of them. correct for these wastes.
When analyzing part of the reverse logistics system for expired or disused
medicines in the Federal District, it is concluded that the main problem is in the
first link of the chain, that is, in consumers who do not dispose of waste correctly,
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since the link next in the chain, pharmacies, and drugstores, are not showing
resistance to receiving the medicines, that is, they comply with their responsibility.
It is also important to draw attention to a weak point which is education since there
is a clear lack of information for consumers. Given this, it is suggested that
education and awareness policies be developed on the importance of the correct
disposal of medicines, covering all links in the chain.
Finally, the research was limited to researching the first links in the drug
RL chain in the FD. Thus, it is suggested, as future research, the expansion of
investigated objects, that is, other links or even the complete medication logistics
chain, considering the collection and correct destination of these residues by the
logistics operators, to be more reliable demographic metrics of the region. For
similar studies, it is recommended to increase the sample size, as among the
limitations is also the relatively low number of participants, both pharmacies and
drugstores and residents, considering the territorial extension and the expressive
population of the Federal District.
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