E-DRUG: The use of expired e-drugs (cont)
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Dear friends,
I find the contribution of Eberhard Lisse a bit overdone. Yes, it used
to be common practice to ship drugs near expiry date from more
developed to to less developed countries. The reason used to be
that indeed they had almost no value anymore in the health
systems of the developed world.
The thought was that distribution systems in developing areas
were as efficient as in the country of shipping. Due to often
irresponsible behaviour of customs and/or other authorities in the
receiving countries, this proved not to be the case. It is not totally
fair to blame the ill informed people in the developed world for that.
As for their use, one can question if using drugs over the expiring date
in a country where no other medicines can be provided, is misconduct by the
prescriber. It is immoral in a certain sense, but I'll be very willing to
take paracetamol or acetyl salicylic acid agains pain, which is 20 years
over expiring date. It is a well known fact that other drugs (e.g.
tetracyclines) might detoriorate into toxic substances and those drugs
should not be given. And in case of doubt they should not be dispensed.
I don't know if pharmacists in developing countries learn such things, and
if they do not, they should. Then there can be a communication between the
physician and the pharmacists about the appropriateness of using expired
drugs in cases where no better alternatives are available.
Foppe van Mil
Snailmail: Margrietlaan 1, NL9471 CT Zuidlaren
Email: jwfvmil@wxs.nl
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