E-DRUG: expired drug donations (cont)
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Dear colleagues,
Since most of my concerns have been raised, I wish to add that
although the idea of donating expired drugs looks attractive, I
wouldn't recommend it. It adds an interesting question as to when do
'expired drugs' expire? This is important in view of the period
required for transportation, distribution and storage until a doctor
prescribes the said drug. Worst still, the recipients are rural
hospitals in developing countries where most drug stores (?pharmacies) are manned by dispensers, at least in the case of
Uganda, such that it is impossible to consider quality tests within.
I would argue that it
would be adding insult to injury by advocating for expired drugs when
storage conditions in the recipient countries (let alone the patient)
are still a risk to drug stability.
Acceptance of expired drugs should only be considered if such a drugs
have another date of expiry and the recipient country/body is to
distribute the said drugs to hospitals/areas where they have
thoroughly assessed its rate of consumption to be within the new
period of expiry. Having said that, the counter argument is that a
similar assessment could as well be performed by donor countries or
agency in their region/business such that the situation of expired
drugs would not arise. I therefore find it unfortunate and
unacceptable that one can keep drugs until expiry, and it is only then
he realizes there are people somewhere without drugs! If the quality
tests done by our good E-drug scientist are applicable and acceptable
(I have no reason to doubt they aren't), instead of focusing on a
particular group of people, it would be even more appropriate to
recommend for a general extension of expiry dates for some drugs.
In conclusion, except in exceptional circumstances, expired drugs
should not be accepted by any country because the needy people being
targeted by the donor agencies are always there. The donor countries
are expected to have an excellent record of their consumption and
prediction so as to donate such drugs before expiry.
Cheers
Andrew Walubo MD
Division of Clinical Pharmacology,
Vanderbilt University School of Medicine,
Tennessee, USA.
Email: andrew.walubo@mcmail.vanderbilt.edu
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