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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