Gareth Lema, MD, Associate Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai, has co-authored a study suggesting that academic medical centers and healthcare systems are unnecessarily throwing away multi-use eye drop bottles ahead of the FDA-regulated expiration dates.
This practice, called self-imposed use cessation dates (SUCD), leads to substantial medication waste, plastic waste, and increased costs for healthcare systems. Additionally, this could potentially have an impact on eye drop availability nationwide, preventing shortages such as the recent scarcity of dilating eye drops. The researchers maintain that adhering to FDA-regulated expiration dates instead could save hospitals millions of dollars annually.
SUCDs, which are often arbitrarily assigned by healthcare systems to presumably minimize the risk of contamination and infection, are not evidence-based and do not prevent contamination. As such, there have been zero reported cases of infections stemming from FDA regulated dropper bottles used in clinical settings.
Lema’s study, the first to document and quantify the wastage of eye drops due to SUCDs, was based on an analysis of 297 discarded eye drop bottles from three ambulatory sites within the Mount Sinai Health System over a six-week period. Their findings showed that 72% of the medication was still in the bottles when they were disposed of, and this could have been reduced had the FDA regulated expiry dates been observed.
With a total annual plastic mass of 17.7 kilograms (or 39 pounds) from discarded bottles, the reduction could have been by up to 72 percent, leading to a 73% cost reduction in annual hospitals costs for ophthalmic medications. The implication is that using FDA-regulated expiration dates would improve efficiency and mitigate the risk of ophthalmic drug shortages and, in the process, enhance patient care.
Lema and his team are currently working with their Health System to consider adopting FDA-regulated expiration dates as the discard date for their drops, and have also initiated measures to lower the number of bottles that are opened and consequently wasted. Plans are underway for a follow-up study to determine if these measures have led to a reduction in drop waste.