Too many people aren’t taking their meds

Another thing that makes prescription drugs very different than Amazon’s typical offerings is that in many cases it’s essential that patients actually take their meds as prescribed. That’s not happening.

Taking drugs in the right dosage for the right amount of time is critical to effectively cure a disease, prevent the formation of antimicrobial resistance and keep a malady from progressing.

Yet on average, only about 50 percent of American patients typically take their medicines as prescribed, costing hundreds of billions of dollars in adverse outcomes and unnecessary hospitalizations each year.

Furthermore, in my own research involving patients with cardiovascular diseases, I have found that people are simply not receiving the medications they need – and when they are, they aren’t following through on the required dosage, leading to worse outcomes. I’ve found that greater interaction between patients and pharmacists can help solve this problem.

Other studies have shown that more active face-to-face engagement with a pharmacist improves a patient’s level of adherence to a prescription, which can lead to better outcomes. A study involving Walgreens pharmacists, for example, suggested direct drug counseling reduced health care costs by $266 on average, mostly due to fewer hospitalizations.

Related Articles

The environmental costs

Finally, another key aspect of prescription drugs is that their waste is a big and growing problem.

Unlike the clothes or appliances you order, medications can’t simply be returned to the merchant, restocked and resold to another customer. There’s no way of ensuring they weren’t adulterated or improperly stored, and the risks are too great. That means every pill that goes unused must be disposed of, which is a huge waste of money but also is a major source of pollution.

In a 2015 assessment of medications turned in for disposal, more than half of the prescriptions purchased from mail-order pharmacies still contained 80 percent of more of the original pills. Even more troubling, 39 percent had every single pill originally dispensed. That compares with much-lower rates of 37 percent and 17 percent for community pharmacies.

Many of the unused drugs, however, aren’t properly disposed of and instead end up in a landfill or flushed down a toilet.

A nationwide study conducted by the U.S. Geological Survey in 1999 and 2000 found low levels of pharmaceuticals – including antibiotics, hormones, contraceptives and steroids – in 80 percent of the rivers and streams sampled, contaminating 40 million Americans’ drinking water.

Studies have shown that aquatic animals are adversely affected by these hormones, with some male fish developing female sex organs, and there are concerns that long-term exposure to a tainted water supply can lead to more superbugs.

Small gains for many pains

Amazon is a revolutionary company that has reshaped how we shop and has helped drastically increase the efficiency of shipping small packages. This could even allow it to reduce some of the negative side effects, noted above, of remote pharmacies, such as by making it more cost-effective to ship small quantities of pills to reduce waste.

But to my mind, any modest gains in efficiencies or cost savings are paid for dearly by the negative outcomes that result from medication-related errors and patients not following through on their prescriptions, while the waste of unused drugs will continue. And while this problem has been with us for a while, Amazon, due to its size and ability to quickly dominate markets, would make the situation a lot worse.

The ConversationDelivering a product more efficiently cannot be the only metric of success. With prescription drugs, saving lives must be considered as well.

C. Michael White, Professor and Head of the Department of Pharmacy Practice, University of Connecticut

This article was originally published on The Conversation. Read the original article.