Editor’s note: The opinions expressed in this blog are those of their respective contributors and do not represent the opinions of Ophthalmology time® or MJH Life Sciences®
Special for Ophthalmology time®
Decades of habituation do not make regulatory policy and must be challenged. In a recent Ophthalmology editorial titled “Waste No More,” Wiley A. Chambers, MD, challenges existing institutional policies that require topical ophthalmic medications (eye drops) to be discarded before the expiration date listed on the bottle.
We consider Chambers another champion for reducing medical waste and increasing access to medicines for taking a strong, common-sense position.
As an ophthalmologist practicing for over 30 years, he says, “Currently, some institutions have instituted policies and rules that require ophthalmic medications to be discarded after a single use, although the packaging is a multi-dose container. . These policies often lack scientific basis and contribute to drug shortages that make it difficult for some physicians to obtain these products. I would like to suggest that it is high time to question these internal rules or policies.
Chambers, while speaking his mind as a practicing ophthalmologist, is currently director of the FDA’s Center for Drug Evaluation and Research in the Division of Ophthalmology.
“Artificial expiration dates, such as 28 days after opening ophthalmic medicine bottles, or restricting the use of ophthalmic medicine bottles to a single patient are not set with the same rigor,” said Chambers after exploring the need for evidence-based decision making. . “To the best of my knowledge, there is no scientific data to support these artificial expiration dates or usage restrictions for topical ophthalmic medications.”
Additionally, there are no regulatory requirements for early bottle disposal and Chambers’ research shows that these policies are often based on misinterpreted rules from other organizations such as the FDA, USP and TJC. .
“It turns out that none of these groups require a drug to be discarded before the expiration date printed on the bottle,” he said.
The pace of change in our healthcare system is admittedly chilling. However, it shouldn’t take another lifetime to eliminate medical waste, improve access to medicines and reduce costs. A recent analysis reveals that if multi-dose dropper bottles are used safely for multiple patients as intended, the cost savings amount to $284 per patient and $331 to the medical facility for each hospitalized cataract case. .
Early bottle disposal policies contribute to waste, drug shortages, increased health care costs, and impede patient access to care. As advocates for data-driven decision-making, and with Chambers among those advocating for change, we are pushing harder than ever to change outdated policies on single-use and early disposal of eye drops.