The logic of reducing medication waste. A case study into the logic of stakeholders towards their will to reduce medication waste in the Netherlands.

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The impact of medication waste on both the economy as well as the environment is becoming a more urgent problem as the world population is aging and the consumption of medication will increase. To reduce medication waste all stakeholders of the pharmaceutical supply and use chain have to contribute. For this reason this study aimed to understand the stakeholders' will to reduce medication waste. The focus of this study towards medication waste was on the medication waste of the generic drugs in primary care that occured at the end of the chain, the patient. This was done by examining the willingness to change the stakeholders towards medication waste reduction was studied by using the logic of the firm that is made out of the parameters interests, priorities and interaction goals. In addition this study added the institutional context as a variable that affects these parameters. Ten interviews were conducted among the different stakeholders of the pharmaceutical supply and use chain in the Netherlands. The results showed that all stakeholders found that correct and appropriate dispensing of medication by the pharmacy is the key to reduce medication waste. This study found that the current financial system between the health insurer and the pharmacy is an incentive to keep delivering medication and a hold back to reduce medication waste for the pharmacy. The tensions between the financial and the healthcare or environmental interest and the tensions between acting out of self-interest or acting for medication waste reduction for the whole supply and use chain ask for a problem owner to step up. Therefore this study advised for the government to step in and take responsibility as a problem owner. Also this study recommends further research into how the financial system between the health insurer and pharmacy can become an incentive to reduce medication waste and reduce healthcare costs.
Faculteit der Managementwetenschappen