A review of medicines reuse: Thematic analysis and metaphors of return economies

Sustainability Assessment of Medicines Reverse Logistics in Brazil: Outcomes from the National and Local Systems

“…The legal concept of RL as a tool for socioeconomic development [63], although mandatory, is not fully applied in the federal MRLS, because it supposes that the reverse flows could bring more environmental benefits than from the incineration or correct disposal in landfills that prevents damage to the soil, surface waters and groundwaters [45][46][47][48][49]. Thus, circularity [13,38] is yet to be achieved in this system; although, in the municipal MRLS, closed loops [25] are observed since the needy persons have access to returned medicines [11,12,14,15].…”

“…Improvements in MRLSs involving a wide range of stakeholders [6,7], and efforts to calculate the financial value of generated waste are also targets of investigation [8,9], although with limitations related to specific legal regulations and scales. With the supply chain disruptions triggered by diverse causes, such as high costs to final consumers and to government procurement [4], scholars have resurrected the debate on medicine returns not only for proper disposal (in the case of a damaged or expired product), but for possible reuse [10][11][12][13][14][15][16], regardless of the traditional argument about the likely risks entailed in a further harnessing of these products [6,11,12,15].…”

“…Nonetheless, to the extent of our knowledge, there are no studies examining both national and local MRLSs in Brazil. This situation has arisen because local systems that facilitate medicine reuse have been historically understood as informal activities, which makes research into the medicines reverse logistics (MRL) problematic [13,14]. Taking such a research gap into consideration, this study proposes the assessment of the outcomes of the recently implemented Brazilian MRLSs in 21 state capitals and in cities with 500,000 or more residents that take part in the official MRLS.…”

“…And what are the principles, concepts, procedures, and (socio)economic results of each system? Such questions address contributions that will enrich the discussion on medicine reuse in Brazil as part of a MRLS, assuming that this activity is a type of black box running in the daily activities of the health sector [14,19]. Although there is recent research comprehensively covering the consumers' impressions of medicine reuse, mainly in the UK [10,11,15,16], including the issues of packaging [20] and technological traceability [18], gaps remain on the description and assessment of the simultaneous routes that left over medications go through, with special focus on local scales [14].…”

“…Although there is recent research comprehensively covering the consumers' impressions of medicine reuse, mainly in the UK [10,11,15,16], including the issues of packaging [20] and technological traceability [18], gaps remain on the description and assessment of the simultaneous routes that left over medications go through, with special focus on local scales [14]. It is assumed that the clarification of the informal features typical of the municipal MRLS can shed light on their approach to redispensation [19]. Parallel to this, the assessment of the formal activities that characterize the national MRLS [6,7] can bring contributions to improve sustainability in this field.…”