Environmental management of disposed medications in Ibero-American Post-Consumer Program countries.

The objective of this study was to conduct a comparative analysis of the characteristics, indicators and strategies implemented by the programs of the four countries affiliated with the Ibero-American Network of Post-Consumer Medication Programs (RIPPM by its acronym in Spanish), identifying best practices and opportunities for improvement. To this end, we collected and analyzed information related to the operation of programs for the management of expired medications (EM) and household leftovers, based on official sources and publicly available data from the RIPPM member programs. A comparative analysis was conducted on the organizational structure, coverage indicators and implementation strategies, with data reported between 2017 and 2023. In the past decade, RIPPM has managed and eliminated more than 66,000 tons of EM, with the majority (89.7%) in Spain and Portugal. In these two countries, the territorial coverage is practically complete, with the participation of the pharmaceutical industry in the entire process (reverse logistics), non-existent in Latin America. Mexico presents the lowest levels of coverage and collection containers per 100,000 inhabitants, while Colombia reports the lowest average rates of collected tons and grams per inhabitants. We conclude that EM and leftovers in the American countries, present a higher potential for environmental contamination. RIPPM offers the opportunity to identify experiences and good practices for EM and leftover medication management, which could be implemented in Latin American countries, oriented towards circular and sustainable models, with complete territorial coverage and responsible participation of the pharmaceutical industry, fostering education and citizen participation as strategic axes.