NCOP FOR WRITTEN REPLY QUESTION NO. 653 DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 November 2011 (INTERNAL QUESTION PAPER NO. 39) Mr D Joseph (DA-WC) to ask the Minister of Health: (1) Whether any (a) medication, (b) consumables or (c) equipment have been destroyed in each province (i) in (aa) 2009 and (bb) 2010 and (ii) from 1 January 2011 up to the latest specified date for which information is available; if not, what is the position in this regard; if so, what (aaa) were the reasons and (bbb) was the value in each case; (2) (a) what are the names of each product that was destroyed in each case and (b) in respect of what treatment were these medications used? CW803E REPLY: The reasons for medication being destroyed are related to change in treatment regimens receipt of short-dated stock. Medication in emergency trolleys sometimes expire and hence have to be discarded. Provinces are expected to check medicines expiry upon receipt of stock from suppliers. If this is not done, then drugs expire and have to be discarded. According to our Provincial Departments of Health, the following are the responses to the questions: Free State: (1) The total value of expired medicine is – 2009/10 2010/11 2011/12 (2) = = = R 1,019,061.84 R 4,917,329.34 R 8,068,932.87 Only a sample of expired medicines is provided due to the high volume of disposal. A sample list of equipment disposed of and sold since 2009 is also available. Gauteng: (1) (a) Expired Medicines & breakages destroyed: Period Turnover Year ending 31 March 2009 Year ending 31 March 2010 Year ending 31 March 2011 Year ending 31 March 2012 to end October 2011 Equipment (i) (aa) (bb) Commodity 1, 549, 177, 992 2, 261, 431, 896 2, 666, 262, 368 1, 585, 390, 563.98 Expired % of medicines and turnover breakages 215, 242 0,013 474, 508 0.16 3, 404, 258 0,12 2, 063,644 0,13 (c) Other Machinery Equipment Other Machinery Equipment Total (ii) 2009 – None 2010 Classification (a) Value Date & Major Scrapping 15 286 000 2010/2011 & Minor Scrapping 5 184 000 2010/2011 20 470 000 From 1 January 2011 up to the latest specified date for which information is available Commodity Classification Other Machinery & Major Equipment Other Machinery & Minor Equipment Total (2) Method Method Scrapping Value 511 037.96 Date 22/8/2011 Scrapping 10 485.21 22/8/2011 521 523.17 The medicines are a mixture of tablets, capsules, injections, creams and ointments used for various conditions. Details are documented and kept at the various institutions. Such information is kept and is available for a period of up to 5 years. Limpopo: In Limpopo province, expired Medication and consumables are being destroyed in all the 3 years 2009, 2010 and in 2011, up to November 2011. Expired medicines are managed by the manager Quality Assurance at the provincial office. Clinics have to return expired stock to the hospitals and hospital management has to submit reports on a quarterly basis through the board of survey to Provincial Pharmaceutical Services. Expired medicines are only disposed of once permission is granted by the Head of the Department. The appointed Waste Management service provider is then instructed to collect the expired stock and dispose of it in the correct manner. 2 Of the 40 hospitals in Limpopo, 23 have already received approval to dispose of expired stock, and the stock has been lifted up (removed) from facilities by the Waste Management Company. 8 hospitals are in the process of receiving approval, while the remaining 9 hospitals are being assisted to get the necessary documentation required to get approval. Up to date R1 688 511 total cost of expired medication and consumables has been disposed of in the 2011/2012 financial year. This may include expired stock from previous years. Individual names of disposed items would be difficult to know as they are already disposed. These include medicines, tablets and consumables used for various kinds of medical conditions, such as medical emergencies (Angina Pectoris, Myocardial infarcts), as well as surgical conditions. Mpumalanga: Mpumalanga have provided a comprehensive list per hospital of medicines, consumables and equipments that have been destroyed to the estimated value of R 849,791,460.74 Northern Cape: During the 2009, 2010 and 2011 years the various facilities (hospitals, Community Health Centres and Primary Health Clinics) have destroyed medication. In most instances the reasons were due to expired stock and vaccines that were exposed to extreme weather conditions. For the above periods the approximate values are as follows: 2009 2010 2011 Approximate total written off: R 288,221.00 R 651,269.00 R 328,940.00 R 1,268,430.00 Although the amounts are minimal, the list of items is huge. Attached list is a summary of the Province’s items that were written off during said years. These products were used to combat chronic diseases, acute infections/conditions and various other items that form part of the emergency trays of facilities. NORTHERN CAPE ITEMS 2011 Amphoteracin B 50mg amps ITEMS 2010 Spironolactone 25mg 84's Doxycycline 100mg tabs 14's Spironolactone 25mg 56's Benzathine Penicillin Folic acid 5mg 100's 1.2MU Aminophylline 250mg/ml Promethazine 10mg 500's amp Heparin 1000IU amps Dapsone 100mg tabs Atropine 0.5mg vial Hyoscine amps Polio vial Gentian violet Methyl prednisolone acetate Beclomethasone aq spray 3 ITEMS 2009 Metronidazole syrup 100ml Beclomethasone inhaler 50mg Metformin 500mg 56's Phenoxymethylpenicillin 250mg 20's Biperiden 2mg 56's Glibenclamide 5mg 28's Atropine 0.5mg vial Verapamil inj 2.5mg/ml 2ml 40mg vial Salbutamol inj 0.5mg Methyldopa 250mg 84's Cefalexin 250mg 20's ketakonazole tabs 200mg Spironolactone 25mg 84's Furosemide 40mg tabs 28's Cimetidine 400mg 60's Aserbine 50g cream Propranolol 10mg 56's Digoxin 0.25mg tabs 28's Heparin 2500IU 5ml Thiamine 100mg 100's Vitamin K 2mg/0.2ml Doxycycline 100mg tabs 14's Sod Bicarbonate 8.5% Clotrimazole vag cream Albendazole syrup 20ml 50g Potassium Chloride 15% Glycerin suppositories 12's amps Naloxone 0.4mg/ml Bupivacaine 50mg vials Betamethasone 4mg inj Dopamine amps Adrenaline amps Griseofulvin 125mg 100's North West: (1) Medication and surgical disposables have been disposed off in the North West Province in 2009, 2010 and up to September 2011. Medicines were disposed off because they had exceeded the expiry date. The value of medicines disposed of is as follows:2009 R1,741,148-75 (2) 2010 R1,795,039-17 2011 R1,681,058-82 Due to limited time for response to this question and the amount of items that have been disposed off since 2009 to date, the consolidated list from all the facilities which contains all the items disposed off during the period could not be compiled in time. These medications are used for a variety of conditions such as: Acute conditions such as headache, fever, diarrhoea, respiratory tract infection Chronic medical conditions such as high blood pressure, diabetes, asthma, psychiatric conditions Inflammatory and musculo-skeletal conditions such as gout, arthritis conditions. Injuries such as fractures, wounds, abrasions Surgical disposables which were disposed off were for the treatment of the conditions mentioned above. 4 Western: Cape: (1) Medication, consumables and equipment were disposed of in each of the financial years 2009/10, 2010/11 and from 1 April 2011 to 30 September 2011. The equipment was not necessarily destroyed but in some cases, is sold as equipment and in others as scrap. (aaa) Medication, consumables and equipment are disposed of because it has either passed the expiry date, redundant stock, obsolete or broken making it useless to the department. (bbb) The values of the items disposed of for the periods as indicated are as follows: PERIODS 2009/ 2010 2010/ 2011 01 April to 30 September 2011 (2) Major Assets R80 235 000 R84 738 000 R20 426 000 Minor Assets R19 522 000 R23 434 000 R6 282 000 Pharmaceuticals TOTALS R4 000 Other consumables R397 000 R896 000 R666 000 R109 734 000 R1 350 000 R168 000 R28 226 000 R100 158 000 (a) & (b): Current records do not allow us to determine what products were disposed of in each case and we are not able to indicate what the products were used for. END. 5