6. Sustainability - Is drug therapy cost-effective and environmentally sustainable?

Polypharmacy guidance: Appropriate prescribing making medicines safe, effective and sustainable 2026-2029
National

Process

Identify unnecessarily costly drug therapy by

  • considering more cost-effective alternatives, formulary choices, safety, convenience

Consider the environmental impact of

  • Inhaler use
  • Single use plastics
  • Medicines waste
    • over-ordering
    • disposal
  • Water pollution

 

Medicines to review

The table below brings together some common areas where prescribers may be able to take action. This list is not exhaustive and does not replace individual clinical judgement. For more detail see Detail by therapeutic area based on amalgamated medication assessment tool.

 

Check for cost-effectiveness Environmental sustainability

Costly formulations (e.g. dispersible)      

Branded products

Unsynchronised dispensing intervals (28/56 days)

Costly unlicensed ‘specials’

>1 strength or formulation of same medicine

Medicines of low/limited clinical value

Inhalers: DPI/SMI versus MDI

Inhalers: multiple single inhalers versus combination

Reusable insulin pens and cartridges

Re-usable products versus single use