Wasting eye drops due to an artificial expiration date

This transcript has been lightly edited for clarity.

Jonathan Tan: Hello, my name is John Tan. I am a third-year medical student at the Icahn School of Medicine at Mount Sinai. Our article addressed eye loss, particularly from eye drops used in the clinic. We looked into this because we noticed that many of our clinics adhere to these 14 or 28 day expiration dates and throw away a medication bottle regardless of how much medication is left in the bottle after those 28 days. We noticed that a lot of it was accumulating. We wanted to see how much waste there is. We conducted a study. We found that over the course of the six weeks we studied, we discarded approximately 72% of the volume of medication from our clinics. And when we extrapolated this over a year, we found that this resulted in a loss of about $80,000 to our health systems. We wanted to do this because companies like AAO EyeSustain are committed to eliminating waste and instead adhering to FDA-mandated expiration dates.

These FDA-regulated expiration dates are based on guidelines based on the preservatives in the medication and decontamination rates that should be effective enough to prevent any infection or contamination of the dropper tip. We just wanted to highlight the amount of waste generated in these clinics and encourage efforts to meet the FDA expiration date to preserve and preserve our eye drops and prevent waste.

Each clinic has slightly different guidelines for how they go about their work. Most clinics follow the 28 day policy. We wanted to release this paper to give broader recognition to this issue and encourage people to implement these measures and adhere to the FDA-mandated expiration date. We have received good feedback from various clinicians at various sites who have used this paper to motivate their administration to follow these guidelines. Nothing official has come out yet, but we hope that things like this will increase in the future and allow people to really see the waste that is occurring and have a numeric number that can actually quantify how much waste is occurring when implementing new measures to promote.

There was no direct communication with the manufacturers. The actual expiration date printed on the bottle is the date they received from the FDA, so they are okay with that. The clinics themselves set the expiry date of 28 days. It is based on this guideline, also published by the US Pharmacopeia in 2015, which states that medications must be disposed of within 28 days. It has since been clarified that these are not the reusable eye drops that most clinics use in their system. It is also intended for single-use injections or drops. And that’s clarified, but not really far-reaching, and the clinics are still using the 28-day policy.