Plastic pill vials

As I recently tossed one of my own pill vials in the recycling bin, I began to think of the increasing concerns about plastic recycling, both the worrying amount found in our oceans and, subsequently, digestive tracts of fish and sea mammals, and the reluctance of some countries to now accept our mass of plastic for reuse. There are now plans for the federal government to either ban certain single-use plastic items and/or make the commercial user of it financially accountable for its disposal.

I began to wonder whether there was something we pharmacists could do about the plastic pill vial. Although not quite single use, most refill prescriptions are put in a new vial, the previous one probably thrown in the recycling bin like mine. I do not know the number of plastic pill vials used and discarded in Canada in a year, but one can probably estimate reasonably accurately by safely assuming most oral medication prescriptions, initial and repeat, are dispensed in a new plastic vial, so we are probably looking at hundreds of millions. I have not even considered the disposable bubble “compliance” packs that are discarded after a single use. I do not know for sure what preceded the plastic pill vial, but I vaguely remember as a child small paper envelopes or cardboard boxes in my parents’ medicine cabinet with a prescription label or pharmacist’s written instruction on them.

I do not have a solution to this issue, and I am not sure going back to nonplastic envelopes or boxes is a practical solution. But I do think the profession should address this issue before we are forced to or before some other nonpharmacy group confronts us with it. Any solution or change will no doubt inconvenience at least one stakeholder, such as the patient or community pharmacist, initially, but in the end, we may not have a choice. Mandating that every patient use a refillable “dosette”-type container and bring it to the pharmacy for refilling would be an example of a solution but also one of a huge increase in workload and an inconvenience. And, of course, there would be pushback from the packaging industry unless it had its own nonplastic solution.

The health care sector creates enough waste because of sterility issues, which are probably unavoidable, but the state of the environment is certainly woven into goals for good health.

As a health profession faced with continuing new challenges but perhaps unaccustomed to dealing with large social concerns, I think we should give some consideration to this issue before it is placed at our front door. Bringing packaging experts, pharmacists and patients (with an environmental interest, too) together to have a discussion about this would be a reasonable start.

—Bill Bartle, BScPhm, Pharm D, FCSHP
Toronto, Ontario