Medications reverse logistics: A systematic literature review and a method for improving the Brazilian case

Medication waste is a concern for today's society, from both environmental and public health perspectives. This study aims to contribute to the issue by presenting a mixed-methods approach to the problem through reverse logistics. First, a systematic literature review was performed to map the literature and identify the best practices implemented worldwide. The review also provided information for the second part of the study: a proposal for the improvement of Brazil's medications reverse logistics system, viewed from an information management perspective. The method proposed introduces a mechanism for estimating the quantity of unused medications that should be returned to the system. Three groups of stakeholders evaluated the proposal by answering a semi-structured questionnaire. The research also adopted Institutional Theory to draw its conclusions. The literature review revealed a concentration of studies in the United States, a country which has a major concern for public health. Brazil was the second most studied country in the literature: the majority of its studies relating to environmental aspects. Both countries, however, particularly recognize the need to improve the ways unused medication is collected from consumers and returned to the reverse logistics system, and see their respective governments as the main actors promoting this process. The measurement system proposed in this study supports the development of better reverse logistics systems for countries that use information systems to manage medication supply chains. Some resistance to the implementation of the improving method was observed in drugstores due to the costs involved; these costs should be shared with other stakeholders in the pharmaceutical sector.