Pharmaceutical market, environmental public policies and water quality: the case of the São Paulo Metropolitan Region, Brazil

Abstract

Water pollution has been an increasing concern for the authorities responsible for planning and executing public policies. In this qualitative research, we have discussed the most sold pharmaceuticals in the São Paulo Metropolitan Region, Brazil, and compared public policies focused on pharmaceuticals and environmental issues among countries/regions. For that, data provided by Close-Up International related to the sales of medicines in the São Paulo Metropolitan Region between April/2016 and April/2017 were collected and processed to identify and quantify the pharmaceutical products. The 300 most sold medicines in the São Paulo Metropolitan Region fall in 26 therapeutic classes, which include 159 drugs. The most sold pharmaceutical products group is nonsteroidal anti-inflammatory drugs (NSAIDs) representing approximately 44.3% of the total. The ten most sold pharmaceuticals sum up 1200 tons. Dipyrone is the first place in mass representing around 488 tons, followed by metformin with around 310 tons commercialized. Public policies focused on pharmaceuticals in the environment still need adjustments to improve reinforcement, even in developed countries. There is no international standard on how to conduct the issue, each country adopting the public policy that best matches to the local. Brazil, despite having some legislation that approaches the theme, still lacks effective public policies and stakeholder awareness. In this aspect, the need for improvement of the reverse logistics system, consumer orientation to the adequate disposal of unused/expired medicines, and the adoption of the unit-dose system as a therapeutic strategy is evident.

Pharmaceutical Pollution and Disposal of Expired, Unused, and Unwanted Medicines in the Brazilian Context

“…Only in São Paulo city, the region most economically active and with the highest gross domestic product in Brazil, several metric tons of non-steroidal anti-inflammatory drugs, anti-diabetic and antihypertensive drugs, and steroid hormones have been consumed in the last years [3]. In Brazil, among the most commercialized medicines, muscle relaxants and medications to treat deep venous thrombosis leads to internal sales (Table 1), in a commercial volume that exceeds the third-place medicine ranked among the best-seller drugs in the world.…”

Valorization of biomass ash for the effective removal of dipyrone from water: an efficient and low‐cost option

“…The presence of drugs in aquatic environments is considered a relevant problem since the sale of drugs without needing a medical prescription favors their appearance. Before the current pandemic scenario, dipyrone was determined to be the best‐selling drug in the state of São Paulo between 2016 and 2017 1 . Currently, with the pandemic, the sale of drugs has increased significantly and, according to the guidance of the World Health Organization, people with symptoms of the new coronavirus should use medications such as dipyrone and paracetamol when necessary, which intensifies their appearance in waters.…”

Descarte de medicamentos e os impactos ambientais: uma revisão integrativa da literatura

“…O aumento da produção, das vendas e do consumo implicam quantidades elevadas de produtos químicos que estarão dispostos no meio ambiente. Na cidade de São Paulo (SP), toneladas de anti-inflamatórios não esteroides, antidiabéticos, anti-hipertensivos e hormônios esteroides foram consumidos nos últimos anos 5 . Segundo informações do Conselho Federal de Farmácia (CFF), a cada ano, cerca de 14 mil toneladas de medicamentos vencem sem serem utilizados, com grande parte descartada de forma inadequada 6 .…”