PERSPECTIVE article
Front. Public Health
Sec. Public Health Policy
This article is part of the Research TopicExploring Adverse Drug Reactions, Medication Adherence, and Forensic Markers in Pediatrics and ObstetricsView all 14 articles
Medication Non-Adherence as a Driver of Pharmaceutical Waste: Integrating Top-Down Policies with Bottom-Up Practice
Provisionally accepted
- 1Medication Adherence Research Centre, Department of Family Medicine, Medical University of Lodz, Lodz, Poland, Lodz, Poland
- 2Medication Adherence Research Group, Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary, Pecs, Hungary
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Medication non-adherence is a widespread challenge affecting up to half of patients with chronic conditions, with profound implications for health outcomes, healthcare costs, and, increasingly recognized, environmental sustainability. Unused and improperly disposed medications contribute to pharmaceutical waste, overproduction, and pollution, amplifying the healthcare sector's carbon footprint. This viewpoint highlights the need for coordinated action across clinical practice and health policy to mitigate this underappreciated dimension of environmental harm. We argue that addressing non-adherence is not solely a clinical imperative but also an ecological one, requiring dual responsibility: bottom‑up engagement by healthcare professionals and patients, and top‑down strategies embedded in policy and system‑level reforms. Drawing on evidence from adherence interventions and sustainable prescribing initiatives, we outline actionable steps — from individualized medication optimization and deprescribing to public health campaigns and regulatory frameworks — to align adherence management with environmental goals. Tackling this problem offers a unique opportunity to improve patient outcomes while advancing climate-conscious healthcare and reducing overall healthcare-related costs. We call on clinicians, health systems, and policymakers to integrate adherence promotion into sustainability agendas and to view every prescription as both a therapeutic and environmental decision. Likewise, we urge optimization of environmentally safe and effective disposal systems for unused and expired drugs, ensuring that such measures become an integral part of comprehensive strategies to protect both human health and the planet.
Keywords: Medication Adherence, Drug wastage, Environmental impact, Health Policy, Sustainable healthcare, Deprescribing, Medication optimization, pharmaceutical pollution
Received: 30 Sep 2025; Accepted: 06 Nov 2025.
Copyright: © 2025 Kardas and Agh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Przemyslaw Kardas, pkardas@csk.am.lodz.pl
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.