Sustainability assessment of medicines reverse logistics in Brazil: Outcomes from the national and local systems

Brazil adopted a national medicines reverse logistic system (MRLS) in 2020 to properly discharge medicines for human use. Parallel to this, there are Brazilian municipal MRLSs that have been working since 2002 that facilitate the appropriate discharge or reuse of medicines. These systems are not linked with each other. This paper evaluates the national and the municipal Brazilian MRLS, and compares them regarding their principles, concepts, procedures, and (socio)economic outcomes using a modified sustainability assessment framework. It was found that shared responsibility is a principle of both MRLSs, but that local systems provide additional community benefits and lead to greater circularity in the use of medicines. Procedural aspects are highly formalized only in the national MRLS. The national MRLS collected and destroyed 52.7 tons of medicines in 2021 but did not disclose the costs. Estimations based on demographic data, information disclosed by one municipality, and secondary data from five other local systems indicate that the six municipalities could return around USD 123 million in 2021 to the benefit of the local population, if they spent USD 12.6 million on correct disposal. Such an estimate, however, is not fully trackable, and it exposes the lack of transparency and data collection at the local level.