DANROAD – Redispensing of Oral Anticancer Drugs in Denmark

How can we ensure a more sustainable and economically responsible use of expensive cancer medicines, without compromising patient safety?

That is the question we aim to answer in DANROAD, a Danish research project that explores the feasibility and safety of redistributing unused oral cancer medicines.

Why DANROAD?

Every year, large amounts of unused medicines are discarded in Denmark, often because treatment ends earlier than planned due to side effects or changes in the patient’s condition. Many of these medicines remain unopened and could potentially be used again.

This is particularly relevant for oral cancer medicines, which are both costly and resource-intensive to produce. In 2023 alone, Odense University Hospital (OUH) dispensed more than 35,000 packages of oral anticancer medicines, worth over DKK 170 million. It is estimated that up to 30 percent of patients do not complete their treatment as planned, leaving significant quantities of unused medicine behind.

What is the project about?

DANROAD investigates whether it is possible and safe to collect unused cancer medicines from patients, verify their quality, and offer them to other patients who can benefit from them.

The project builds on experience from the Dutch ROAD study (Redispensing Oral Anticancer Drugs), which showed that 68 % of the returned medicines could be reused safely, leading to substantial cost savings.

How does it work in practice?

Patients taking part in DANROAD receive their medicine in sealed bags with a temperature logger. If treatment is stopped, patients return any unopened medicine during a scheduled hospital visit. Hospital staff then perform a thorough quality check:

• Is the packaging intact and the bag still sealed?
• Has the medicine been stored correctly?
• Is the expiry date acceptable?

Medicines that pass all checks are registered and prepared for redispensing to another patient.

Patients are informed in advance that they may receive redispensed medicine, but they will not be able to see which packages are new and which are redispensed. The quality is the same.

What are we investigating?

The project has four main objectives:

• Economy: Can cost savings be achieved when the value of redispensed medicines is compared with the additional costs of logistics, staff and quality control?
• Environment: How much CO₂ can be saved by avoiding unnecessary disposal and new production
• Safety and quality: What proportion of the returned medicines can be approved for redispensing, and what are the reasons when they cannot?
• User perspectives: How do patients, caregivers and healthcareprofessionals feel about redispensed medicines?

Where and when?

DANROAD is a national research project based at the Center for Research in Sustainable Medicines at the Department of Pharmacology, OUH and the University of Southern Denmark (SDU).

The project begins with a pilot study at OUH (Departments of Oncology and Haematology) in 2025–2026.

If the results show that redispensing is feasible, the project will be expanded regionally and later nationally.

We start redispensing at OUH on December 1st 2025.

Who is behind DANROAD?

DANROAD is a collaboration between:

Department of Pharmacology, OUH
Hospital Pharmacy of Funen
Health Innovation Centre of Southern Denmark
University of Southern Denmark (SDU)
Department of Oncology, OUH
Department of Haematology, OUH

Contact

If you would like to know more about DANROAD, are interested in collaboration, or would like to help share our findings, please contact us using the email below.