During the height of the UK Swine Flu pandemic in 2009, scientists collected sewage samples from two waste water treatment plants. After the researchers tested samples for the active ingredient in Tamiflu, they ascertained many of the drugs prescribed to Britons had been wasted. Scientists tested the samples for drugs that were dumped down the toilet – not counting those that were simply excreted after being ingested. The analysis indicated a compliance rate between 45 and 60 percent, meaning roughly half – 45 to 60 people out of every 100 – actually completed their Tamiflu course as prescribed.

The new data, which was published by a team of European scientists, could be used to inform the next pandemic reaction by health officials and served as validation for the novel method used to measure widespread prescription drug compliance.



“Influenza pandemics are rare, making a study such as this a unique and important window into how people behave during a public health emergency such as a pandemic,” said study co-author Andrew Singer, from the UK’s Centre for Ecology & Hydrology.



“This study sheds new light on people’s willingness to follow medical advice on antiviral usage.



"Importantly, this method could be used to monitor how many people take certain kinds of medicine in real time and alert national health authorities to the need for stronger public information campaigns during pandemic emergencies.”



Compliance rates are important to health officials, as poor rates waste limited antiviral stocks and misused drug can lead to antiviral resistance.



“With approximately half the collected antivirals going unused, there is a clear need to improve public health messages so that less antiviral is wasted and that the duration and severity of infection is reduced,” Singer said.



“Furthermore, we feel the waste water epidemiology approach undertaken can potentially help shape future public health messages, making them more timely, targeted, and population sensitive, while potentially leading to less mis- and un-used antiviral, less wastage and ultimately a more robust and efficacious pandemic preparedness strategy.”