<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112025000102603</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2025.102520</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Environmental management of disposed medications in Ibero-American Post-Consumer Program countries]]></article-title>
<article-title xml:lang="es"><![CDATA[Gestión ambiental de medicamentos desechados en países de la Red Iberoamericana de Programas Posconsumo]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quiroz-Razo]]></surname>
<given-names><![CDATA[Ramón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Saturno-Hernández]]></surname>
<given-names><![CDATA[Pedro Jesús]]></given-names>
</name>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,National Institute of Public Health Center for Evaluation Research and Surveys ]]></institution>
<addr-line><![CDATA[Cuernavaca Morelos]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>39</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112025000102603&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112025000102603&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112025000102603&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The objective of this study was to conduct a comparative analysis of the characteristics, indicators and strategies implemented by the programs of the four countries affiliated with the Ibero-American Network of Post-Consumer Medication Programs (RIPPM by its acronym in Spanish), identifying best practices and opportunities for improvement. To this end, we collected and analyzed information related to the operation of programs for the management of expired medications (EM) and household leftovers, based on official sources and publicly available data from the RIPPM member programs. A comparative analysis was conducted on the organizational structure, coverage indicators and implementation strategies, with data reported between 2017 and 2023. In the past decade, RIPPM has managed and eliminated more than 66,000 tons of EM, with the majority (89.7%) in Spain and Portugal. In these two countries, the territorial coverage is practically complete, with the participation of the pharmaceutical industry in the entire process (reverse logistics), non-existent in Latin America. Mexico presents the lowest levels of coverage and collection containers per 100,000 inhabitants, while Colombia reports the lowest average rates of collected tons and grams per inhabitants. We conclude that EM and leftovers in the American countries, present a higher potential for environmental contamination. RIPPM offers the opportunity to identify experiences and good practices for EM and leftover medication management, which could be implemented in Latin American countries, oriented towards circular and sustainable models, with complete territorial coverage and responsible participation of the pharmaceutical industry, fostering education and citizen participation as strategic axes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El objetivo de este estudio fue realizar un análisis comparativo de la estructura, los indicadores y las estrategias implementadas por los programas de los cuatro países adheridos a la Red Iberoamericana de Programas Posconsumo de Medicamentos (RIPPM), identificando las mejores prácticas y oportunidades de mejora. Para ello, se llevó a cabo la recolección y el análisis de información relacionada con el funcionamiento de los programas de gestión de medicamentos caducos (MC) y sobrantes de los hogares, a partir de medios oficiales y datos de libre acceso de los programas que integran la RIPPM. Analizamos comparativamente la estructura organizativa, los indicadores de cobertura y las estrategias de implementación, con datos reportados entre 2017 y 2023. En la última década, la RIPPM ha gestionado y eliminado más de 66.000 toneladas de MC, la mayor parte (89,7%) en España y Portugal. En estos dos países, la cobertura territorial es prácticamente completa, con la participación de la industria farmacéutica en todo el proceso (logística inversa), inexistente en Latinoamérica. México presenta los niveles más bajos de cobertura y de contenedores de recogida por 100.000 habitantes, y Colombia las menores tasas promedio de toneladas recogidas y gramos por habitante. Podemos concluir que los MC y sobrantes en los países americanos presentan mayor potencial contaminante. La RIPPM ofrece la oportunidad de identificar experiencias y buenas prácticas, que podrían ser implementadas en países latinoamericanos, orientándose hacia modelos circulares y sostenibles, con cobertura territorial completa y la participación responsable de la industria farmacéutica, fomentando la educación y la participación ciudadanas como ejes estratégicos.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Hazardous waste]]></kwd>
<kwd lng="en"><![CDATA[Comprehensive waste management]]></kwd>
<kwd lng="en"><![CDATA[Drug residues]]></kwd>
<kwd lng="en"><![CDATA[Drug contamination]]></kwd>
<kwd lng="es"><![CDATA[Residuos peligrosos]]></kwd>
<kwd lng="es"><![CDATA[Gestión integral de residuos]]></kwd>
<kwd lng="es"><![CDATA[Residuos de medicamentos]]></kwd>
<kwd lng="es"><![CDATA[Contaminación de medicamentos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Calderón]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Tarapués]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Medicamentos sobrantes y caducados en el hogar: ¿su almacenaje y desecho representan un problema de salud pública?]]></article-title>
<source><![CDATA[Salud Colect]]></source>
<year>2022</year>
<volume>17</volume>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quadra]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[PSA]]></given-names>
</name>
<name>
<surname><![CDATA[Paranaíba]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Investigation of medicines consumption and disposal in Brazil: a study case in a developing country]]></article-title>
<source><![CDATA[Sci Total Environ]]></source>
<year>2019</year>
<volume>671</volume>
<page-range>505-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Queiroz]]></surname>
<given-names><![CDATA[ACP]]></given-names>
</name>
<name>
<surname><![CDATA[da Silva Souza]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impactos ambientais relacionados ao descarte de medicamentos no Brasil: uma revisão bibliográfica e documental]]></article-title>
<source><![CDATA[Rev Colomb Ciencias Quimico-Farmaceuticas]]></source>
<year>2023</year>
<volume>51</volume>
<page-range>1296-319</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mampaso]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<source><![CDATA[Tratamiento de residuos de medicamentos y sus envases en Iberoamérica]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Spain; Red Iberoamericana de Programas Posconsumo de Medicamentos]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<collab>European Union</collab>
<source><![CDATA[European Union strategic approach to pharmaceuticals in the environment]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Brussels ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<collab>RIPPM</collab>
<source><![CDATA[Plataforma posconsumo de medicamentos (PPM)]]></source>
<year>2023</year>
<publisher-name><![CDATA[Red Iberoamericana de Programas Posconsumo de Medicamentos]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<collab>Punto Azul</collab>
<source><![CDATA[Página de inicio]]></source>
<year>2024</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<collab>SIGRE</collab>
<source><![CDATA[Conócenos. Medicamento y medio ambiente]]></source>
<year>2024</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="">
<collab>Valormed</collab>
<source><![CDATA[Homepage]]></source>
<year>2024</year>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<collab>SINGREM</collab>
<source><![CDATA[¿Quiénes somos?]]></source>
<year>2024</year>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Andrade Aragão]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Semensatto]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Calixto]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pharmaceutical market, environmental public policies and water quality: the case of the São Paulo Metropolitan Region, Brazil]]></article-title>
<source><![CDATA[Cad Saude Publica]]></source>
<year>2020</year>
<volume>36</volume>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saturno-Hernández]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Quiroz-Razo]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gestión y disposición final de medicamentos caducos: un problema económico y de salud pública]]></article-title>
<source><![CDATA[Salud Publica Mex]]></source>
<year>2025</year>
<volume>67</volume>
<page-range>56-64</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caban]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Stepnowski]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How to decrease pharmaceuticals in the environment? A review]]></article-title>
<source><![CDATA[Environ Chem Lett]]></source>
<year>2021</year>
<volume>19</volume>
<page-range>3115-38</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aedo]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[González Vidal]]></surname>
<given-names><![CDATA[NL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Red Iberoamericana de Programas Posconsumo de Medicamentos: pasado, presente y futuro]]></article-title>
<source><![CDATA[Rev Salud Ambient]]></source>
<year>2024</year>
<volume>23</volume>
<page-range>162-73</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cassetti]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Paredes-Carbonell]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[López Ruiz]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evidencia sobre la participación comunitaria en salud en el contexto español: reflexiones y propuestas. Informe SESPAS 2018]]></article-title>
<source><![CDATA[Gac Sanit]]></source>
<year>2018</year>
<volume>32</volume>
<numero>Suppl 1</numero>
<issue>Suppl 1</issue>
<page-range>41-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
