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Background and Importance Use of oral targeted anticancer medications has increased considerably in recent years, leading to substantial healthcare costs. Medication waste has simultaneously become a growing global concern, with environmental, ethical and economic implications. High‑cost oncology medicines returned unused by patients represent a potential opportunity for reducing waste through safe redispensing.Aim and Objectives The aim of this study was to assess the extent, quality and economic impact of unused, returned targeted anticancer medication at Landspítali – The National University Hospital of Iceland. Objectives included evaluating treatment use and costs, examining the amount and quality of returned medication, identifying reasons for return, assessing patient and healthcare‑professional attitudes toward redispensing, and proposing procedures to minimise medication waste.Materials and Methods A multifaceted retrospective and prospective study was undertaken. Retrospective data (2020) included economic value and use of PKH and LTP medications. Prospective data (Jan–Mar 2021) assessed quantity, quality, reasons for return and economic value of unused medication. A questionnaire evaluated attitudes toward waste, redispensing and proposed interventions. Findings informed suggested procedures to reduce waste and support safe redispensing.Results In 2020, 453 treatments were dispensed to 283 patients, with a total economic value of 608 million ISK (4.2 million EUR). During the prospective phase, 2,193 prescription units of unused medication were returned, valued at 24 million ISK (168,000 EUR). Approximately 71% met criteria for potential reuse, indicating possible savings of up to 75%. The most common reasons for return were treatment discontinuation due to adverse effects or cancer progression. Both patients and healthcare professionals showed strong support for reducing waste and for redispensing unused high‑cost medication.Conclusion and Relevance Targeted anticancer treatments represent substantial economic investment. Most unused returned medication was of high quality and suitable for redispensing. Positive attitudes among patients and healthcare professionals support implementing structured procedures to reduce medication waste and promote sustainable oncology practice.