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Pharmaceuticals

The Problem  

According to the U.S. Centers for Medicare & Medicaid Services which publishes the National Health Expenditure Projections 2012-2022, approximately $275.9 billion in prescription drugs will be prescribed in the U.S in 2014. By 2020, that number is projected to reach $379.9 billion. A report estimated that 10 to 33 percent of proscribed medicines are not consumed. With a lack of safe and secure disposal options, consumers traditionally have had the option of trashing, flushing or storing these medicines in the home. For example, a City of Roseville telephone survey of residents conducted in January 2014 found that although 48% of respondents used responsible disposal methods, 30% still disposed through the household trash or toilet and 17% did not know how to get rid of unwanted medicines. Numerous studies have documented the widespread consequences of improperly stored and disposed medicines, including the impacts on water quality and public health.

NEW Report “Options for Managing Home Generated Medications in San Joaquin County” released by CPSC on January 29, 2016.

To learn more about the problems caused by improper disposal of pharmaceuticals and other health products such as sharps, read CPSC’s “A Prescription for Change,” which appeared as an insert in the Sacramento News & Review in March 2014. A second “A Prescription for Change” for Marin County was published in December 2014, and the third “A Prescription for Change” insert for San Mateo County was published electronically in June 2015. Educational inserts were also published in Alameda County and Santa Clara County in Spring 2016. The inserts can be accessed by clicking on the corresponding cover below.

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The Solution – Extended Producer Responsibility

Extended Producer Responsibility (EPR) laws requiring that pharmaceutical manufacturers manage their products’ waste at end-of-life have been implemented throughout the world. To comply with such legislation pharmaceutical manufacturers and others in the product chain will design, manage and fund take-back programs to securely collect unwanted medicines and sometimes their packaging from the public and ensure the collected materials are properly managed.


Pharmaceutical EPR Programs From Around the World

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Click flag graphics above for fact sheets and information on international programs.


Pharmaceutical EPR in the United States

Following the lead of Canada, France, Spain, and others, local governments in the United States are beginning to implement pharmaceutical EPR laws through local ordinances since state legislation has not passed.

Resources:


Alameda County, California

On July 24, 2012, Alameda County adopted the Safe Drug Disposal Ordinance. This ordinance is based on the program in British Columbia, operated by many of the same pharmaceutical companies doing business in the U.S. This precedent setting ordinance was the first in the nation to hold pharmaceutical companies responsible for the safe collection and disposal of unused medications from the public, starting with a challenge by the pharmaceutical industry in December of 2012 and two appeals which resulted in the U.S. Supreme Court denying the request to hear the case on May 26, 2015.

On January 26, 2016, Alameda County adopted proposed revisions to the 7/24/2012 Safe Drug Disposal Ordinance. Key changes in the revisions include:

  • Adds Over-the-Counter (OTC) medications to the covered items
  • Allows for collection of Controlled Substances at both law enforcement AND DEA registrants (Pharmacies and Hospitals)
  • Requires the stewardship organization to provide a kiosk to any DEA Registrant even if they have reached the 110 site goal originally stated
  • Minor changes to definitions to clarify ordinance, and make enforcement easier

Ordinance Timeline
Alameda County Safe Drug Disposal Ordinance Information
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lameda County Safe Drug Disposal Ordinance Amendment Update Package Slideshow – Bill Pollock, 1/11/16

US Ninth Circuit Court of Appeals Hearing Video – PRMA v. County of Alameda, 7/11/2014:
(Alameda hearing begins at 1:01:50)

 

King County, Washington

On June 20, 2013 the King County Board of Health in Washington passed the Secure Medication Return Rule & Regulation to create a drug take-back program for King County residents. The program promotes the safe disposal of unused prescription and over-the-counter drugs, and will be funded and operated by the drug manufacturers. On November 27, 2013 four groups of major drug manufacturers sued the County. The suit was dismissed following the U.S. Supreme Court’s 5/26/2015 decision not to hear industry’s legal challenge to the Alameda County Safe Drug Disposal Ordinance.

Status – On October 16, 2015, King County approved the Return Meds LLC stewardship plan and rejected the King County MED-Project LLC stewardship plan. The MED-Project submitted a revised proposed stewardship plan for review in accordance with the December 14, 2015 deadline; King County will review the plan and approve or reject by March 12, 2016. The compliance deadline for the approved stewardship plan to be fully implemented is no later than April 13, 2016.


City & County of San Francisco, California

In 2010, San Francisco introduced a Safe Drug Disposal Ordinance. However, in 2012 the city chose to instead accept $110,000 from PhRMA and Genentech to fund a pilot project to collect data on the issue. In August 2013 the same two organizations provided another payment of $125,000 to fund the pilot project an additional year. A separate Safe Drug Disposal Information Ordinance was passed in May 2011 to supplement the PhRMA-funded pilot program by requiring pharmacies that won’t host a bin to advertise those that do.

The Safe Medicine Disposal Pilot program has been well-utilized, with over 37,000 pounds collected in the first 26 months.

Following the U.S. 9th Circuit Court of Appeals ruling upholding Alameda’s ordinance, San Francisco Board President David Chiu reintroduced the Ordinance on October 21, 2014. Board President Chiu was elected to the California State Assembly in November 2014 and Supervisor London Breed became the author of the ordinance and was elected President of the Board of Supervisors. The ordinance was heard in committee on February 26th with a 3 – 0 vote to move the ordinance to the full Board. The ordinance was heard before the full Board twice – once on March 10, 2015 where it received an 11 – 0 vote to adopt and again on March 17, 2015 where it received a second and final unanimous vote to adopt. San Francisco Mayor Edwin Lee signed the legislation on March 26, 2015 and the ordinance’s date of enactment is 30 days after signing.


San Mateo County, California


Santa Barbara County, California

Santa Clara County, California

  • 5/19/15 – Ordinance introduced at Board of Supervisors Meeting and passed by a 3-0 vote with two Supervisors recusing themselves due to pharmaceutical investments.  6/23/15 – Ordinance second reading before Board and received a unanimous 3 – o vote to adopt, with two Supervisors recusing themselves due to pharmaceutical investments. 7/23/15 – ordinance went into effect.
  • Resources:

Marin County, California

 

Los Angeles County, California


Santa Cruz County, California

  • 9/1/15 – agenda item #27 passed and directed staff to initiate the stakeholder process for development of a pharmaceutical and medical sharps EPR ordinance.  10/8/15 – a public stakeholder meeting was held at the Santa Cruz County Board of Supervisors Chambers.  11/10/15 – Ordinance read for the first time at the Santa Cruz County Board of Supervisors Hearing and received a 5-0 vote to approve the first reading and then approved again at the second reading 12/8/15 with a 5-0 vote. 1/8/16 – Ordinance goes into effect.
  • 8/25/16 – City of Capitola passes a pharmaceutical and medical sharps EPR ordinance

Snohomish County, Washington


Transitional EPR Local Programs for Pharmaceuticals

San Luis Obispo County, California

  • 3/11/15 – Ordinance passed by the the San Luis Obispo County Integrated Waste Authority (IWMA) Board of Directors by an 11-0 vote with two Directors absent.  Ordinance is “Transitional to EPR” policy since a different group in the product chain – in this case retailers – is having to pay for the program but not producers.  4/11/15 – Ordinance takes effect. Effective 9/11/15, retail pharmacies in the IWMA region are required to provide a mail back program and/or collection receptacle program to dispose of unwanted prescription drugs as required under the Ordinance


Voluntary Pharmaceutical Stewardship

Walgreens Leads National Chains on Medication Take Back1280px-Walgreens_Logo.svg

In 2016 Walgreens became the first retailer to implement an ongoing national stewardship program by installing safe medication disposal kiosks in more than 500 drugstores in 39 states and Washington, D.C. to make the disposal of medications — including opioids and other controlled substances — easier and more convenient while helping to reduce the misuse of medications and the rise in overdose deaths. In a Walgreens press release announcing the program, Richard Ashworth, Walgreens president of pharmacy and retail operations said “Walgreens pharmacists play an important role in counseling patients on the safe use of their medications, and now we are leading the way in retail pharmacy’s fight against prescription drug abuse.”

Don’t Rush to Flush, Meds in the Bin We All Win! Medicine Collection ProgramDontFlushLogo 2-5-16 update

CPSC received a grant from the Rose Foundation to establish a medication collection program in Sacramento and Yolo counties in July 2013. The resulting program, named “Don’t Rush to Flush, Meds in the Bin We All Win!” (DRTF) established six permanent medication sites available to the public free of charge in Sacramento and Yolo counties and has since expanded to Contra Costa, Santa Clara, and Madera counties. DRTF is being licensed and sold to communities across the country. Email info@calpsc.org for more information.

Dispensary of Hope

An estimated $2.2 billion in sample medications provided to medical practices go to waste each year, meanwhile millions of uninsured patients go without the medications they need. Dispensary of Hope is a national, not-for-profit social enterprise that serves patients by recovering donated surplus medication from physician offices, hospital pharmacies, manufacturers, distributors, and other licensed healthcare providers. The medication is given away for free to patients who lack healthcare insurance and are under 200% of the Federal Poverty Level. The list of sites is available here.

Click here to connect with Dispensary of Hope on Social Media!

SIRUM

Supporting Initiatives to Redistribute Unused Medicine (SIRUM) is 501(c)3 nonprofit that has developed an online platform to connect safety-net clinics with donated medications from suppliers, pharmacies, and health facilities. They give pharmacies an option to donate rather than destroy their unused & returned medicines. To learn more about SIRUM, watch this video.

Click here to connect with SIRUM on Social Media!


Safely Dispose of Your Medications


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