Recycling Unused Medication To Save Lives

By Elizabeth Landsverk, M.D.

In a 2012 survey, over a quarter (28%) of American adults with chronic conditions reported skipping doses or not filling a prescription because they could not afford to pay for it. Among those who were uninsured or under-insured, rates of cost-related problems getting medications were 30-60%*. At the same time, hospitals, pharmacies, manufacturers and nursing homes dispose of unused medications worth billions of dollars every year, much of which is dumped or burned and ends up in the water we drink and the air we breathe.

The costs of prescription medications have reached crisis levels. Many people cut back on basics like food and utilities to pay for their prescriptions and many suffer serious declines in their health, increased hospitalizations, and even premature death by taking less medication than directed. Now, innovative programs are saving lives by bridging the gap between unused pharmaceutical supplies and those in need.

State legislatures began taking action on pharmaceutical donation and reuse programs in 1997. These programs create repositories that provide for unused prescription drugs to be donated and re-dispensed to patients. As of mid-2016, 38 states have enacted donation and reuse laws although not all these states have functioning programs. California enacted initial legislation in 2005 and significantly expanded its donation and redistribution law in 2012. In California, as in most states, redistribution does not include controlled substances and donations cannot be made by individual consumers, only by institutions such as hospitals and licensed, skilled nursing facilities. In 2015, the Santa Clara County Public Health Department opened the Better Health Pharmacy in downtown San Jose, the first dedicated drug donation pharmacy in Northern California.

The goal of the Better Health Pharmacy is to improve health by increasing medication access for all and serve patients who cannot afford their medications. It provides medication without charge to the patient. There is no copay for insured patients and no need to have insurance. All that is needed is a valid prescription from a licensed U.S. physician and an ID. No proof of citizenship, residency, or income is required.

The pharmacy receives unused, unopened, and unexpired medications from licensed healthcare facilities. The drugs most commonly distributed are for asthma, high blood pressure, diabetes and depression. Because of the unpredictable nature of donations and demand, inventory is constantly changing and specific medications may not always be available. Commonly stocked drugs are listed on the pharmacy’s web site and patients are advised to phone in advance for an inventory check.

Patients who take less medication than directed are not only risking their health and perhaps even their lives. They also drive up costs by having more visits to the emergency room and stays in the hospital. This service is not only vitally beneficial for patients but it helps control healthcare costs and prevents the environmental pollution caused by disposing of millions of pills.

Elizabeth Landsverk, MD, is founder of ElderConsult Geriatric Medicine, a house-calls practice in the San Francisco Bay Area that addresses the challenging medical and behavioral issues often facing older patients and their families. Dr. Landsverk is board-certified in internal medicine, geriatric medicine and palliative care and is an adjunct clinical professor at Stanford University Medical School. http://www.elderconsult.com