Recycling unused prescription medication from nursing homes might seem like a no-brainer.
Yet many states haven’t installed programs to recycle unexpired pills, tablets, vials, and other much-needed medications.
The upshot is that long-term facilities destroy prescription drugs worth $2 billion every year, according to a University of Chicago study.
SafeNetRx, a small nonprofit in Iowa, wants to plug up that wasteful pipeline.
It distributes dozens of bins of medications, which include pricey cancer drugs costing more than $100 per pill, that come from nursing homes in Iowa and elsewhere.
These facilities throw out the drugs after they’re no longer needed, since patients may have died or their prescriptions changed.
So far, the program has helped Iowa bank sizable prescription drug savings.
Up to $6 million is shaved off costs every year, SafeNetRx Chief Executive Officer Jon Rosmann told Healthline.
On the flip side, Iowa currently pays only $437,000 to fund the program.
When not recycled, medications are flushed down the toilet, thrown out, or incinerated, Rosmann said.
The U.S. Food and Drug Administration (FDA) still recommends getting rid of any unused medications, he added. Controlled substances like opioids are the only drugs excluded.
“All these scripts accumulate,” Rosmann said. “Yet the medications are already paid for. They can go into the hands of people who need them.”
The recycling movement picks up steam
Rosmann believes strongly in the power of his program.
He wants every state to eventually begin recycling medications.
Although 46 states have passed legislation allowing unused medications to be collected and dispersed, only 20 have programs are in place.
“It’s a win, win situation,” Rosmann said. “Nursing homes save money on incineration and patients get medications they can’t afford.”
Oklahoma and Wyoming already have successful drug recycling programs in place.
Other states like Illinois have failed to pass legislation.
And still others have required laws on the books, trying to put programs into place.
Tennessee falls into the latter category.
The state passed a bill allowing a wide range of medications to be recycled, though no funding was allocated.
So Phil Baker, chief executive officer of Memphis-based Good Shepherd Pharmacy, is moving ahead to create a program — and bootstrapping it.
“Every day, people are cutting their medications in half to afford them,” Baker told Healthline.
Some people can’t even afford to treat their diabetes with vials of insulin, he added. Those cost $17 in 1997 versus over $200 today.
Yet waste is rampant. One pharmacy that Baker surveyed in Tennessee had 12 cancer drugs waiting to expire. Their cost was $33,000.
With the passage of the Tennessee bill, a Pandora’s box was opened, said Baker.
Like other programs, most medications will come from nursing homes, since seniors typically use 40 percent of all prescription drugs.
“Prison systems are also wasting a lot of medications,” Baker said. “We will tap into every available resource. All of this stuff is being flushed down the toilet.”
Other states are hammering out legislation that can propel drug recycling programs forward.
Florida currently has an awaiting bill that would allow the recycling of an array of medications.
“The state already has a cancer medication donation program,” said Rep. Nicholas Duran (D-Miami), who co-sponsored the bill and also heads the Florida Association of Free and Charitable Clinics. “But it’s limited. We want to create a mechanism where it’s easy to donate medications and re-disperse them.”
Duran heard about the drug recycling program on the radio. So he did some research and found out that pharmacies were boxing up unused mediations and burning them.
That’s when he decided to change the system. The bill’s passage could help the working poor stay healthier and out of hospitals, he said.
“A lot of Floridians don’t have health insurance,” Duran told Healthline. “They’re priced out of the healthcare marketplace. So about 300,000 Floridians work with free clinics instead.”
New Hampshire and Vermont have also proposed bills to start drug recycling programs.
A tech-centric model
California offers another model that’s tech-centric.
The nonprofit service SIRUM runs an online platform that connects low-income clinics with donated drugs.
These are also mostly from nursing homes in California and some other states.
The program was started by three Stanford University graduates after one of them saw that donated medications were being wasted.
“Medicine donation should be as easy as recycling,” Kiah Williams, a SIRUM co-founder, told Healthline. “How do we make it the norm?”
She compares drug waste to restaurants and their food waste.
So far, SIRUM has recycled enough medicine for 150,000 people to stay healthy.
Their ultimate goal is to help the 50 million people in the United States who skip medications because they can’t afford them.
In Tennessee, Baker has ambitious plans, too. He wants to help create a national drug recycling program that can be duplicated in every state.
“This should be a national project,” he said. “It’s so simple. And it’s self-sustainable.”