[Pharmwaste] FW: Purchasing Drugs: The point at which we have the most power

[Tenace, Laurie]

Sent in by a non-list serve member.

Laurie J. Tenace
Environmental Specialist
Florida Department of Environmental Protection
2600 Blair Stone Road, MS 4555
Tallahassee, Florida 32399-2400
PH: (850) 245-8759
FAX: (850) 245-8811
Laurie.Tenace at dep.state.fl.us 

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Unwanted Medications web pages:
http://www.dep.state.fl.us/waste/categories/medications/default.htm




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From: McCarron, Matthew [mailto:MMcCarron at CIWMB.ca.gov] 
Sent: Friday, April 04, 2008 1:53 PM
To: Tenace, Laurie; pharmwaste at lists.dep.state.fl.us
Subject: Purchasing Drugs: The point at which we have the most power

Below is a DOD Pharmaceutical purchasing study for their members.

Report

1.  DOD Pharmacy Program:  Continued Efforts Needed to Reduce Growth in
Spending at Retail Pharmacies.  GAO-08-327, April 4.
http://www.gao.gov/cgi-bin/getrpt?GAO-08-327
Highlights - http://www.gao.gov/highlights/d08327high.pdf

It occurs to me, that this (point of purchase) is where we have the most
leverage in the whole drug delivery - EOL management system.  It is easier to
ask for incentives at the time they want your money, then when you are trying
manage End of Life material.  This would require a concerted and coordinated
effort to buy drugs with needed EOL conditions for Governmental Agencies,
Hospitals, Pharmacies, Clinics, general retailers like Long's, Safeway,
Albertson's, Wal-Mart, Costco, CVS, Rite-Aid and corner stores and the
consumer demand to make it happen.  The initial sales contracts are the key
to solving our basic issue.  If the solution is manufacturer take back, we
buy with that condition.

With a proposed system like this, we will start to see two prices from the
manufacturer one with that EOL built in and one with out.  For the low bid or
cost constrained buyers, they will need to know the cost of disposal and
somehow be assessed the cost, if they are outside the system of Manufacturer
take back.  Does this cause illegal dumping, most likely.  Will consumers buy
"cheaper" drugs from some one who buys outside the Manufacturer take back
sellers, yes they will.  Education on the cost of this behavior is critical.
It would require a national effort, and other limitations on forgiven
internet or other purchasing methods that go around traditional delivery of
drugs in the US.  At a time when drug delivery is high cost is this a
palatable solution?  Tough Sell, yes.  But the real costs of disposal are
normally bifurcated from discussion on cost to consumers and understated for
the cost of proper disposal, due to the need for more cost info EOL
management options, and on water quality data and clean up to unknown
standards.

There is one real fact to rely on: The manufacturers can do the job of take
back and proper management cheaper, than a government oversight system could.
Why can the manufacturers do a better job?  If they can compete on a level
playing field, they will find efficiencies, just like they do on the
production, marketing and delivery end, where competition is the incentive.
Government needs to assist the manufacturer, they need clear guidance and a
streamline approach to solve the legal and inter-agency issues.

This scenario is the same one we have gone through for other specialty waste
steams, such as paint, oil, batteries, white goods, automobiles, tires,
electronics, mercury containing materials (lamps), household hazardous wastes
and pesticides.  The consumer creates the demand in most cases and they will
always bear the cost. To have the lowest cost and most efficient system we
need coordination and cooperation from all stakeholders.

Matt McCarron
California Integrated Waste Management Board
1001 I Street, MS-9
Sacramento, Ca. 95814
916-341-6456
916-319-7658 fax
<mmccarron at ciwmb.ca.gov>

http://www.ciwmb.ca.gov/WPIE/HealthCare/