[Pharmwaste] Who Foots the Bill For Expired Medicine? One Proposal: Drug Makers

[Tenace, Laurie]

Who Foots the Bill For Expired Medicine? One Proposal: Drug Makers

  *   By
  *   Ed Silverman
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Millions of pills go unused in household medicine cabinets - often long past expiration dates - and now some California lawmakers think drug makers should pay to get rid of them. A new bill to create a 'take-back' program<http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_1001-1050/sb_1014_bill_20140213_introduced.pdf> is pending in the California legislature. If passed, the state would become the first to adopt such a measure and proponents hope the idea will gain traction elsewhere.

The move, which has drug makers on edge, reflects growing frustration among California officials worried about drinking water and contamination from medicines flushed down the toilet or drug abuse from stockpiled painkillers. They say disposal costs can overwhelm local governments, which are starting to turn to the pharmaceutical industry to underwrite these programs.

"It's long overdue for the pharmaceutical companies to accept responsibility," says California state senator Hannah-Beth Jackson, who introduced the bill. Her office suggests a program would cost about $6.5 million annually, assuming all 6,500 pharmacies in the state act as drop-off locations and the expense for collection bins and shipping containers, among other things, per pharmacy is $1,000.

Jackson joins a growing chorus of California politicians who say drug makers profit from the sale of medicines and, therefore, should help with disposal. Her initiative mimics an ordinance passed two years<http://www.acgov.org/aceh/safedisposal/documents/SDD_Ordinance.pdf> ago by California's Alameda County, which became the first local government in the nation to require drug makers to pick up the cost.

But drug makers vehemently disagree. They argue that pharmaceutical waste and drug abuse can be lessened by educating consumers to take their medicines as prescribed and by expanding monitoring of inappropriate prescribing. Drug makers also say that safe disposal is a shared responsibility and they are being unfairly required to develop, manage and fund disposal operations

The bill "offloads state costs of municipal waste removal onto private actors who don't have anything to do with the problem other than that their products end up there," says John Murphy, assistant general counsel at the Pharmaceutical Research and Manufacturers of America trade group. "There are far better and more effective ways to get at waste and drug abuse."

One suggestion: toss meds in the garbage. The trade group cites a 2012 study in Environmental Science & Technology, partly funded by Merck, which found trash disposal would be nearly as effective<http://www.ncbi.nlm.nih.gov/pubmed/22489940> and achieving 100 percent consumer participation is unlikely. The study cites data showing a long-running national program in Sweden achieved only 43 percent participation.

Throwing medicines in the trash, however, is something more folks are likely to do. And take-back programs could lead to increases in other important environmental emissions such as smog-forming gases and greenhouse gases" as people drive to disposal locales, according to Steve Skerlos, a professor at the University of Michigan and study co-author.

Meanwhile, the pharmaceutical industry believes the Alameda ordinance violates the US constitution. Last September, a federal court judge in California dismissed a lawsuit filed by the industry trade group<http://freepdfhosting.com/50519ce29c.pdf>, although PhRMA filed an appeal. Since then, the trade group filed another lawsuit to thwart a similar ordinance passed by Kings County, Washington.

The trade group, however, has angered take-back proponents by predicting that consumers, notably seniors, will eventually absorb some costs. Jackson calls this a "scare tactic. We have attempted to have discussions [with the pharmaceutical industry], but the response so far has been to say we should pound sand," she says.

Whether other states will follow suit is unclear. So far, only New York has introduced similar legislation, but this has stalled. "Industry opposed the bills, so they haven't moved," says Marilyn DuBois, director of program development for state Assemblyman Steve Englebright, who is spearheading the legislation.

Nonetheless, some take-back advocates are unperturbed. "The day is coming when there is either a one solution or multiple ordinances from different counties or different states," says Heidi Sanborn, executive director of the California Product Stewardship Council, a non-profit devoted to improving waste handling. "... And whether this bill passes or not, this issue is not going away."


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