State Rx Reuse Snapshot

State Prescription Drug Return, Reuse and Recycling Laws

10/1/2018

Pharmaceutical donation and reuse programs are distinct prescription drug programs providing for unused prescription drugs to be donated and re-dispensed to patients. Such drug repository programs began with state legislative action in 1997. As of fall 2018 there are 38 states and Guam with enacted laws for donation and reuse.

Although states have passed laws establishing these programs, more than a dozen of these states do not have functioning or operational programs. “Operational programs” are those states that have participating pharmacies, charitable clinics, and/or hospitals collecting and redistributing donated drugs to eligible patients. Some common obstacles are the lack of awareness about the programs, no central agency or entity designated to operate and fund the program, and added work and responsibility for repository sites that accept the donations.

Tip: At WMDP, we have enough medication donations to fill about 2/3 of our prescriptions. The other 1/3 is filled using product ordered from a nonprofit vendor or purchased using grant funds.

STATE  REUSE PROGRAMS: Four Spotlight Examples (as of mid-2018)

  • Iowa created its program in 2007 and has served 71,000 patients and redistributed $17.7 million in free medication and supplies donated to people in need (taken from 2016 Performance Update).
  • Wyoming’s Medication Donation Program was created in 2005 and has helped Wyoming residents fill over 150,000 prescriptions, adding up to over $12.5 million.
  • Oklahoma created its program in November of 2004 and has filled 227,603 prescriptions, worth about $22,518,462 based on the average wholesale price of medication, through the end of May 2018.
  • Georgia’s return and reuse repository, despite being a newer program, has quickly grown into one of the nation’s more successful programs.
  • See: Medicine donation program helps many Georgians who can’t afford what they need – GA news article, Aug. 7, 2018 

Figure 2.

Pharmaceutical donation and reuse programs are distinct prescription drug programs providing for unused prescription drugs to be donated and re-dispensed to patients. Such drug repository programs began with state legislative action in 1997. 

Although many states have passed laws establishing these programs, almost half of these states do not have functioning or operational programs. “Operational programs” are those states that have participating pharmacies, charitable clinics, and/or hospitals collecting and redistributing donated drugs to eligible patients. Some common obstacles are the lack of awareness about the programs, no central agency or entity designated to operate and fund the program, and added work and responsibility for repository sites that accept the donations.

Nationwide Rx Reuse Snapshot

  • As of mid-2018, 38 states and Guam had passed laws establishing drug redistribution programs. Many of these programs are not operational or small, but successful programs are growing.  A few measures have been repealed.
  • Twenty-one states currently have enacted laws with operational repository programs.
  • At least a dozen and a half additional states are categorized as having non-operational enacted laws. New York’s Nov. 2016 law is the latest.
  • Filed legislation: In 2015-2016 there were 19 bills regarding this topic introduced throughout the states and the District of Columbia.

Cancer-Specific Programs: The enacted laws in 13 states—Colorado, Florida, Kentucky, Michigan, Minnesota, Montana, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Washington, and Wisconsin—allows them to accept and distribute cancer-related prescription drugs.

NOTE ON SAFE DISPOSAL:

This NCSL report does not include the numerous programs that coordinate disposal and safe destruction of unwanted drugs, either legal or illegal. Such disposal programs are designed to prevent re-use, rather than aid the health of needy patients.  Disposal policies and laws are handled by the NCSL Environmental Health Program (link).

Comparison of Provisions in Enacted Legislation

  • Most state programs have a number of provisions in common:
    • No “controlled substances” medication is allowed to be accepted or transferred.
    • No adulterated or misbranded medication is allowed to be accepted or transferred.
    • All pharmaceuticals must be checked by a pharmacist prior to being dispensed.
    • All pharmaceuticals must not be expired at the time of receipt.
    • All pharmaceuticals must be unopened and in sealed, tamper-evident packaging.
    • Liability protection for both donors and recipients usually is assured.
  • Some current differences in legislation across states include:
    • Drugs accepted for re-distribution: Prescription only vs. Over the Counter vs. Drug specific (i.e. only cancer drugs)
    • Eligible donors, recipients and patients.
    • Minimum number of months before expiration date.
    • Protocol for transfers and repackaging.
    • Maximum dispensing fees
    • Centralized / decentralized
    • Programs funded or unfunded

In states where drug donation programs have demonstrated success, the benefits of the program are enjoyed by a variety of stakeholders, resulting in improved outcomes for patients seeking assistance, and significant cost savings to program donors and healthcare providers.