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Secure Medicine Return: PH:ARM Pilot in Washington State

Shirley Reitz, Pharm.D., BCPSAssociate Director, Pharmacy Clinical ServicesGroup Health CooperativeSeattle, WA 206-901-4334Reitz.sj@ghc.org

November 2008

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Patient Demand

• 2006 WCRC survey of 400 King County households revealed– 39% have 10 or more medicine containers in their homes

– Only 33% report that they are currently using or plan to use these meds

– 74% stated they would be willing to dispose of the meds in a convenient location

• “We are cleaning out my Grandfather’s house and I have a suitcase full of drugs that we need to get rid of. Can we bring them into your disposal site?”

• “Our neighborhood association (over 400 homes) would like to provide some education to the families in our neighborhood about drugs in their homes – can we tell them to bring their meds to you for disposal?”

• “Please dispose of this medication. Enclosed is a donation….”

namePharmaceuticals in Landfills

Leachate

• pumped to sewer treatment plants– Could leach to

groundwater

– studies find drugs

• 9 unlined landfills in Washington State

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PH:ARM TeamPharmaceuticals from Households: A Return Mechanism

•HEALTH CARE PROVIDERS– Group Health

Cooperative

•BUSINESSES– Bartell Drugs

– Boarding/assisted living homes

•NON-PROFIT AGENCIES– Interagency Resource for

Achieving Cooperation (IRAC)

– Northwest Product Stewardship Council

– Pacific NW Pollution Prevention Resource Center (PPRC)

– WA Citizens for Resource Conservation (WCRC)

•STATE & LOCAL GOVERNMENT– King County Dept. of Natural

Resources & Parks

– Local Hazardous Waste Management Program in King County

– Public Health - Seattle and King County

– Snohomish County Solid Waste Management Division

– WA Department of Ecology

•ADVISORS– WA State Board of Pharmacy

– WA State Dept. of Social and Health Services - Aging and Disability Services Administration

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Group Health’s Goal

• Work with community partners to develop a medication disposal system that is:– Secure– Affordable– Reproducible– Sustainable– Meets all regulatory requirements– Easy for our patients to use

• Remove from the home medications posing risk of unintentional poisoning, overdose, or abuse

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Group Health Pilot Bin Signs

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Group Health Pilot

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Pilot Project

• 25 Group Health clinic pharmacies statewide•12 Bartell Drugstores around Puget Sound• 3 boarding /assisted living homes in Seattle

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Group Health’s ExperienceGroup Health Collected Meds

Percent by Weight1,238 pounds total

16,460 drug containers

Over 15,000 lbs of unwanted medications collected and safely destroyed from GHC locations over 2 year pilot

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Interesting Findings

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Snapshots of collected materials

14 Doses of Enbrel

$5,600

Migranal Nasal Spray

$120

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What we’ve learned:

• Security is Critical!– Secure drop boxes– Complete tracking of

secure containers– DEA utilization

• Staff Satisfaction– “Makes my job easier”

• Regulatory issues remain

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• Cost Considerations– Need affordable solutions– Pilot ending this year– Looking for interim

Manufacturer funding

• Pilot project final report– Report expected Jan ’09– www.medicinereturn.com

• Legislative efforts in 2009