Prepared by the Product Stewardship Institute 1

National Summit on Preventing Pharmaceutical Waste

October 19, 2010University of the Sciences Philadelphia, Pennsylvania

October 19, 2010

Prepared by the Product Stewardship Institute 2

Who is PSI?

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Non-profit founded in 2000 Membership

46 States 170+ Local governments 55+ Corporate, Organizational, Academic

Partners

Board of Directors: 7 states, 4 local agencies

• Multi-stakeholder product stewardship network

What is Product Stewardship?

“Product Stewardship" is a principle

that directs all those involved in the life

cycle of a product to take shared

responsibility for reducing the health

and environmental impacts that result

from the production, use, and end-of-

life management of the product.

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Pharmaceuticals Initiative

• National Dialogue Meeting #1 – June 2008• National Dialogue Meeting #2 – Dec 2008– Suggestion for a summit on waste reduction– SR Workgroup at the time: organizations,

pharmaceutical companies, EPA, state gov’t• Workgroup focused on Controlled Substances

Act change

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“Source Reduction” Focus

• Qualitative research under Dr. Becker’s study– Florida Department of Environmental Protection

• Workgroup helped to develop agenda• Partnership with WHEN on developing

educational modules also under EPA Region 3 project

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PSI’s Role

• Creating a forum & facilitating discussion• Listening for potential action items, policy

ideas• Summarize what we hear at the meeting– Circulate for review

• Next steps?

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Participants’ Role

• Ask questions• Share information/perspectives• Think outside the box• Be specific–Multiple contexts represented

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Agenda:

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Time Session Presenters9:00 am Introductions and Welcome Andrew Peterson, PharmD, PhD

University of the Sciences in Philadelphia9:20 am Purpose of the Meeting

Introduction to PSI Background on the issue Focus and goals for the meeting

Sierra Fletcher, PSI Joel Kreisberg, DC, MA

Teleosis Institute

10:00 am BREAK10:20 am Preventing Waste from Unused Prescriptions: Short-cycle

dispensing, building co-pays & other options Overview of the issue & stakeholder considerations MaineCare initial prescription limitation policy Discussion

Tracy McCutcheon, MHSA, MBACenters for Medicare & Medicaid Services

TBD

12:00 pm LUNCH

1:15 pm Preventing Waste from Drug Samples Overview of the issue and program experience Discussion

Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC

2:15 pm Preventing Waste: Different stakeholders’ perspectives Research and potential policy options Discussion

Julie Becker, PhD, MPHWomen’s Health and Environmental Network

3:30 pm Next steps: Are there other strategies to discuss? Sierra Fletcher, PSI4:00 pm Adjourn Sierra Fletcher, PSI

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Goal• Develop public and corporate policy

recommendations to reduce the quantity of pharmaceuticals that are no longer wanted or needed in homes and healthcare facilities.

We seek to build on information and policy ideas from around the country and from different

perspectives.

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Focus of this Meeting

• Preventing waste by reducing the quantity of drugs that are no longer wanted or needed in homes and healthcare facilities.

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This meeting will not address issues associated with drug disposal including mail-back or other take-back programs,

incineration, etc.

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Challenge

• Complexity of the “ecosystem”• Not “one-size-fits-all”• Momentum is towards getting people their

medicines as easily and cheaply as possible• These are not reasons to avoid developing

solutions

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Thank you to our meeting sponsors:

U.S. Environmental Protection Agency (Region 3)

Purdue Pharma L.P.

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Preventing Waste from Unused Prescriptions

• Overview of the issue & stakeholder considerations

• MaineCare initial prescription limitation policy• Discussion

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Questions• What are the pros and cons of short-cycle

dispensing?– Initial prescription limitations?

• Are there specific contexts in which this approach would be easier to implement?

• Voluntary? Mandated?• What would need to happen for this to be

widely adopted (if that’s what we want)?

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Questions• Should it apply to all medicines? – Only those with higher discontinuation rates?– Only those most likely to be abused?– To what extent does this depend on the context?

• What are the options for pro-rating co-pays?• What would be the best possible scenario?• Are there any next steps on this topic?– Other information?– Other stakeholders?

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Thank you to our meeting sponsors:

U.S. Environmental Protection Agency (Region 3)

Purdue Pharma L.P.

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Samples/Vouchers: Questions• How can we minimize clinic sample waste?• How can we encourage the use of vouchers in

place of samples?• What are the pros and cons?• How/can this work in other contexts?• Voluntary? Mandated?• What would need to happen for this to be

widely adopted (if that’s what we want)?

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Thank you to our meeting sponsors:

U.S. Environmental Protection Agency (Region 3)

Purdue Pharma L.P.

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One more time…

• What are the pros and cons?• Are there specific contexts in which this

approach would be easier to implement?• Voluntary? Mandated?• What would need to happen for this to be

widely adopted (if that’s what we want)?

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Next steps?

• Additional information?• Strategies?• People?• Forums?

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