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More States Hatch Plans to Recycle Drugs Being Wasted in Nursing Homes

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Daylina Miller/Health News Florida
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Inspired by a ProPublica story in April that described how nursing homes and their pharmacies nationwide throw away hundreds of tons of valuable medicines — and how one Iowa nonprofit successfully recycles them — two states are working to create similar programs.

Other states, including Vermont, are exploring the idea as well.

“All that medicine is perfectly good and perfectly safe,” said Rep. Nicholas Duran, D-Miami, who co-sponsored a bill in Florida modeled on the Iowa program. “Rather than being burned up, it could be put back to some great use.”

ProPublica’s story detailed how the nursing home industry dispenses medication a month at a time, but then is forced to destroy it after patients pass away, stop using it or move out. Some send the drugs to massive regional incinerators or flush them down the toilet, creating environmental concerns.

In Iowa, a program called SafeNetRx retrieves the excess medication, inspects it and dispenses it for free to needy patients. Almost 80,000 Iowans have used SafeNetRx to obtain medication — from cheap antibiotics to cancer drugs worth thousands of dollars per month.

The state funds the program for about $600,000 a year and in fiscal 2016 it recovered and distributed drugs valued at about $3.4 million. This year it’s on pace to hand out more than $6 million of reclaimed medicine.

Many states have laws that allow the donation of drugs, but they don’t have programs that get the drugs safely from nursing homes to those who need them.

After reading ProPublica’s story, Duran, who is also the executive director of the Florida Association of Free and Charitable Clinics, said he visited a long-term care pharmacy and saw firsthand how much valuable medication was being destroyed.

The people at Polaris Pharmacy Services, he said, told him they’d love to donate the medicine, but can’t legally. The new law would create a program to transfer the drugs so they can be dispensed free to patients, he said.

About $400,000 worth of the drugs Polaris dispenses each month are returned because they’ve been stopped for some reason, said David Rombro, the pharmacy’s chief executive. The drugs come back in the same sterile packaging, untainted and unexpired.

Polaris can get credit for about half the unused medication, but the remaining drugs — worth about $2.5 million a year — must be taken away for incineration, he said. Based on the size of his pharmacy and how many others exist in Florida, he estimates about $50 million worth are destroyed annually statewide.

“It’s perfectly good medication,” Rombro said. “There are people that need drugs that don’t have them.”

In New Hampshire, radio show host Arnie Arnesen became excited about the idea after featuring the ProPublica story and the executive director of SafeNetRx on “The Attitude with Arnie Arnesen.” She pitched the drug donation idea to New Hampshire Sen. Dan Feltes, D-Concord, urging him to make it happen in New Hampshire.

“This makes so much sense,” she recalled saying to the senator. “It even fits in with our thrifty values.”

Feltes is now the sponsor of a New Hampshire bill that would create a commission to research how to start a drug donation program like Iowa’s.

Vermont leaders also say the Iowa program would be a good fit for their state, where the “ethos” favors recycling, being environmentally conscious and improving access to medication, said Meg O’Donnell, director of government relations at The University of Vermont Medical Center. There’s a chance Vermont would even hire SafeNetRx in Iowa to run its program, she said.

“We can say pretty confidently there are some real opportunities,” O’Donnell said.

It costs money for nursing homes or pharmacies to properly dispose of the unused medication, Rombro said. Polaris employs two people full time to process the excess drugs, and pays about $5,000 a month to incinerate them.

Other companies and nursing homes simply flush them and trace amounts of pharmaceuticals have been found in water supplies throughout the country. In Florida, wastewater is treated and then pumped into the aquifer, or used to water lawns and golf courses, said Jay Sheehan, senior vice president of Woodard & Curran, a company that runs two utilities in the state. But Sheehan said the wastewater is not treated for possible pharmaceutical contamination.

“We have a problem and we need to collectively address it,” Sheehan said. “The more we can [donate excess drugs] the better we are as a holistic community, because everything is connected.”