4 fletcher presentation get the meds out 5 18-10

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4 fletcher presentation get the meds out 5 18-10

  1. 1. SIERRA FLETCHER, SENIOR ASSOCIATE PRODUCT STEWARDSHIP INSTITUTE, INC. National Snapshot
  2. 2. What is the Product Stewardship Institute? <ul><ul><li>Non-profit founded in 2000 </li></ul></ul><ul><li>Membership </li></ul><ul><ul><ul><li>45 States </li></ul></ul></ul><ul><ul><ul><li>100+ Local governments </li></ul></ul></ul><ul><ul><ul><li>50+ Corporate, Organizational, Academic </li></ul></ul></ul><ul><ul><ul><li>Partners </li></ul></ul></ul><ul><li>Board of Directors: 7 states, 4 local agencies </li></ul><ul><li>Multi-stakeholder product stewardship network </li></ul>
  3. 3. Today’s Topics <ul><li>Status of the Issue </li></ul><ul><li>Disposal Recommendations – Who says what? </li></ul><ul><li>Source Reduction </li></ul><ul><li>Federal Legislation to Amend the CSA </li></ul><ul><li>State-level Extended Producer Responsibility </li></ul>
  4. 4. What is the size of the problem? Household Trash Disposal Flushing (some) Take-backs Source Reduction Reduce Regulatory Barriers to Cut Cost, Ensure Safety, Enhance Environment Preferred Disposal Facilities The Problem Disposal Options for Waste Pharmaceuticals
  5. 5. Clear & Consistent Message
  6. 6. <ul><li>States & locals </li></ul><ul><li>Federal government </li></ul><ul><li>Many say do not flush </li></ul><ul><li>Vary somewhat in first choice given </li></ul><ul><ul><li>Take-back </li></ul></ul><ul><ul><li>Trash disposal </li></ul></ul><ul><li>Don’t distinguish different types of drugs </li></ul><ul><ul><li>Ex: Take-back programs vary </li></ul></ul><ul><li>Use take-back programs </li></ul><ul><li>Trash disposal </li></ul><ul><ul><li>“ Undesirable substance” </li></ul></ul><ul><li>FDA list of drugs to be flushed </li></ul>What’s a consumer to do?
  7. 7. Source Reduction <ul><li>PSI Workgroup: need for “Source Reduction Summit” </li></ul><ul><ul><li>Philadelphia, Oct 2010 </li></ul></ul><ul><li>Dr. Julie Becker’s qualitative research </li></ul><ul><ul><li>Pennsylvania </li></ul></ul><ul><ul><li>Florida </li></ul></ul><ul><ul><li>Illinois </li></ul></ul><ul><li>Many others advancing this issue </li></ul><ul><ul><li>Alliance for the Great Lakes summer meeting </li></ul></ul>
  8. 8. “ Source Reduction”: For discussion <ul><li>Reducing direct-to-consumer advertising </li></ul><ul><li>Re-examining the expiration date </li></ul><ul><li>Improved inventory management </li></ul><ul><li>Database of prescriptions </li></ul><ul><li>Changing co-pay structures </li></ul><ul><li>Restricting automatic re-fill mail-order programs </li></ul><ul><li>Limit amount dispensed at first (certain medications) </li></ul><ul><li>Voucher program for sample medications </li></ul>
  9. 9. Buuuttt… <ul><li>Considering environmental/toxicity data when prescribing </li></ul><ul><li>Still need to figure out how to make these things happen – time for the nitty-gritty </li></ul>
  10. 10. Controlled Substances Act <ul><li>Leads us to law enforcement as the only take-back option for a small # of important drugs </li></ul><ul><li>Works for some, but not all </li></ul><ul><li>Confuses messaging to public </li></ul><ul><li>Costs money </li></ul><ul><li>Competing with other local law enforcement priorities </li></ul>
  11. 11. <ul><li>HR 1191 & S 1336 </li></ul><ul><li>HR 1359 & S 1292 </li></ul><ul><li>More prescriptive </li></ul><ul><li>Specifies range of people able to dispose </li></ul><ul><li>Requires different collection methods </li></ul><ul><ul><li>Urban/rural </li></ul></ul><ul><ul><li>Cost </li></ul></ul><ul><li>More prescriptive </li></ul><ul><li>Favored by DEA </li></ul><ul><li>“ Ultimate user” & long-term care facilities </li></ul><ul><li>What would the regulations look like? </li></ul>Federal Legislation: Changing the CSA
  12. 19. Pharm EPR Legislation 2009 & 2010
  13. 20. <ul><li>SIERRA FLETCHER </li></ul><ul><li>[email_address] </li></ul><ul><li>(617) 236 4886 </li></ul>Thank you

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