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2018 6 7_globaldrugtakeback

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2018 6 7_globaldrugtakeback

  1. 1. thank you for joining! the webinar will begin shortly. a special thank you to our sponsor:
  2. 2. Global Best Practices for Drug Take-Back Programs June 7, 2018 Product Stewardship Institute
  3. 3. who is the Product Stewardship Institute?
  4. 4. solar panels packaging paint electronics pharmaceuticals HHW thermostats fluorescent lamps textiles mattresses phone books batteries product categories
  5. 5. gas cylinders radioactive devices framework pesticides tires carpet auto switches appliances with refrigerants medical sharps product categories used motor oil
  6. 6. accidental poisonings drug abuse health and safety ecological impacts water quality aquatic environment why pharmaceuticals?
  7. 7. Europe Canada United States the solution: extended producer responsibility
  8. 8. pharmacy-based drug take-back programs
  9. 9. Therese Hansen Sweden Quality + Environment Coordinator Apoteket Robert Svanström Sweden Managing Pharmacist Swedish Pharmacy Assoc. Thierry Moreau Defarges France President Cyclamed Ginette Vanasse Canada Director General Health Products Stewardship Assoc. Vivian Fuhrman United States Senior Assoc. Policy + Programs Product Stewardship Inst. please welcome today’s panelists:
  10. 10. today’s moderator: Scott Cassel Chief Executive Officer + Founder Product Stewardship Institute
  11. 11. webinar logistics!
  12. 12. how to ask technical questions (e.g., “how do I…?”)
  13. 13. how to ask content-related questions (e.g., “what does the speaker mean by…?”)
  14. 14. please welcome our 1st speaker: Vivian Fuhrman Senior Associate for Policy and Programs Product Stewardship Institute United States
  15. 15. u.s. drug take-back approaches and funding sources voluntary programs • government funded programs • retail pharmacy initiatives • law enforcement initiatives legislation • laws requiring program funding from pharmaceutical industry with government oversight
  16. 16. collection systems on-site receptacles mail-back envelopes one-day events
  17. 17. sustainable funding pharma industry opposition to EPR laws regulatory barriers at the state and federal levels challenges to drug take-back
  18. 18. successes and status of u.s. drug stewardship today 2008 2010 2014 2015 federal secure and responsible drug disposal act passes DEA’s final rule on the collection of controlled substances comes out psi’s briefing document + stakeholder meetings 2005 psi identified the problem & need for a national solution alameda county supreme court case = Extended producer responsibility (EPR) law passed 2012
  19. 19. what does the DEA rule allow? • flexibility in collection of controlled substances • mail-back programs by DEA-authorized entities • take-back events by law enforcement agencies continue • addition of pharmacies as authorized collection sites increase in potential collectors leads to additional permanent collection sites
  20. 20. US institutional support drug take-back • drug enforcement administration (DEA) o runs national prescription drug take-back days • office of national drug control policy (ONDCP) o included in national drug control strategy • food and drug administration (FDA) o developed guidelines with ONDCP for drug disposal • environmental protection agency (EPA) o promotes consumer use of take-back programs • states o majority of state agency websites provide information on their own state programs and/or federal DEA take-back days
  21. 21. pharmaceuticals EPR in the united states legislative activity at local, state, & federal levels
  22. 22.  3 states  18 counties  4 cities 25 drug stewardship EPR laws:
  23. 23. • usda-funded pilots in rural ny  2016: 4 independent retail pharmacies + 1 hospital pharmacy  2018: 5 hospital pharmacies • collection receptacles + mail-back envelopes • community outreach/education • resources developed:  how-to guide  educational toolkit for medical professionals psi drug take-back Pilot projects • 2017 oklahoma deq pilot • at 5 independent retail pharmacies across state • collection receptacles • community outreach/education
  24. 24. PSI’s drug take-back resources www.productstewardship.us/page/GoToGuide
  25. 25. thank you! Vivian Fuhrman Senior Associate for Policy and Programs Product Stewardship Institute United States
  26. 26. Ginette Vanasse Director General Health Products Stewardship Association Canada please welcome our 2nd guest speaker:
  27. 27. Overview of Drugs Take-Back Programs in Canada June 7, 2018
  28. 28. HPSA Overview  National industry stewardship association (1999) representing companies (160) that introduce medications and medical sharps into the Canadian marketplace.  Manage the collection of all Rx drugs, natural health products, OTC medications and medical sharps waste generated by the public in their homes.
  29. 29. Regulations 1. B.C. Medications Return Program (1996) B.C. Regulation 449/2004 Recycling Regulation, Environmental Management Act. 2. Manitoba Medications Return Program (2011) Household Hazardous Material and Prescribed Material Regulation, The Waste Reduction and Prevention Act. 3. Ontario Medications Return Program and Ontario Sharps Collection Program (2012) Regulation 298/12: “Collection of Pharmaceuticals and Sharps – Responsibilities of Producers”, Environmental Protection Act. 4. Island Medication Return Program and Island Sharps Collection Program (2015) Prince Edward Island Materials Stewardship and Recycling Regulations, Environmental Protection Act.
  30. 30. Implementation  Obligated producers sign up as members of HPSA.  HPSA acts collectively on behalf of member producers to collect and disposed of pharmaceuticals and/or medical sharps collected in pharmacies.  100% funding by brand-owners based on market share of regulated product introduce into the applicable market.  Retail pharmacies sign HPSA standards agreement to participate as collection locations (voluntary).  HPSA coordinates campaign to increase awareness and usage of programs.  HPSA submits annual reports on program performance to provincial environment ministries/departments.
  31. 31. Funding Producer Member: Manufacturer, brand owner and first importer/seller of a pharmaceutical covers 100% of costs of programs.
  32. 32. Collection Retail pharmacies acts as collection sites. Voluntarily register to participate in HPSA programs. HPSA delivers supplies, collects waste and oversees transportation for final destruction (incineration).
  33. 33. Program Performance  Over 160 member producers of Rx drugs, NHP and OTC medications and sharps.  Close to 5,695 retail pharmacies are registered as voluntary collection locations.  Over 414 tons of unused and expired medications were collected through community pharmacies in 2017.  Collected, handled, stored, transported and disposed of (incineration, autoclaved) in a safe and secure manner.
  34. 34.  Sales of units (Rx only) 14,875,152,244  Sold for residential market  # of Rx per Canadian (prescription) 18  Sales of OTC’s per household (package) 10-12  Quantity collected in 2017 414,154 kg  Population covered 19,804,821  Quantity collected per person .021 kg
  35. 35. Challenges  Packaging/empties  Incineration facilities permitted to receive Rx  Needles & syringes disposal in containers  Reporting volume dispensed on a market  Qualifying volume available for collection  Reporting metrics  Drivers: Health Safety / Environmental issues
  36. 36. Medical Sharps  First stewardship program in North America  Paid by members with medical sharps’ devices  Ontario (2013) and PEI (2015) First Sharps Collection programs 100% industry funded  Parallel systems, distinctive program from Rx  Sharps containers, over packaging and biomedical or cytotoxic waste classification requiring different standards.
  37. 37. Thank You Health Products Stewardship Association 330-2255 St. Laurent Blvd. Ottawa, Ontario, K1G 4K3 Canada Tel: 623-723-7282 gvanasse@healthsteward.ca www.healthsteward.ca
  38. 38. thank you! Ginette Vanasse Director General Health Products Stewardship Association Canada
  39. 39. please welcome our 3rd guest speaker: Thierry Moreau Defarges President Cyclamed France
  40. 40. CYCLAMED : Drug take back June 7 - 2018
  41. 41. 2005 : • 62,7 millions of inhabitants (INSEE) • 3,118 milliards of packagings ( GERS) 2017 : • 67,6 millions of inhabitants (INSEE) • 2,895 milliards de packagings ( GERS) Sales in units of pharmaceutical industry are decreasing since 2005.
  42. 42. Regulations oAgreement for 6 years (2016-2021) To collect and to destroy NUD (arrêté du 17/12/2015, JO du 23/12/2015) oObligation for retail pharmacist to collect NUD (Law n°2007-248, J.O. du 27/2/2007 et décret d’application n°2009-718 du 17/6/2009) oObligation for pharmaceutical companies to organize collection of NUD (décret n°2009-718 du 17/6/2009)
  43. 43. The Organization Unions of Pharmacists • FSPF • UNPF • APR • USPO CNOP Conseil National de l’Ordre des Pharmaciens CSRP Wholesalers Pharmaceutical Companies LEEM Censeur de l’Etat
  44. 44. CYCLAMED – THE ACTORS 100 % of Retail Pharmacist (22 000) 100 % of Pharmaceutical companies selling drugs in retail pharmacy (191) 100% of Wholesalers (195 agencies ) 79% of patients declare drug take back (67 500 000)
  45. 45. How it’s works ? Household Communities Pharma industries EMPTY PACKAGING FINANCIAL FLOW NUD FLOW Energy recycling unit Wholesalers Pharmacy
  46. 46. Results : 2012 / 2013 / 2014 / 2015 / 2016 2012 2013 2014 2015 2016 Evolution 2016 / 2015 (%) TONNAGE GLOBAL VALORISÉ (T) 14 271 14 730 15 465 15 477 15 874 + 2,6 TONNAGE M.N.U. (T) 11 309 11 849 12 056 12 108 11 884 - 1,9 GISEMENT 23 300 19 200 19 200 19 000 19 000 PERFORMANCE 49 % 62 % 63 % 64 % 63 %
  47. 47. 2016 Results by territories
  48. 48. Performance 63 % Tons 11 083 Number of cartons 1 857 652 Average weight of cartons 8,1 kg % of Non drugs 19,2 % Energy recovered units 52 CYCLAMED : KEY FIGURES
  49. 49. CYCLAMED – EXPENSES 2017 Collected tools in recycled materials , transportation, energy recovery units 83% Communication (TV, DIGITAL) 10% Salaries 4,7% R&D 2% National campaign Ministers 0,3% 100%
  50. 50. CYCLAMED – HOW IS IT FINANCED ? Contribution=Yearly Number of units x0,0032 € Highest Contribution 1 850 000 € Number of compagnies > 100 000 € 19 Average Contribution 5 800 € Mediane contribution 9 300 € Lowest Contribution 5,97 € Number of Companies < 10 000 € 100
  51. 51. CYCLAMED Drugs DASTRI Sharp Date of Birth 1993 2013 Number of pharma Companies 191 32 Number of medical devices Companies 0 18 Number of retail pharmacy 22 000 16 000 Headcount 4 10 Budget (Million €) 9 900 8 000 (estimation) Type of waste Not dangerous Dangerous Quantities of collected drugs 11 083 tons 800 tons
  52. 52. Communication
  53. 53. Objectives : o To reinforce return of NUD to pharmacists : o To protect our environnement o To facilitate good practices around drugs and to ensure safety at home o To encourage patients to separate drugs from packagings and package leaflet . o To Develop communication to avoid non-drugs
  54. 54. CYCLAMED – COMMUNICATION TV DIGITAL PARTNER SHIP WITH • PHARMACEUTICAL COMPAGNIES • INSURANCE COMPANIES • COMMUNITIES « TOUR DE France » • PROFESSIONALS • MEDIAS
  55. 55. Public at large communication 2018 o 2 TV spots o Internet site and web : www.cyclamed.org o Free mobile application : « Mon armoire à pharmacie »,
  56. 56. DIGITAL Cyclamed in 2017 : More than 149 000 visits on internet site : www.cyclamed.org (vs 136 738 in 2016, meaning + 9 %) 34 221 Facebook Fans (vs 27 0007 in 2016) 3 787 Twitter Fans (vs 2 851 in 2016) 335 230 vidéos sen on Youtube in 2017 (vs 203 376 in 2016, + 65 %)
  57. 57. QUANTIFICATION OF THE NON USED DRUGS STOCK WITHIN THE FRENCH HOUSEHOLDS 2018
  58. 58. 30% 25% 24% 22% 23% 48% 48% 53% 53% 50% 16% 19% 18% 17% 18% 6% 8% 5% 8% 9% 2012 Base=518 2016 Base=504 2014 Base =500 2010 Base=512 2018 Base=653 A nonsignificant increase of the Non Used Drugs stock in households compared to 2016 DRUGS CATEGORIES WITHIN THE FRENCH HOUSEHOLDS EVOLUTIONS Acute treatment 5 to 10 days Chronic treatment 1 month and more Self-treatment Non Used Drugs No statistical significance at 95% compared to 2016 Quantification of the Non Used Drugs stock within the French households - 2018
  59. 59. NUD Stock / household (weighed at interviewee’s home) NUD Stock / household / year (non used drugs stock per household X destocking frequency*) NUD Stock of the French people / year (non used drugs stock / household / year X number of French households**) What is the evolution of the Non Used Drugs Stock? 2010 * Destocking frequency calculated from the question « In 2017, how often did you sort through your medications and get rid of all drugs that you do not use or that you will not use anymore, whether they are out of date or not? » 2010 : 1.84 / 2012 : 1.95 / 2014 : 1.93 / 2016 : 2.08 / 2018 : 1.95 ** Source of data: INSEE [Statistics and Studies Institute],census of the French population : 2006 - 26 696 000 households / 2008- 27 270 000 households / 2010- 27 786 000 households / 2012 – 28 270 000 households / 2014 – 28 766 000 households 477 439 358 323 315 2012 2014 2016 2018 878 856 691 672 614 23,500 23,300 19,200 19,000 17,600 -8% -18% -10% -2% g g g g g g g g g g T T T T T -3% -19% -3% -9% -<1% -18% -1% - 7% g: grams T: tonnes Quantification of the Non Used Drugs stock within the French households - 2018
  60. 60. Notoriety and behaviours barometer towards Cyclamed Thierry MOREAU DEFARGES Emmanuelle HASSON Bénédicte NIERAT Muriel BURGLE Louise GOUPIL TRAVERT A P R I L 2 0 1 8 CONTACT CYCLAMED : CONTACT BVA :
  61. 61. of French people give away their drugs in a pharmacy78% An habit more common among … 35 years old and more 85% Retired pop. 86% Including 69% always or often Including 55% always Q2. Concerning yourself, do you give away, presently, your unused drugs at your pharmacist ? Basis : combined (1008) Rate of individuals who give away their unused drugs at the drugstore 39 45 49 49 54 55 60 56 55 72 72 75 78 77 80 80 79 78   Always gives away Gives away  10 11 12 13 14 15 16 17 18 Womens 87% Womens with under 15 years old children 91% Less than 2000 inhabitants area 86%
  62. 62. of French people know about Cyclamed Through a TV commercial Through a drugstore Including 19% thanks to a sticker and/or a poster in a drugstore 51% 46% 29% 51% Basis : Cyclamed knowers vs 32% in 2017 Q5. And have you ever heard about / do you know a company named Cyclamed ? Basis : 1008 Q6. How did you learn about Cyclamed ? Basis : 532 Q7.You told me that you knew about Cyclamed thanks to your drugstore? Basis : 151 Notoriety and way of knowledge of Cyclamed 60 61 57 51 15 16 17 18  vs 57% in 2017  vs 45% in 2017 On which targets the evolution is the most significant? Mens : -10pts (52% in 2017 vs 42% in 2018) 65 years old and more: - 9pts (69% vs 60%) Managerial and Professional occupations : - 12 pts (65% vs 53%) Intermediate prof. : - 10 pts (63% vs 53%) Others unemployed : - 11 pts (41% vs 29%) Rural pop. : - 11 pts (67% vs 56%)
  63. 63. Cyclamed values o Environmental protection with production of energy. o Health safety o « Les médicaments sont utiles o Ne les rendons pas nuisibles »
  64. 64. thank you! Thierry Moreau Defarges President Cyclamed France
  65. 65. please welcome our 4th guest speaker: Robert Svanström Managing Pharmacist Swedish Pharmacy Assoc. Sweden
  66. 66. 66 Global Best Practices for Drug Take-back Programs 2018-06-07 Chief Pharmacist Robert Svanström
  67. 67. Swedish Pharmacy Association Established in December 2009 • 9 members plus one member association • Community pharmacies, inc. online pharmacies • Hospital pharmacies • Compounding pharmacies • Dose dispensing pharmacies
  68. 68. Today1971 2009 910 community pharmacies 1412 community pharmacies State-owned monopoly Deregulation After 1971 several functions centralized and nationalized • e-prescriptions • compounding • take back of medicines • etc. After 2009 practice for take back of medicines was put into legislation
  69. 69. Reference: https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/forordning-20091031-om-producentansvar-for_sfs-2009-1031 (2018-05-09) The Regulation (2009: 1031) on Producer Responsibility for medicinal products entered into force on the 15th of Dec 2009. The pharmacy shall receive, without compensation, waste made up of medicinal products submitted by the public. Pharmaceuticals classified as hazardous waste and discarded syringes and needles are not covered by this responsibility, neither is drug waste produced in healthcare. The obligation to take care of drug waste applies only to an amount that is proportionate to the amount supplied by the producer. The waste must be handled in a health and environmentally acceptable way (Ch. 15. Section 11 2016: 807). The pharmacy shall inform those who purchase medicines about the possibility of disposing of waste at the pharmacy and why the waste should be handled in a particular manner.
  70. 70. Nationwide Campaign in 2012 Take away messages • Do not take out more medicines than you need from your pharmacy • Never pour medicines into the sink or toilet • Always leave waste medicine to the pharmacy • Packaging that has visible residues of medicinal products should be left to the pharmacy • Leave drug patches, such as hormone patches, both used and unused to the pharmacy • Sort and leave empty packagings as other packages Between 19th March - 16th April 2012, an information campaign in the country took place in 1200 pharmacies. The aim of the campaign was to increase awareness that all unused waste medicines shall be left to a pharmacy. This will reduce negative environmental impact as well as lowering the risk for misuse of those medicines The campaign was performed together with the Medical Products Agency, Research-based pharmaceutical industry, The Swedish Association of Local Authorities and Regions, The Swedish Water & Wastewater Association, Swedish Food Retailers Federation, The Swedish Generic Medicines and Biosimilars Association, Medicines Distribution Association, The Keep Sweden Tidy Foundation, Swedish Waste Management and Recycling association.
  71. 71. Several pharmacy chains reward customers that leave waste medicines in loyalty programs - Pharmacies in Sweden work hard with several initiatives to be class leaders in sustainability Several pharmacy chains always on top in this index Actively engaged in the European initiative #medsdisposal program via PGEU See more information here: http://www.medsdisposal.eu
  72. 72. 1a. Sales in units ( packages) for 2017 162 039 420 1b. Sales in units (DDD) for 2017 7 303 897 418 2.Weights produced and sold tons 9 722 3a. Ratio of number of units (packages) sold per inhabitants and per year 16 3b. Ratio of number of units (DDD) sold per inhabitants and per year 722 4a. Quantities of non used drugs collected: in weight (ton) 1 200 4b. Percentage of non used drugs collected in % of drugs sold 12 % 5. Quantities of non used drugs collected (per gram and year) by inhabitants 119
  73. 73. Robert Svanström Chief Pharmacist, Swedish Pharmacy Association Twitter: Chefsfarmaceut E- mail: robert.svanstrom@sverigesapoteksforening.se Telephone: +46 705211256
  74. 74. thank you! Robert Svanström Managing Pharmacist Swedish Pharmacy Assoc. Sweden
  75. 75. please welcome our 5th guest speaker: Therese Hansen Quality + Environment Coordinator Apoteket Sweden
  76. 76. Drug take-backs Operating procedures, Apoteket AB Therese Hansen, Sustainability Coordinator
  77. 77. Sweden´s leading pharmacy chain Net sales SEK 20.3 billion (2016) 34 million customer encounters in our pharmacies annually 20 million visitors at apoteket.se and our app annually Present at hospitals and delivers to wards Customer club with 2.2 million members 3,200 employees Employees from 88 countries, and who speaks 55 languages Welcome to Apoteket
  78. 78. Drug take-backs in Sweden: an efficient and well-known national system Incineration facilitiesAll pharmacies in Sweden Traceability and safety Pharmaceutical distributor Temporary storage and transshipment
  79. 79. Annual information campaign Loyalty bonus Taking back used syringes and needles Transportation by pharmaceutical distributor Most importantly: Prevent and reduce the amount of left-over medicines At our pharmacies: information and drug take-back
  80. 80. At the incineration facilities: 1200 degrees Celsius
  81. 81. Not dispense more than necessary (for instance use start packs) Encourage and support therapy compliance to reduce amount of leftover medicines Information to more people in more languages Encourage sorting and recycling of packaging materials Correct handling of syringes and needles to reduce incident risk Always have take-back bags exposed so customers are reminded of the importance of correct disposal Challenges and key lessons
  82. 82. Therese Hansen Sustainability Coordinator, Apoteket AB E- mail: therese.hansen@apoteket.se Telephone: +46 702352181
  83. 83. thank you! Therese Hansen Quality + Environment Coordinator Apoteket Sweden
  84. 84. questions or comments?
  85. 85. thank you! Therese Hansen Sweden Quality + Environment Coordinator Apoteket Robert Svanström Sweden Managing Pharmacist Swedish Pharmacy Assoc. Thierry Moreau Defarges France President Cyclamed Ginette Vanasse Canada Director General Health Products Stewardship Assoc. Vivian Fuhrman United States Senior Assoc. Policy + Programs Product Stewardship Inst.
  86. 86. to access recordings of past webinars:
  87. 87. your opinion matters.
  88. 88. For more information and to register, visit: productstewardship.us/Webinars June 7 Fall 2018May 25January 4
  89. 89. For more information and to register, visit: productstewardship.us/Webinars Exploring TreadWright and Tire Sustainability Tuesday, June 12, 2018 | 1 pm - 2:30 pm ET
  90. 90. Scott Cassel CEO + Founder 617.236.4822 scott@productstewardship.us www.productstewardship.us thank you!

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