Brief State Prescription Drug Repository Programs

Overview

Unused medication worth billions of dollars in ends up in the trash every year. For example, research shows medication worth over $3 billion is thrown out by hospitals every year, and an additional $2 billion worth is discarded in long-term care facilities. Medication in these settings often goes unused because a patient’s condition improves, they change doses, change care settings or die. Any unopened medicine not used by the patient must be disposed of.

Instead of disposing of the unused medicine, facilities in states with repository programs may donate it. By collecting unused prescription drugs and redistributing them to qualifying individuals, prescription drug donation and reuse programs, or drug repositories, aim to increase medication access, especially to underserved populations.

As of September 2023, 44 states, Washington D.C., and Guam, have laws establishing prescription drug repository programs. Twenty-eight states have operational programs, with three more expected to be operational within the next year. Eighteen states, Guam, and Washington D.C. have laws enacted but are not operational. Operational programs are those with participating pharmacies, charitable clinics or hospitals approved by the state to collect and redistribute donated drugs.  

Most state laws also permit the donation of cancer drugs within their existing drug repository programs. In addition to their general drug repository program, Florida, Michigan and Montana, also have a separate repository program specific for cancer drugs.

Comprehensive state donation and redistribution programs may help expand access to affordable drugs for patients across the country. Existing programs have had significant success in helping people afford the prescriptions they need to remain healthy, but barriers exist that prevent many operational and non-operational programs from reaching their full potential, including: 

• Administrative and operational burdens on participating entities. 
• Inadequate financial resources and funding. 
• Lack of public awareness of existing programs. 
• Limited donor and recipient organization eligibility. 
• Restrictive patient eligibility. 
• Inadequate interstate collaboration.

Examples of State Donation Programs

• While only operational since 2017, Georgia’s Good Pill Pharmacy Donated Drug Repository Program has filled over 796,000 prescriptions, worth over $64 million. 
• Established in 2001, Iowa’s SafeNetRx Program has served over 123,700 patients and redistributed more than $74.2 million of medication and supplies. 
• Since 2004, Oklahoma’s Drug Recycling Program has donated over 285,000 prescriptions, worth at least $28.4 million. 
• Wyoming’s Medication Donation Program began in 2007 and has helped the state fill over 150,000 prescriptions worth over $44.2 million. 

Comparison of Provisions in Enacted Legislation

Most state programs have a number of common provisions such as:

• No acceptance or transfer of a controlled substance medication.
• All prescription drugs must be unopened and in sealed, tamper-evident packaging, though some exceptions exist for cancer drugs.
• Expired drugs are never accepted.
• Expiration dates must be visible, and drugs must not expire before use.
• Usually, donated drugs must be delivered to a specific type of medical facility or pharmacy. Some may require the donor to sign a form or waiver. 
• All products must be checked by a pharmacist prior to being dispensed.
• Financial compensation or payment for donations is prohibited. 
• Selling or reselling donated prescription drugs is illegal.
• Donations may be tax-deductible under certain conditions. 
• Adulterated or misbranded medications are not accepted or transferred.
• Protection from liability is guaranteed for both donors and recipients.
• Donated prescription drugs may only be dispensed to patients with valid prescriptions. 

Some differences across state programs include:

• Types of drugs accepted for redistribution, e.g. over-the-counter drugs, condition-specific drugs.
• Eligible donors, recipients and patients.
• Protocols for transferring and repackaging donated drugs.
• Administrative and record-keeping requirements. 
• Maximum pharmacy dispensing fees.
• Agency oversight.
• Funding mechanisms.

This table only examines drug reuse and repository laws—any drug take-back and disposal-only programs are not included in this report. For the details of each state law, please click the hyperlinked state statute, bill or visit the state’s website.