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Pharmaceutical donation and reuse programs are distinct prescription drug programs providing for unused prescription drugs to be donated and re-dispensed to patients. Such drug repository programs began with state legislative action in 1997. As of fall 2018 there are 38 states and Guam with enacted laws for donation and reuse.
Although states have passed laws establishing these programs, more than a dozen of these states do not have functioning or operational programs. “Operational programs” are those states that have participating pharmacies, charitable clinics, and/or hospitals collecting and redistributing donated drugs to eligible patients. Some common obstacles are the lack of awareness about the programs, no central agency or entity designated to operate and fund the program, and added work and responsibility for repository sites that accept the donations.
STATE REUSE PROGRAMS: Four Spotlight Examples (as of mid-2018)
- Iowa created its program in 2007 and has served 71,000 patients and redistributed $17.7 million in free medication and supplies donated to people in need (taken from 2016 Performance Update).
- Wyoming’s Medication Donation Program was created in 2005 and has helped Wyoming residents fill over 150,000 prescriptions, adding up to over $12.5 million.
- Oklahoma created its program in November of 2004 and has filled 227,603 prescriptions, worth about $22,518,462 based on the average wholesale price of medication, through the end of May 2018.
- Georgia’s return and reuse repository, despite being a newer program, has quickly grown into one of the nation’s more successful programs.
See: Medicine donation program helps many Georgians who can’t afford what they need - GA news article, Aug. 7, 2018
Pharmaceutical donation and reuse programs are distinct prescription drug programs providing for unused prescription drugs to be donated and re-dispensed to patients. Such drug repository programs began with state legislative action in 1997.
Although many states have passed laws establishing these programs, almost half of these states do not have functioning or operational programs. “Operational programs” are those states that have participating pharmacies, charitable clinics, and/or hospitals collecting and redistributing donated drugs to eligible patients. Some common obstacles are the lack of awareness about the programs, no central agency or entity designated to operate and fund the program, and added work and responsibility for repository sites that accept the donations.
Nationwide Rx Reuse Snapshot
- As of mid-2018, 38 states and Guam had passed laws establishing drug redistribution programs. Many of these programs are not operational or small, but successful programs are growing. A few measures have been repealed.
- Twenty-one states currently have enacted laws with operational repository programs.
- At least a dozen and a half additional states are categorized as having non-operational enacted laws. New York's Nov. 2016 law is the latest.
- Filed legislation: In 2015-2016 there were 19 bills regarding this topic introduced throughout the states and the District of Columbia.
Cancer-Specific Programs: The enacted laws in 13 states—Colorado, Florida, Kentucky, Michigan, Minnesota, Montana, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Washington, and Wisconsin—allows them to accept and distribute cancer-related prescription drugs.
NOTE ON SAFE DISPOSAL:
This NCSL report does not include the numerous programs that coordinate disposal and safe destruction of unwanted drugs, either legal or illegal. Such disposal programs are designed to prevent re-use, rather than aid the health of needy patients. Disposal policies and laws are handled by the NCSL Environmental Health Program (link).
Comparison of Provisions in Enacted Legislation
- Most state programs have a number of provisions in common:
- No “controlled substances” medication is allowed to be accepted or transferred.
- No adulterated or misbranded medication is allowed to be accepted or transferred.
- All pharmaceuticals must be checked by a pharmacist prior to being dispensed.
- All pharmaceuticals must not be expired at the time of receipt.
- All pharmaceuticals must be unopened and in sealed, tamper-evident packaging.
- Liability protection for both donors and recipients usually is assured.
- Some current differences in legislation across states include:
- Drugs accepted for re-distribution: Prescription only vs. Over the Counter vs. Drug specific (i.e. only cancer drugs)
- Eligible donors, recipients and patients.
- Minimum number of months before expiration date.
- Protocol for transfers and repackaging.
- Maximum dispensing fees
- Centralized / decentralized
- Programs funded or unfunded
Practical Guidelines for Consumers Hoping to Donate Drugs
Most state programs described in this report have substantial restrictions on who can donate and what types of prescription products may be donated. Very strict safety rules also apply, intended to protect the patient that ultimately obtains and takes the drug. In many states, all donations must meet standards such as:
- Only professionally-designated persons are allowed to make a donation. Some states do allow individuals patients to donate directly.
- Pills in opened or partly used bottles are never accepted.
- Old drugs are never accepted. Expiration dates must be visible, and often at least six months later than the date of donation.
- Commonly, donated drugs must be delivered to a specific type of medical or pharmacy facility. Some may require the donor to sign a form or waiver.
- Financial compensation or payment to the donor is usually prohibited. Donations may be tax-deductible if paid for by the individual patient and taxpayer. Beyond donation programs, patients and other individuals may not sell any prescription drugs; such transactions are strictly regulated by State Boards of Pharmacy and other state and federal laws.
- If your goal as a consumer is simply to protect your local water supply or clean out your medicine cabinet, these programs will not meet your needs.
- If you wish to participate, check with a local pharmacy or prescriber for practical advice on what may work in your situation, in your state.
Legislative History: 1997-2018 (Enacted laws in bold)
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YEAR
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STATES WITH ACTIVITY OR LAWS
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1997-98
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Georgia passed the first known state law permitting reuse within a long-term care facility. In 1998 Louisiana began a pilot program without statutory authority.
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2000
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Connecticut enacted the second of the earliest laws
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2001
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Oklahoma and Montana authorized long-term-care based programs
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2002
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New Jersey and Virginia enacted authorizing language
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2003
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Ohio and Florida authorized a program; Alabama Department of Health adopted Administrative Code Chapter 420-11-1: Procedures for Donation of Certain Prescription Drugs to Charitable Clinics.
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2004
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Massachusetts and Louisiana enacted similar laws; Michigan permitted the Department of Corrections to redistribute drug products
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2005
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The following 21 states considered legislation on this topic: Arkansas, California, Colorado, Connecticut, Georgia, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Nebraska, Oklahoma, Pennsylvania, Rhode Island, Virginia, Washington, West Virginia, Wisconsin and Wyoming.
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2006
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The following 25 states considered legislation on this topic: Alabama, Arizona, Florida, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Mississippi, Nebraska, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Washington, West Virginia and Wisconsin.
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2007
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The following 15 states considered legislation on this topic: Alabama, Colorado, Illinois, Maine, Massachusetts, Minnesota, Mississippi, New Mexico, New York, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Texas and Wisconsin.
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2008
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Kansas added a reuse program, signed into law 3/20/08; Minnesota expanded an earlier program; Pennsylvania created a cancer reuse repository. Ten other states, including Alaska, Illinois, Massachusetts, Nebraska, New Mexico, New York, Oklahoma, South Carolina and West Virginia considered legislation that was not passed.
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2009
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New Mexico created a reuse program within the Corrections Department; Virginia expanded its program to allow both hospitals and clinics to dispense donated drugs. Additional laws passed in Iowa, Idaho, Montana, Nebraska, Nevada (2), Oregon, Virginia (4) and Wyoming
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2010
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Pennsylvania Senate approved legislation allowing jails to redistribute their unopened prescription medicines. It's a cost-cutting measure that's began at the Armstrong County Jail.
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2011
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Both Alabama and Indiana passed bills related to unused drugs and each state's Department of Corrections. New Hampshire passed legislation to allow manufacturer's samples to be donated as an 'unused prescription drug' to the preexisting NH program. New Mexico passed legislation allowing for a prescription drug donation program by enacting a new section of the New Mexico Drug, Device and Cosmetic Act. This new section provided standards and procedures for accepting, storing, labeling and redistributing donated prescription drugs by clinics
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2012
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California passed and signed SB 1329, which significantly expanded the prescription drug donation and distribution law enacted in 2005.
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2013
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Colorado updated their program.
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2014
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Missouri passed SB 491, which made amendments regarding out-of-state donations.
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2015
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Texas passed legislation that created a drug donation pilot program. Nebraska made amendments to the existing drug donation program relating to dispensing and labeling. Colorado made amendments to their program relating to expiration dates and licensed facilities.
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2016
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Washington and Idaho passed legislation that amended participation and donations in the prescription drug donation program. Georgia passed a bill that amended its program, which added over-the-counter drugs for acceptable donations. Minnesota and Utah passed bills establishing new programs.
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| 2017 |
Nevada passed legislation combining the HIV and AIDS Drug Donation Program and the Cancer Drug Donation Program to form the Prescription Drug Donation Program. Tennessee amended legislation to allow prescription donations to charitable organizations. The District of Columbia considered legislation to create a drug donation pilot program within the Department of Health. |
| 2018 |
Florida considered legislation revising and expanding the cancer drug program to accept other medication as the Prescription Drug Donation Program. Virginia amended legislation and New Hampshire sent legislation to the Governor pertaining to their drug donation and reuse policies. |
Source: NCSL legislative research, 2001-2018
State Laws and Programs
This table only examines drug reuse and repository laws; all 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. This chart reflects the operational status of state repository/donation programs; recently enacted laws are updated as of June 2018. There are currently 21 operational programs. Research for the table below was performed in cooperation with SIRUM, an organization based in California.
OPERATIONAL STATE PROGRAMS
The designation “Operational” refers to a state that has some level of donation and reuse transactions during 2017-2018. It does not mean that a repository may be open or available in a given geographic area, nor that a potential recipient will be able to receive a prescription drug, or that a requested drug is authorized or available for reuse.
Disclaimer: NCSL provides material about state laws as general information, primarily for policymakers. No information in this report is intended as personal legal or medical advice; NCSL is not responsible for any such uses or application of material in this report. All program status descriptions are subject to change. States may have additional regulations or executive agency guidelines that clarify or modify the terms described below.
Archive records: This table does not include all introduced but not enacted bills. NCSL's Prescription Drug Legislation Database for bills considered during the 2015-2018 legislative sessions.
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STATE
Bill #; Year
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DESCRIPTION; HISTORY
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ARIZONA
AZ Rev Stat
§ 32-1909
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Program Status: Enacted law; Pilot.
Accepted by: Physician office, pharmacy, hospital, or healthcare institution.
Who can donate: Person, manufacturer or healthcare institution.
Program eligible patients: Only state residents who meet eligibility standards set by Board.
Rx: Accepted only in original sealed & tamper-evident unit dose packaging.
Restrictions: Expiration must be more than 6 months from donation date. Recipient must sign waiver form about the program.
Legislative History: Final regulations promulgated, effective 6/6/08; HB 2382 (2006).
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CALIFORNIA
CA Health and Safety Code §§150200-150208
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Program Status: Enacted law; Operational.
Accepted by: County-owned pharmacy or pharmacy that contracts with the county.
Who can donate: Skilled Nursing Facility (SNF), a SNF designated as an institution for mental disease (IMD), general acute care hospital, psychiatric hospital, intermediate care facility, correctional treatment center, chemical dependency recovery hospital, psychiatric health facility, residential care facility for the elderly, mental health rehabilitation center, and wholesalers.
Program eligible patients: Medically indigent persons, free of charge.
Rx: Drugs that are received and maintained in their unopened, tamper-evident packaging.
Restrictions: Must be ensured that drugs received have not been in the possession of any individual member of the public.
Operated by: SIRUM
Legislative History: Signed into law by governor as Chapter 444, 9/30/05. In September 2012, California passed and signed SB 1329, which significantly expanded the prescription drug donation and distribution law enacted by SB 798 in 2005. It adds primary care clinics and pharmacies to those who can participate in the program. California amended the bill authorizing pharmacies to repackage donated medicine in preparation for redistribution A 1069, 9/13/16.
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COLORADO
CO Rev Stat § 12-42.5-133
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Program Status: Enacted law; Operational.
Accepted by: Health care facility, hospital, pharmacy, assisted living facility, correctional facility, and hospice center located in-state.
Who can donate: Any charitable clinic, pharmacy, physician, patient, or patients’ family.
Program eligible patients: Uninsured and underinsured patients.
Rx: Unused cancer drugs or medical devices.
Restrictions: Cancer drugs or medical devices; needs to be prescribed by a practitioner, as defined in section 12-22-102 (27), C.R.S., for use by an eligible patient and is dispensed by a pharmacist.
Operated by: SIRUM
Legislative History: The act took effect 8/8/07, SB 07-231 (2007). The law was revised in 2015 to remove the 6-month expiration date for donations and change the definition of a “licensed facility;” HB 1039.
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FLORIDA
FL Stat §499.029
FL Admin. Code R. 61N-1.026
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Program Status: Enacted law; Operational. **
Accepted by: A physician's office, pharmacy, hospital, hospice, or health care clinic that participates in the program.
Who can donate: A person, health care facility, hospital, pharmacy, drug manufacturer, medical device manufacturer or supplier, wholesaler of drugs or supplies, or any other entity may donate.
Program eligible patients: Residents, except those Medicaid-eligible or under any other prescription drug program funded in whole or in part by the state are ineligible to participate.
Rx: Unused cancer drugs or supplies in its original, unopened, sealed and tamper-evident unit dose packaging.
Restrictions: All drugs submitted to the program will be administered by a pharmacist to determine the drugs and supplies are not adulterated or misbranded. Additionally, a cancer drug may not be accepted or dispensed under the program if such drug bears an expiration date that is less than six months after the date the drug was donated.
Legislative History: SB22A (2003). HB 371 (2006) took effect July 1, 2006. The state has a webpage that provides further information about their Cancer Drug Donation Program.
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GEORGIA
O.C.G.A. § 31-8-301
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Program Status: Enacted law; Operational.
Accepted by: Any pharmacy, hospital, federally qualified health center, or nonprofit clinic that participates in the drug repository program and meets criteria for participation in the program.
Who can donate: Any person, including a drug manufacturer, wholesaler, reverse distributor pharmacy, third-party logistics provider, government entity, hospital, or health care facility.
Program eligible patients: Medically indigent person, uninsured, underinsured, or enrolled in a public assistance health benefits program.
Rx: Over-the-counter and unused prescription drugs.
Restrictions: Only drugs in their original sealed and tamper-evident unit dose packaging may be accepted and dispensed. For prescription drugs must not expire before the completion of the medication by the eligible patient based on the prescribing health care professional's directions. For over-the-counter drugs, they must not expire before use by the eligible patient based on the directions for use on the manufacturer's label. Controlled substances are not accepted.
Legislative History: The state-wide program required by this Code section was to be implemented no later than January 1, 2007; HB 430 (2006). HB 897 was signed by the governor 4/27/16; effective date 7/1/16.
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IOWA
IA Code
§§ 135M.1—7
641 IAC 109.1
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Program Status: Enacted law; Operational.
Accepted by: Medical facilities or pharmacies that elect to participate in the program and meet the requirements established by the department.
Who can donate: Any person or organization may donate prescription drugs and supplies.
Program eligible patients: Drugs may be donated to individuals or may be distributed to another eligible medical facility or pharmacy for use. Iowans at or below 200% of the federal poverty level as well as individuals who are uninsured or under-insured are eligible to receive donated drugs.
Rx: Prescription drugs, over-the-counter drugs, and supplies.
Restrictions: Must be inspected to assure the prescription drug or supplies have not been adulterated or misbranded. The drug must be in its original sealed and tamper-evident packaging.
Legislative History: HF 724 (2005) was approved and signed by the governor on May 3, 2005. Dept. of Public Health Regulations ARC 5563B (Chapter 109) effective March 2007. Program is currently Operational serving over 71,000 patients as of 2016. The Department of Public Health has a webpage explaining the inception of the program and further information.
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KANSAS
Board of Pharmacy
Laws and Regulations
KS Stat §§ 65-1668 – 1675
KS Stat § 65-1664
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Program Status: Enacted law; Operational.
Accepted by: A qualifying center or clinic in consultation with a pharmacist.
Who can donate: Residents of adult care homes and donating entities that volunteer to participate in the program.
Program eligible patients: Medically indigent residents of Kansas.
Rx: Unused medications; excludes controlled substances.
Restrictions: The medications must come from a controlled storage unit of a donating entity and be in its original packaging or tamper-evident packaging. Drugs purchased under Medicaid or SCHIP do not apply.
Legislative History: Signed into law by governor on March 20, 2008. The Kansas Department of Health and Environment has a webpage that provides further information about the program.
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LOUISIANA
LA Rev Stat
§§ 37:1226.2—3
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Program Status: Enacted law; Operational. *
Accepted by: Charitable pharmacies.
Who can donate: Any person, including a drug manufacturer, hospital, health care facility, or governmental entity.
Program eligible patients: Appropriately screened and qualified patients free of charge.
Rx: Prescription drugs.
Restrictions: Drugs must be in their original sealed and tamper-evident packaging. In addition, donor shall execute a form stating the donation of the drugs. The pharmacy should retain that form along with other acquisition records.
Legislative History: A pilot program began in 1998 without statutory authority.
HB 1402 was signed into law as Act 811 of 2004. Program effective August 15, 2004. SB 19 was signed into law by the governor as Act 643 of 2006, 6/29/06. Amended 6/02/16, H671, to provide for the return of prescription drugs from individuals within the custody of law enforcement.
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MARYLAND
MD Health-Gen Code § 15–605
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Program Status: Operational.**
Accepted by: Board approved drop-off sites, such as licensed pharmacies, and/or repositories which meet specified criteria.
Who can donate: Any person.
Program eligible patients: A needy patient who is a resident of Maryland, as indicated by the individual’s health care practitioner.
Rx: Prescription drugs or medical supplies.
Restrictions: The drugs must be in their original unopened and sealed packaging; or packaged in tamper-evident unit dose packaging and unadulterated. The donor must sign a statement that indicates the donor is the owner of the drugs and are voluntarily offering them to the program. A repository may not establish a waiting list for any prescription drug or medical supply dispensed by the program. Cannot charge a dispense fee that exceeds $10.
Legislative History: Signed by the governor as Chapter 287, 5/2/06. SB 1059 was effective July 1, 2006. Program expanded to include drug disposal locations and broaden citizen knowledge in 2014. The Maryland Board of Pharmacy has a public webpage providing further information about the program. More information can be found in the Annual Board of Pharmacy Prescription Drug Repository Program 2016 report.
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MICHIGAN
MI Comp L § 333.17775
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Program Status: Enacted law; Operational.**
Accepted by: A pharmacy, health professional, or charitable clinic that participates in the program.
Who can donate: Residents, guardians of residents, manufacturers, pharmacies, and clinics.
Program eligible patients: Residents eligible to receive Medicaid or Medicare, or has no health insurance, and otherwise lacks reasonable means to purchase prescription drugs.
Rx: Unused prescription drugs and cancer drugs.
Restrictions: Expired prescription drugs and controlled substances are not accepted.
Legislative History: HB 6021 (2004) was signed as Public Act 329, effective September 23, 2004. HB 5672 (2006) created a Cancer Drug Repository program in the state, effective September 29, 2006. HB 5089 (2012) required the Department of Licensing and Regulatory Affairs to establish and maintain the Utilization of Unused Prescription Drugs Program, which was created to dispense unused or donated prescription drugs, effective March 28, 2013. The state has a public webpage that provides further information about their repository programs.
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MONTANA
MT Code
§§ 37-71401—08
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Program Status: Enacted law; Operational.**
Accepted by: Provisional community pharmacies.
Who can donate: Long-term care facilities.
Program eligible patients: Qualified patients for transfer free of charge or at a reduced charge to those individuals.
Rx: Unused prescription drugs, devices, and cancer drugs.
Restrictions: Drugs defined as a dangerous drug or a drug designated as a precursor to a controlled substance cannot be accepted.
Legislative History: This act was effective 10/1/01; SB 288 (2001). It was to be fully implemented by 1/1/05. In 2009, the state also created a cancer drug repository program with HB 409. All participating repository pharmacies can be found on their Cancer Drug Repository Donor Registry Log.
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NEBRASKA
NE Code §§71-2422—2430
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Program Status: Enacted law; Operational.**
Accepted by: Any physician's office, pharmacy, hospital, or health clinic that elects to participate in the program and meets criteria established by the department for such participation.
Who can donate: Any person or entity, including, but not limited to, a cancer drug manufacturer or health care facility.
Program eligible patients: Eligible Nebraska residents.
Rx: Cancer drugs and immunosuppressant drugs.
Restrictions: The drug needs to be in its original, unopened, sealed, and tamper-evident unit dose packaging, except that a cancer drug packaged in single unit doses may be accepted and dispensed if the outside packaging is opened but the single-unit-dose packaging is unopened.
Legislative History: The Act, RRS Neb. 71-2424 et seq., became operative on 9/15/03; LB 756 (2003). In addition, LB 1116 of 2006, signed into law 3/13/06, clarified the program, including eliminating a restriction on the number of doses that can be donated; allowing donation of injectable cancer drugs and requiring donation forms to include the name of the original patient. LB 37 (2015) made amendments to the existing drug donation program relating to dispensing and labeling. The Department of Health & Human Services has a program webpage available to the public.
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NEW HAMPSHIRE
NH Rev Stat § 318.58
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Program Status: Enacted law; Operational.
Accepted by: Pharmacy, hospital, nursing home, outpatient clinic, veterans home, and correctional facility.
Who can donate: Any person or entity.
Program eligible patients: Uninsured or underinsured persons.
Rx: Unused prescription drugs, including manufacturer's samples that have not reached their expiration date, are contained in unopened unit dose or other tamper-evident packaging, and show no evidence of contamination. Medical devices that have not been opened.
Restrictions: Minimum 3 months from expiration date. Unused prescription drugs and medical devices may not be resold, but the facility or service redistributing may charge a handling fee for the service not to exceed $15. All individuals in the program shall be informed that these products have been redispensed.
Legislative History: Current program effective as of July 2011. In 2018, legislation established a Commission to review and to study enhancing the program of donating, accepting, and redispensing unused drugs.
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NORTH DAKOTA
ND Century Code § 43-15.2
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Program Status: Enacted law; Operational.**
Accepted by: Practitioners or pharmacies that meets the criteria established for participation in the program.
Who can donate: Any person or entity.
Program eligible patients: Eligible patients who fill out the “Recipient Information Form.”
Rx: Legend drugs, devices, or supplies.
Restrictions: A drug donated, prescribed, or dispensed under the program must be in the original, unopened, sealed, and tamper-evident unit dose packaging, except a drug packaged in single-unit doses may be accepted and dispensed if the outside packaging has been opened and the single-unit-dose package is unopened.
Legislative History: Signed into law by governor in April 2007; HB 1256 (2007). Patients may find out more information on the North Dakota Board of Pharmacy’s webpage for the Drug Repository Program.
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OHIO
OH Rev Code § 3715.87
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Program Status: Enacted law; Operational.
Accepted by: Any pharmacy, hospital, or nonprofit clinic that participates in the program and meets certain eligibility requirements established in rules adopted by the Board.
Who can donate: Any person, including a drug manufacturer or health care facility.
Program eligible patients: Individuals that meet the economic eligibility standards.
Rx: Prescription drugs, including cancer drugs.
Restrictions: Drugs must be in their original sealed and tamper-evident unit dose packaging.
Operated by: SIRUM
Legislative History: Signed by governor on 1/6/03; HB 221 (2003). Amended in 2009 and 2012.
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OKLAHOMA
59 OK Stat §§59-367.1—8
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Program Status: Enacted law; Operational.
Accepted by: Any pharmacies operated by a county, pharmacy operated by a city-county health department or a pharmacy under contract with a city-county health department, a pharmacy operated by the Department of Mental Health and Substance Abuse Services or a charitable clinic for the purpose of distributing the unused prescription medications.
Who can donate: Drugs may be transferred from residential care homes, nursing facilities, assisted living centers, public intermediate care facilities for people with mental retardation (ICF/MR) or pharmaceutical manufacturers.
Program eligible patients: Oklahoma residents who are medically indigent.
Rx: Unused prescription drugs.
Restrictions: Prescription drugs defined as controlled substances will not be accepted.
Legislative History: Became effective on 6/3/04 and includes amendments up to November 2015.
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TENNESSEE
Tenn. Code Ann. § 63-10-504
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Program Status: Enacted law; starting *
Accepted by: Charitable clinic pharmacies.
Who can donate: Nursing homes or hospice services programs.
Program eligible patients: Tennessee residents who are indigent.
Rx: Unused prescription medications; controlled substances are excluded.
Restrictions: Drugs in their original sealed and tamper-evident packaging should be accepted.
Legislative History: The act took effect 7/1/06 and began as a pilot program. HB 3560 & SB 3660 (2006). Amended in 2017, S429 & H 137, to replace part 5 of the legislation and reestablish administrative rules for the drug donation program.
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TEXAS
TX Health and Safety Code §§ 6.431.451—460
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Program Status: Enacted law; Pilot.
Accepted by: Charitable medical clinic, charitable pharmacy, physicians, and penal institutions.
Who can donate: Health facility, assisted living facility, hospice, hospital, physician, and pharmacies.
Program eligible patients: Uninsured and underinsured humans.
Rx: Unused prescription drugs.
Restrictions: No refrigerated drugs and no REM drugs.
Legislative History: Original program was signed into law in 2007, SB 1896 (2007). A pilot program, SB 1243 (2015), was signed into law 6/19/15 and has been operational since 9/1/15.
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VIRGINIA
VA Code § 54.1-3411.1
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Program Status: Enacted law; Operational.**
Accepted by: Hospitals and on-site hospital pharmacies.
Who can donate: Hospitals are authorized to donate drugs that were originally dispensed to hospital patients, but have been returned. The program also accepts donations from individuals, including those residing in nursing homes, assisted living facilities, or intermediate care facilities, or from those pursuant to a power of attorney, a decedent's personal representative, a legal guardian of an incapacitated person, or a guardian ad litem on behalf of the represented individual.
Program eligible patients: Indigent patients.
Rx: Prescription drugs.
Restrictions: The pharmacist-in-charge at the pharmacy shall be responsible for determining the suitability of the product for re-dispensing. A re-dispensed prescription shall not be assigned an expiration date beyond the expiration date or beyond-use date on the label from the first dispensing and no product shall be re-dispensed more than one time. No product shall be accepted for re-dispensing by the pharmacist where integrity cannot be assured.
Legislative History: H 154 signed 4/6/02. HB 1854 signed by governor as Chapter 68, 3/24/05. HB 2682 signed as Chapter No. 114, 2/5/09. Amended by S 544 enacted on 3/19/18 to broaden the donor pool. The Board of Pharmacy has a list of donating sites posted online.
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WISCONSIN
WI Stat
§§ 148.01—10
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Program Status: Enacted law; Operational.**
Accepted by: Medical facilities or pharmacies that elects to participate in the program and meets requirements specified by rule by the department. State prison pharmacies.
Who can donate: Any person or entity.
Program eligible patients: Residents who have a valid prescription, have cancer, and do not have the means to pay for the medication.
Rx: Prescription drugs, cancer drugs or supplies. Includes supplies for other chronic diseases.
Restrictions: The prescription drug should never have been in the possession of the patient to whom it was originally prescribed. The prescription drug is returned in its original container. A pharmacist determines that the prescription drug has not been adulterated or misbranded. The cancer drug or supplies needed to administer a cancer drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging or, if packaged in single-unit doses, the single-unit-dose packaging must be unopened.
Legislative History: SB 56 approved by governor 8/20/03. AB 845 enacted April 6, 2004. AB 197 signed into law by governor as Act 16, 7/5/05. The Department of Health Services has a public webpage displaying information about the current donation program.
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WYOMING
Wyo. Stat. § 35-7-1603
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Program Status: Enacted law; Operational.
Accepted by: Any physician's office, a pharmacy or health care facility that elects to participate in the program and meets criteria established by the Department of Public Health.
Who can donate: Any person or entity, including but not limited to a drug manufacturer, physician or health care facility.
Program eligible patients: Wyoming residents; those without prescription insurance, low income or on Wyoming Medicaid
What Rx: Prescription drugs.
Restrictions: Drugs shall be accepted or dispensed under the drug donation program only if they are in their original, unopened, sealed packaging or, if the outside packaging is opened, the contents are single unit doses that are individually contained in unopened, tamper evident packaging. Do not except expired, half tablet, or multi, bubble pack medication.
Legislative History: HB 194 (2005) was signed by the governor as Chapter 158, 3/2/05. The statute was amended for the program to include drug disposal. They changed the requirement for all donated drugs to be six months out from expiration, rather than two months. However, as of 2018, the program website currently mentions “in-date” as being 5 months before expiration. The Wyoming Department of Health maintains a website dedicated to the program that provides further information.
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NON-OPERATIONAL STATES
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ALABAMA
AL Admin Code 420-11-1.01—1.03
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Program Status: State Board of Health administrative regulation; not operational. *
Accepted by: Charitable clinics.
Who donated: A licensed hospital, nursing facility, intermediate care facility, assisted living facility, specialty care assisted living facility, a hospice, a patient and patients’ family.
Program eligible patients: A person who is a recipient of services of a charitable clinic but shall not include people who are eligible to receive drugs under Medicaid or under any other prescription drug program funded in Alabama.
Rx: Legend drugs.
Restrictions: Drugs must be originally dispensed by unit dose or an individually sealed dose and they are still intact in the original dispensed container. Medications in a bulk container are only acceptable from a hospice program.
Legislative History: Original program signed into law in 2002; HB 61 (2002). SB 113 (2011). In 2015, the Governor pocket vetoed bill, H 247, regarding HIV prescription return and redispensing.
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ARKANSAS
A.C.A. § 17-92-1103
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Program Status: Enacted law; not operational. *
Accepted by: Charitable clinic.
Who can donate: Nursing facility by the clinic pharmacy.
Program eligible patients: Appropriately screened and qualified indigent patients who are not eligible for Medicaid but cannot afford private health insurance.
Rx: Accepts drugs only in their original sealed and tamper-evident packaging.
Restrictions: The charitable clinic pharmacy cannot accept controlled substances. No product of which the integrity cannot be assured is accepted for re-dispensing.
Legislative History: Signed into law by governor as Act 132, 2/15/05. Scheduled effective date: August 2005; HB 1031 (2005).
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CONNECTICUT
CGS § 17b-363a
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Program Status: Enacted law; not operational.
Accepted by: Vendor pharmacy or the Department of Social Services for drug repackaging and reimbursement.
Who donated: Long-term care facilities.
Program eligible patients: Eligible patients.
Rx: Drug products.
Restrictions: Prescription drug products that are not controlled substances, sealed in individually packaged units, returned to the vendor pharmacy within the recommended period of shelf life for the purpose of re-dispensing such drug products, determined to be of acceptable integrity by a licensed pharmacist.
Legislative History: Signed into law by the governor 6/21/00. In 2001, Connecticut Legislature passed HB 7507, during a Special Session P.A. 01-9, §§ 25-27, which requires correction facilities to return specific unused drugs for future redispensing and reuse within the Department of Corrections.
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GUAM
§§ 5101—5107
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Program Status: Enacted law; not operational. *
Accepted by: Medicine Bank, created at Community Health Centers and various institutional facilities that are government owned and operated.
Who can donate: Any pharmacy, wholesale prescription drug distributor, pharmaceutical company, institutional facility, or practitioner, as well as, charitable, religious, or nonprofit organizations.
Program eligible patients: Eligible individuals in need as defined by the Guam MIP law or the Medicaid Poverty Guidelines.
Rx: Prescription drugs, non-prescription drugs, over the counter drugs, medical supplies, and other items that are identified, dated, and transported to the Medicine Bank in accordance with accepted and required standards established by Guam law, Federal law and/or Federal guidelines to include the United States, Food and Drug Administration.
Restrictions: No medication which has been previously dispensed by a practitioner to a private citizen will be accepted. Materials received which are not prescription medicines such as over-the-counter medicines, home health equipment, medical supplies, and any other items, will also be carefully inspected upon receipt. They must be judged fit for use before being distributed or will be properly disposed of in accordance with Guam law.
Legislative History: Signed into law, 2004 as §5103 & §5104.
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IDAHO
ID Code § 54-1762
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Program Status: Enacted law; not operational. *
Accepted by: A qualifying charitable clinic's or center's pharmacy; qualifying charitable clinic or center in consultation with a pharmacist; a qualifying charitable clinic or center designated as a regional behavioral health center or a state charitable institution acting in consultation with a pharmacist, physician, physician assistant or advanced practice professional nurse with prescriptive authority licensed in the state of Idaho.
Who can donate: Pharmacy, hospital, nursing home, wholesale distributor, or prescriber drug outlets.
Program eligible patients: Qualifying medically indigent patients.
Rx: Unused medications.
Restrictions: Drugs are no less than 3 months from expiration at donation.
Legislative History: Signed into law in 2009; SB 1109 (2009). HB 373 (2016) amended previous law to update who can donate and accept drugs in the program.
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INDIANA
IC § 25-26-20
IC § 25-26-23
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Program Status: Enacted law; not operational. *
Accepted by: Pharmacy or pharmacist who initially dispensed the medication.
Who donated: Health facilities with unused drugs.
Donated to: Pharmacists, hospitals, health care facilities or practitioners.
Rx: Unused medications.
Restrictions: Requires the office of Medicaid policy and planning to review the process of returning unused medication.
Legislative History: HB 1251 (2004). Statute Sec. 1 - 6 effective 07/01/04. Program not operational as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities)
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KENTUCKY
KRS § 315.452
Formerly § 194A.452
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Program Status: Enacted law; not operational. *
Accepted by: Donations can be made on the premises of a health facility or pharmacy that elects to participate in the program and meets requirements specified by the cabinet by an administrative regulation promulgated by the cabinet.
Who donated: Health facilities and pharmacies.
Program eligible patients: Individuals who meet the eligibility criteria specified by an administrative regulation promulgated by the cabinet or eligible health facility or pharmacy for use under the program.
Rx: Cancer prescription "legend" drugs or supplies needed to administer such drugs.
Restrictions: The legend drug cannot be classified as a controlled substance. Upon inspection, the drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging. In addition, the legend drug or supplies must be prescribed by a physician, advanced registered nurse practitioner, or physician assistant and dispensed by a pharmacist.
Legislative History: SB 23 (2005) was signed into law by the governor on March 18, 2005. In 2017, SB 23 was repealed, reenacted, and renumbered through § 315.452. Program not operational as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities)
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MINNESOTA
MN Stat § 151.555
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Program Status: Enacted law; not operational. *
Accepted by: Pharmacies or medical facilities on the premises that volunteer to participate in the program. The medical facilities or pharmacies need to be licensed and in compliance with all applicable federal and state laws and administrative rules.
Who can donate: A pharmacy, medical facility, drug manufacturer, or wholesale drug distributor, can donate if the donated drugs have not been previously dispensed. In addition, any individual over the age of 18 may donate.
Program eligible patients: Any Minnesota resident who is uninsured or without prescription coverage.
Rx: Medication or medical supplies that are at least 6 months from expiration
Restrictions: Drugs must be in its original, unopened, tamper-evident unit dose packaging and not adulterated or misbranded. The donation must also be accompanied by a drug repository donor form that is signed by the person making the donation or that person's authorized representative.
Legislative History: Statute effective 2007. SF 2941 expanding terms for a state repository and reuse of unused drugs program; signed into law as Chapter 327 of 2008, 5/15/08. S 3113 (2016) made several provisions, including requiring the cancer drug repository form to be available online, was signed by the governor 5/22/16. H 2987 repeals 151.55 Cancer Drug Repository Program establishing new laws and creating Minnesota’s drug repository program.
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MISSISSIPPI
§ 43-13-501-§ 43-13-509
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Program Status: Enacted law; not operational.
Accepted by: Any participating pharmacy, hospital, or nonprofit clinic.
Who can donate: Any person, drug manufacturer, health care facility, and government entities.
Program eligible patients: Individuals who meet the economic needs standard according to the Board.
What Rx: Prescription drugs.
Restrictions: Only drugs in their original sealed and tamper-evident packaging may be accepted and dispensed.
Legislative History: The drug repository program shall be fully implemented not later than July 1, 2005. However, according to the National Association of Boards of Pharmacy in 2018, the state does not allow a drug repository/donation program. (Survey of Pharmacy Law, 2018)
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MISSOURI
MO Rev Stat § 196.979
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Program Status: Enacted law with amendments effective on January 1, 2017; no participating repository sites according to the Department of Health & Senior Services as of August 2016.
Accepted by: Any pharmacy, hospital, or nonprofit clinic that meets the requirements established by 196.984 to participate in the program.
Who can donate: Any person, including but not limited to a prescription drug manufacturer or health care facility, may donate prescription drugs to the prescription drug repository program.
Program eligible patients: Persons that demonstrate economic need; economic need is defined as a net family income below 300 percent of the federal poverty level.
Rx: Sealed and unopened prescription drugs.
Restrictions: Prescription drugs must be in their original sealed and tamper-evident unit dose packaging. Any drugs that are not accepted or used in the state may be distributed to out-of-state charitable facilities.
Legislative History: HB 898, SB 1160 (2004); program initially effective on 8/28/04. Governor approved HB 1687 on 7/12/2006. SB 491 (2014) made amendments regarding out-of-state donations to current statute that go into effect on 1/1/17.
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NEVADA
NV Rev Stat §§ 453B.010—240
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Program Status: Enacted law; not operational. * Donation sites are still to be determined.
Accepted by: A pharmacy, medical facility, health clinic or provider of health care that participates in the program.
Who can donate: Any person.
Program eligible patients: Any Nevada resident eligible to receive the drugs according to Program guidelines after submitting an application to the Board of Pharmacy.
Rx: HIV/AIDS and cancer drugs.
Restrictions: The drugs must not require refrigeration, a compounded product, or be from a clinical trial. No controlled substances are accepted.
Legislative History: The act becomes effective on July 1, 2003; SB 327 (2003). A public webpage for the Cancer Drug Donation Program is available for up-to-date information. In 2017, the HIV and Cancer drug donation programs merged, S 19, to create the Prescription Drug Donation Program.
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NEW MEXICO
NM Stat § 26-1-3.2
16.19.34 NMAC (2011)
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Program Status: Enacted law; program not operational. *
Accepted by: A pharmacy operated by, or under contract with, the Corrections Department.
Who can donate: A corrections facility that has a registered or licensed nurse.
Program eligible patients: Any individual who signs a form acknowledging the drug donation process.
Rx: Unused medication
Restrictions: All donations must be unopened and more than 6 months from expiration. All controlled substances are ineligible for the drug donation program.
Legislative History: Signed into law by governor as Chapter No. 2009-236, 4/7/2009; additional rules were added to the program in 2011.
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NORTH CAROLINA
NC Gen Stat § 90-85.44
Board of Pharmacy Rules, 21 NCAC 46.2513
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Program Status: Enacted law; not operational. *
Accepted by: Free clinics and pharmacies.
Who can donate: A patient, patient’s family member, manufacturer, wholesaler, supplier of drugs or medical devices, pharmacy, free clinic, hospital, or hospice care program.
Program eligible patients: An uninsured or underinsured North Carolina resident who meets criteria established by the Board of Pharmacy.
Rx: Drugs, supplies, or medical devices.
Restrictions: All donations must be in their original, tamper-evident packaging. Expiration must be six months out from expiration at minimum.
Legislative History: Program was effective as of October 1, 2009; HB 1296 (2009). The Board of Pharmacy has frequently asked questions about the program posted online for interested patients.
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OREGON
OR Rev Stat §§ 689.770—830
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Program Status: Enacted law; not operational.*
Accepted by: Charitable pharmacy only.
Who can donate: Manufacturer, wholesaler, pharmacy, health facility, assisted living facility, and physician.
Program eligible patients: Uninsured or underinsured residents.
Rx: Unused prescription drugs.
Restrictions: No refrigerated drugs, minimum 9 months from expiration date.
Operated by: SIRUM
Legislative History: Program established in 2009 and amended in 2015.
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PENNSYLVANIA
49 PA Code §§ 27.501—506
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Program Status: Enacted law; not operational. *
Accepted by: Authorized participating pharmacies, designated by the Cancer Drug Repository Program of the State Board of Pharmacy.
Who can donate: Health care facility, health clinic, hospital, pharmacy or physician's office.
Program eligible patients: Needy residents, as defined in income eligibility criteria and other standards and procedures for individuals participating in the program, determined by the Department of Public Welfare and the Pharmacy Board.
Rx: Unused cancer drugs
Restrictions: Unit dose medication must be maintained by a health care facility, health clinic, hospital, pharmacy or physician's office rather than an individual patient, as "part of a closed drug delivery system." Expiration date must be at least six months in the future. A pharmacy "may charge a handling fee", to be determined by the Board of Pharmacy. Regulations to be drafted within 90days of effective date.
Legislative History: SB 638 was signed into law by governor as Act No. 14 on 5/13/08; effective date 7/12/08. The Board of Pharmacy updated regulations in 2013.
Pending new Legislation, H 79, creates/expands the program through the Prescription Drug Donation Program Act to establish, implement and administer a program for the return of prescription drugs
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UTAH
UT Code §§ 58-17b901—17b907
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Program Status: Enacted law; not operational. *
Accepted by: An eligible pharmacy, charitable clinic.
Who can donate: Nursing care facility, assisted living facility, a licensed care facility for people with an intellectual disability, a manufacturer, a pharmaceutical wholesale distributor, eligible pharmacies, and a physician’s office.
Program eligible patients: Medically indigent individuals.
Rx: Prescription drugs, cancer drugs.
Restrictions: Controlled substances and a drug that can only be dispensed to a patient registered with the drug’s manufacturer in accordance with FDA requirements. Drugs must be unopened unit packages or in the manufacturer’s sealed container. A cancer drug packaged in an unopened single-unit dose that has been removed from a multi-dose package can be accepted.
Legislative History: Initial program became effective on July 1, 2005; program not operational as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities) Revised program enacted in 2016 with HB 236.
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WASHINGTON
RCW § 69.70.020
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Program Status: Enacted law; not operational. *
Accepted by: Any participating pharmacy.
Who can donate: Any practitioner, pharmacist, medical facility, drug manufacturer, or drug wholesaler who meet prioritization criteria. Any patient or patient’s representative can donate a drug determined by a pharmacist’s judgement.
Program eligible patients: Eligible individuals. Priority is given to those that are uninsured.
Rx: Legend drugs. The program also includes cancer drugs and antirejection drugs.
Restrictions: Controlled substances are not accepted.
Legislative History: SB 5158 (2013) established drug donation standards and was signed by the governor May 16, 2013. HB 2458 (2016) amended current law and was signed by the governor March 29, 2016. Amended May 5, 2017 relating to the drug donations though HB 1765.
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NO RX REUSE or DONATION LAW/PROGRAM
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ALASKA
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Program Status: Not operational.
Legislative History: According to the National Association of Boards of Pharmacy, the state does not allow a drug repository/donation program. (Survey of Pharmacy Law, 2018) Bills have been introduced regarding drug repository programs, but not enacted.
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DELAWARE
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Program Status: Not Operational. *
Legislative History: According to the National Association of Boards of Pharmacy, the state does not allow a drug repository/donation program; return and reuse is only allowed in specific cases. (Survey of Pharmacy Law, 2018) Bills have been introduced regarding drug repository programs, but not enacted.
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HAWAII
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Program Status: Not Operational *; law repealed.
Accepted by: Institutional facilities or repositories of the state of Hawaii.
Who donated: Patients or personnel of an institutional facility with unused drugs.
Donated to: Pharmacists.
Rx: Prescription drugs previously dispensed or distributed by a pharmacy for administration to patients in an institutional facility by personnel of the institutional facility may be returned to the pharmacist.
Restrictions: The prescription drugs should be returned only to the original dispensing pharmacy. Also, prescription drugs from individual members of the public are not accepted for reuse.
Legislative History: This act was effective July 1, 2004, and set to sunset on July 1, 2010. (HB 2005) Law has been REPEALED.
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ILLINOIS
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Program Status: Not operational.
Legislative History: According to the National Association of Boards of Pharmacy, the state does not allow a drug repository/donation program. (Survey of Pharmacy Law, 2018) The state does have an existing administrative code (Section 1330.750) concerning the return of drugs. HB 2534 (2014) drafted a repository program, billed action ended with session sine die. In 2018, the Senate introduced SB 2849 creating a Prescription Drug Repository Act; bill was still in Senate process as of April 2018.
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MAINE
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Program Status: Not operational.
Legislative History: The state had a pilot program for distributing unopened medicines after LD 129 / HP0105 was enacted in 2005. According to the National Association of Boards of Pharmacy, the state does no longer allows a drug repository/donation program. (Survey of Pharmacy Law, 2018). The House proposed LR 501, assigned to LD 1273, which required the Board of Pharmacy to create rules establishing a redispensing process; however, it failed.
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MASSACHUSETTS
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Program Status: Not operational; law repealed.
Accepted by: Health care facilities.
Who donated: Residents or consultant pharmacist in a health care facility.
Program eligible patients: Eligible residents of Massachusetts.
Rx: Unused medications.
Restrictions: The donated medication should be sealed in unopened, individually packaged units and within the recommended period of shelf life. Excluded are schedule I or II controlled substances as defined in MA chapter ninety-four C.
Legislative History: Law signed by governor in 2004, repealed in 2012. Pending legislation introduced creating a Cancer Repository Program in 2015 and 2017 through HB 2056 and HB 1222.
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NEW JERSEY
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Program Status: Not operational.
Who donated: Unopened, unexpired prescription drugs dispensed to, but not used by, a patient within a licensed health care facility, may be reused at the facility in accordance with regulations issued by the State Board of Pharmacy.
Rx: Prescription drugs.
Restrictions: Must be unopened and unexpired.
Legislative History: Title 24 (2007). No program was in operation as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities) Bills have been introduced, not enacted.
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NEW YORK
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Program Status: Not operational; enacted law
Legislative History: According to the National Association of Pharmacy, the “return and reuse permitted only in certain facilities with approved systems for medication storage.” (Survey of Pharmacy Law, 2018) Bills have been introduced regarding prescription repository programs. During the 2015-16 session, SB 5903 passed to the Governor directing the commissioner to create regulations for the reuse and redistribution of prescriptions.
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RHODE ISLAND
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Program Status: Not operational; law repealed.
Accepted by: Authorized participating pharmacies and wholesalers.
Who donated: Nursing homes, assisted living centers, residential care facilities, community health organizations and state correctional facilities that centrally store prescription drugs.
Program eligible patients: Medically indigent Rhode Island residents.
Rx: Unused prescription medication.
Restrictions: Program does not accept controlled substances or drugs that can only be dispensed if a patient is registered with the drug manufacturer. Must be licensed at the M1 licensure level by the department of health, within 45 days of dispensing.
Legislative History: HB 5107 (2005) created a program was scheduled to begin 1/1/06. In 2007 HB 5850 extended the implementation date to 4/1/07 and required notification to all nursing homes of the new program; program not operational as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities) H 5230 repealed the existing act and created a new program that would allow pharmacies to accept and re-dispense certain prescription drugs; signed by governor 7/15/13. Law is now REPEALED. (§§ 23-25.41—49)
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SOUTH CAROLINA
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Program Status: Not Operational. *
Legislative History: According to the National Association of Boards of Pharmacy, a state drug repository program is not permitted; however, return and reuse of medications are allowed with a pharmacist’s professional judgement (Survey of Pharmacy Law, 2018). Several bills have been introduced regarding prescription repository programs, but not enacted.
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SOUTH DAKOTA
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Program Status: Not operational.
Accepted by: Hospice programs, nursing facilities, or assisted living facilities.
Who can donate: Patients in hospice programs, nursing facilities, or assisted living facilities.
Program eligible patients: Eligible patients.
Rx: Unused unit dose drugs.
Restrictions: The drugs are provided in the manufacturer's unit dose packaging or are repackaged by the pharmacy in a hermetically sealed single unit dose container.
Legislative History: HB 1165 was signed by governor 2/19/04; program not operational as of August 2009. (2010 Draft EPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities)
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VERMONT
S 164
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Program Status: Not operational.
Legislative History: In 2007, Vermont’s Department of Health delivered a study on the feasibility of developing a repository program. The study concluded, “…the Department of Health urges the Legislature to proceed with caution in its further consideration of a drug and medical supply repository program.” According to the National Association of Boards of Pharmacy, the state does not allow a drug repository/donation program. (Survey of Pharmacy Law, 2018).
In 2018, Legislature enacted S 164 which repeals provisions relating to the Unused Prescription Drug Repository Program and directs the Agency of Human Services to evaluate the implementation of an unused prescription drug repository program to accept and dispense donated prescription drugs and supplies eligible residents.
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WEST VIRGINIA
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Program Status: Not Operational.
Legislative History: According to the National Association of Boards of Pharmacy, the state allows drug donation in limited circumstances and the return of unit-dosed non-controlled substance drugs is allowed (Survey of Pharmacy Law, 2018). Several bills have been introduced regarding drug repository programs, but not enacted.
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Source: NCSL Legislative Research
* = Operational status research gathered by SIRUM, 2018. ** status based on NCSL research, 2018
Drug Reuse Activities by SIRUM:
NCSL has an informal collaborative information exchange with Sirum, a non-profit organization that provides advice and services related to reuse projects.
Their mission statement: “Using an innovative technology platform, SIRUM saves peoples’ lives by allowing health facilities, manufacturers, wholesalers, and pharmacies to donate unused medicine rather than destroy it. Because SIRUM makes donation quick, easy, and free, most organizations not only save lives by donating their medications, but also save time and money over destruction which is often costly and time-consuming. Their platform enables the closed, safe peer-to-peer redistribution of medications. Unlike traditional drug redistribution programs that rely on intermediaries, they connect donor facilities directly with recipient safety-net clinics.”
For information see www.sirum.org . Contact: Adam Kircher (adam@sirum.org;) Phone: (650) 488-7434.
Definitions:
Controlled Substances: Generally a drug or chemical whose manufacture, possession, and use is regulated and restricted by a government. It may include illegal drugs and legal but restricted prescription medications. The federal government sets the standard for controlled substances; states may modify regulation by, for example, requiring additional restrictions on certain individual products.
Legend Drugs: Any drug that requires a prescription; more commonly called prescription drugs. These may be a controlled substance (narcotic) or any other non-narcotic drug.
EPA’s Information on Collecting and Disposing Unwanted Medicine
The U.S. Environmental Protection Agency has a webpage that informs individuals on the collecting and disposing of unwanted drugs. The page examines what to do with medicines, provides details about take-back events, and information for hospitals, pharmacies and other businesses with unwanted medicines. https://archive.epa.gov/region1/healthcare/web/pdf/unuseddraft.pdf
Evidence of Effectiveness
It is still not an abundance of analysis to know the overall impact these programs have on offsetting the costs of caring for the uninsured in emergency rooms and clinics. But hopes are high in some states. For example, between 2007 and 2012, Iowa’s drug recycling program reports $5,896,000 worth of drugs donated to 26,800 eligible residents. The main obstacles: lack of awareness about the programs, lack of designated funding to market and coordinate donations and added work for repository sites such as pharmacies to accept the donations.
EPA 2010 Guidelines for Safe Permanent Disposal
The U.S. Environmental Protection Agency released draft guidelines on September 8, 2010 for the proper disposal of unused pharmaceuticals by hospitals and other health care facilities. The 43-page document describes techniques for reducing or avoiding pharmaceutical waste, practices for identifying and managing types of unused pharmaceuticals, and applicable disposal regulations. Note that this NCSL report is cited as the source for pages A1-A5 of the EPA document..
Disclaimer: NCSL provides material about state laws as general information, primarily for policymakers. No information in this report is intended as personal legal or medical advice; NCSL is not responsible for any such uses or application of material in this report.
NABP’s Position Statement on the Return and Reuse of Prescription Medications
Definitions
Controlled Substances: generally a drug or chemical whose manufacture, possession, and use are regulated by a government. It may include illegal drugs and prescription medications. The federal government sets the standard for controlled substances; states may modify regulation by, for example, requiring additional restrictions on certain individual products. For complete lists, refer to the Controlled Substances Act and "Schedules I through V" detailed at Sec. 812. Schedules of controlled substances, online at https://www.deadiversion.usdoj.gov/schedules/
Legend Drugs: any drug that requires a prescription. This may be a controlled substance (narcotic) or a non-narcotic drug.
Resources and Media Articles
Wall Street Journal
National Public Radio
Iowa Press
Wyoming Press
Other States
News Archives (2005-2016)
Authors: Richard Cauchi, program director; Kristina Berg, research assistant (2018), NCSL Health Program, Denver.
Research for previous editions compiled by Karmen Hanson, program director (2005-2011), Savannah Robinson, Research Assistant (2016)