Pharmacy Industry News: Pharmaceutical industry yields to pressure from San Francisco to fund a drug take-back program
Pharmaceutical industry yields to pressure from San Francisco to fund a drug take-back program
Starting as soon as August, San Franciscans will be able to dispose of their unused medicines for free at 16 independent pharmacies and five police stations throughout the city. The pharmaceutical industry is funding the pilot program with $110,000, after facing city plans that threatened to extend producer responsibility to pharmaceuticals. The program has funding for at least 12 to 18 months after which officials hope it will be become permanent. All household medication can be brought to police stations, and participating pharmacies will collect everything else except controlled substances. Disposing of pharmaceuticals has been a chronic problem in San Francisco without a sustainable solution. Currently, no pharmacy accepts unused or expired drugs. For decades, officials told people to simply flush their unused drugs or throw them in the trash. Especially in the past decade, scientists have started to measure the toxic effects of pharmaceuticals in the waterways and groundwater. Continuous exposure to low levels of pharmaceutical residue can threaten wildlife like fish and frogs. Minor residue has been found even in tap water, as Associated Press revealed in 2008 in an investigative report. No comprehensive studies have been published about long-term effects of low levels of pharmaceuticals consumed in drinking water, but officials now advise that no unused pharmaceuticals be disposed down the drain or in the trash. San Francisco supervisor Ross Mirkarimi, who led the negotiations with the pharmaceutical industry to fund the pilot program, said that the scope of the problem with pharmaceutical waste in the Bay Area waterways is not fully known. “What we do know is that our infrastructure is not designed to filter waste,” said Mirkarimi. Most European countries have take-back programs for unused or expired medications. In the United States, the medical waste disposal is primarily regulated at state level. One problem is that a federal law states that only law-enforcement officers may collect controlled substances. Colorado, for example, is piloting a program with eleven take-back boxes around the state and Washtenaw County in Michigan has eleven pharmacies accepting unused medication. Teleosis, a nonprofit organization for greener health care, lists take-back programs nationwide. The pharmaceutical companies have been reluctant to take responsibility for the disposal of their products. When Mirkarimi initiated an ordinance to extend producer responsibility to pharmaceuticals, the companies called for a more “collaborative” approach rather than an ordinance to require them to develop and implement their own collection program. After negotiations, PhRMA, the trade association for pharmaceutical companies, donated $100,000, and Genentech gave $10,000 toward the pilot program. Big chains like Walgreens and Safeway decided not to participate. Mirkarimi said he was neither disappointed nor surprised. “They need to understand what it means to become corporate partners and they’ve got a long way to go,” Mirkarimi said. He said the decision will reflect poorly on the big chains. “I think people will start to ask the obvious question: ‘Why are Safeway and Walgreens not providing this service either free or at very low cost?’” Walgreens said customers can already buy specially designed envelopes for $3.99 to return unused medication for incineration. “We also believe that there are legal risks if we participated in the initiative and that it could violate federal drug enforcement rules regarding the collection of controlled substances,” wrote Walgreens spokesman Robert Elfinger in an email. The pharmacy participates in local take-back events organized by Bay Area law-enforcement organizations. Apart from Walgreens, at least Safeway’s and Kaiser’s pharacies sell similar envelopes. San Francisco residents can pick up these envelopes for free at three locations. This SF Environment initiative will be discontinued when the envelopes run out because they are too expensive ($3.75 each). “The envelopes are really expensive for the city to provide free but we also don’t think that pharmaceutical disposal should be something that people should have to pay for,” said Caitlin Sanders, a Residential Toxics Reduction associate at San Francisco’s Department of the Environment. The pilot program is still in the works. SF Environment does not want to reveal the take-back locations because not all pharmacies have signed the official paperwork. Nine of the city’s 11 districts have independent pharmacies and in each of them at least one pharmacy is participating in the program. SF Environment chose the participating police stations to cover the outlying areas. The program is expected to launch in August. Sanders said she hopes that the pilot is a success and that the companies will renew the funding voluntarily. If not, supervisor Mirkarimi will consider pushing forward with the legislation to extend the producers’ responsibility. “That would depend on how well the pilot program works, what kind of relationship — positive or not — we develop with the pharmaceutical industry, and if federal law evolves by that time,” he said. Having a place to take unused medication does not mean that people actually will do it. Even in countries with effective take-back programs, pharmaceutical waste ends in the wrong place, especially liquid waste that is too often flushed into the sewage system. That’s why about $50,000 of the pilot program funding is going to outreach and education about the program. Mirkarimi has also proposed an ordinance to require all small businesses selling prescription drugs to publicly display materials explaining how to safely and lawfully dispose of unused drugs. The ordinance passed the public safety committee but hasn’t yet been heard in front of the full Board of Supervisors.
Research and Markets: Distribution on the Pharmaceutical Market in Poland 2011 – Development Forecasts for 2011-2013
Distribution on the pharmaceutical market in Poland 2011, development forecasts for 2011 to 2013 was created in order to satisfy increasing client requests for in depth reporting, comprehensive data and professional analysis of this important segment of the pharmaceutical industry in Poland. This new report analyses all major distribution channels, profiles the most influential companies in the sector, and examines in detail the potential effects of legislative changes. It looks at loyalty schemes, parallel imports and the status of current and forecasts trends in the distribution channels. This unique document offers clear and precise data on top achievers in each of the channels – from the biggest wholesalers to the largest pharmacy chains to franchises, purchasing groups and online and hospital providers of pharmaceutical products. Their locations, size, reach and market share are presented along with numbers of customers and outlets. Financial results are highlighted along with strategies for expansion and consolidation in response to current and forecast market conditions. The activities of the sector’s largest wholesalers are scrutinized, and background information about shifts in dominance over recent years is supplied. The geography of Poland is examined in terms of the locations of the greatest numbers of warehouses, pharmacies and degree of chain penetration to reveal concentrations in market activity. Pharmacy chains that operate independently of wholesale distributors appear in an Excel database with complete details on their operations. Pharmaceutical distribution activity extends beyond Poland’s borders via importer and exporter business and increasingly popular online pharmacies. This report is equipped to answer the questions of readers regarding the most extensive parallel imports, their main distributers and permit data for the past year and as forecast into the future. The extent of online activity is also reviewed and accompanied by astute analysis of the effects of current and potential government regulation on this distribution channel, which has experienced worldwide growth in recent years. Key Topics Covered: I. Report methodology II. Executive summary III. Main trends and events in the distribution segment 2009-2013 IV. Wholesale distribution V. Pharmacy distribution VI. Non-pharmacy distribution VII. Online distribution VIII. List of graphs IX. List of tables
Optimizing health-system workflows to meet patient needs
Hospital and health-system pharmacies continue to develop proactive strategies to manage drug shortages and promote patient safety with the support of Pharmacy Technician Certification Board (PTCB) Certified Pharmacy Technicians (CPhTs). Manufacturing issues, including shortages in raw materials and packaging supplies, product discontinuation, limited manufacturing capacity, and pharmaceutical industry consolidation, have led to a significant increase in drug shortages over the last five years. To avoid compromising patient care associated with shortages, hospital and health-system pharmacies have developed proactive strategies to streamline inventory maintenance and utilize key staff, including CPhTs, in pharmacy operations. As part of the supply chain team, many health-system pharmacies utilize CPhTs as the pharmacy purchaser or buyer. In this capacity, CPhTs play a crucial role in assisting the pharmacy team with procurement of medications and managing inventory. “Pharmacy technicians are instrumental in managing inventory and communicating department needs to supervisors,” said Erin Fox, PharmD, Manager, Drug Information Services, University of Utah Hospitals and Clinics. “By working cooperatively within the pharmacy team, they allow the department to better optimize daily workflow output and reprioritize medication distribution activities as patients’ needs change.” Health-system pharmacies may better manage drug shortages by effectively utilizing available technology. Automation has evolved to expand distribution system capabilities and improve safety and efficiency in distribution. Automation pharmacy technicians, responsible for the management of automated dispensing devices such as robots or automated dispensing cabinets, assist with implementation, maintenance, and optimization of these technologies and may be called upon to assist with drug shortage responsibilities. This includes assisting with product distribution, database modification, and the redistribution of product to areas of higher need.
“The accurate and timely distribution of medications to patients is a well-established responsibility in pharmacy practice,” said Melissa Murer Corrigan, RPh, Executive Director and CEO of PTCB. “With the support of CPhTs in purchasing and automation roles, pharmacists may increase their involvement in patient care activities.” In response to recent drug shortages, U.S. Senators Amy Klobuchar (D-MN) and Robert Casey (D-PA), with support of the American Society of Health-System Pharmacists, introduced the Preserving Access to Life-Saving Medications Act (S 296) in February. If enacted, this legislation would provide the U.S. Food and Drug Administration with additional tools to help prevent future drug shortages and require manufacturers to advise FDA when any discontinuance, interruption, or other action may decrease the supply of a drug to a level below the current demand.