Recycling Expensive Medication: Why Not?

Jay M. Pomerantz, MD


Medscape General Medicine. 2004;6(2):4 

In This Article

Abstract and Introduction

New (and proposed) advances in packaging, preserving, labeling, and verifying product integrity of individual tablets and capsules may allow for the recycling of certain expensive medicines. Previously sold, but unused, medication, if brought back to special pharmacies for resale or donation, may provide a low-cost source of patent-protected medicines. Benefits of such a program go beyond simply providing affordable medication to the poor. This article suggests that medicine recycling may be a possibility (especially if manufacturers are mandated to blister-package and bar-code individual tablets and capsules). This early discussion of medication recycling identifies relevant issues, such as: need, rationale, existing programs, available supplies, expiration dates, new technology for ensuring safety and potency, environmental impact, public health benefits, program focus, program structure, and liability.

Americans crossing over to Mexico and Canada to buy medicine and Internet pharmacies doing a brisk business in the United States (selling both reimported American-made medicines and low-cost, foreign-made products) suggest that medication is seen as high-cost and not very affordable in the United States. Indeed, US spending on prescription drugs has risen 15% or more per year over the past several years and more than 17% in 2001 alone.[1] In 2002, prescription drug spending increased at a slightly lower, but still considerable, rate of 13.2% over its 2001 level.[2] As a proportion of overall national healthcare costs, prescription drugs rose from 5.8% in 1990 to 9.9% in 2001.[3] A recent report[4] from Families USA, a nonpartisan, nonprofit healthcare advocacy group, found that the 50 drugs seniors used most commonly had, on average, a 6% price rise while inflation, excluding energy, rose 1.8%. Not only do drugs rise in price, but direct-to-consumer (DTC) advertising and drug company marketing practices to physicians (eg, provision of samples of expensive, brand-name medications only) attempt to shift consumers to higher-cost but not necessarily better drugs.[5]