Recycling Expensive Medication: Why Not?

Jay M. Pomerantz, MD

Disclosures

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

In This Article

Conclusions

Individual tablet and capsule tamper-resistant packaging, including bar code identification of manufacturer, date of manufacture, expiration date, medication name, and dosage would bring us close to the possibility of recycling appropriately chosen medications. Such a system, combined with appropriate safeguards to assure product authenticity, is worth discussing.

Special recycling pharmacies would have to work with manufacturers, wholesalers, retail pharmacies, health insurers, and the FDA to work out ways to make the whole process of drug manufacturing and distribution compatible with recycling. No doubt Congress would have to pass new laws and insurance companies would have to determine liability risk. That is a lot of work and a lot of change.

Clearly, there would also be the need for the FDA to fully monitor and stop the distribution of recycled medicines that might be adulterated, misbranded, expired, subpotent, contaminated, or counterfeit. That task may not be one that the FDA embraces, unless substantial additional funds for monitoring are made available either by Congress or medication recyclers.

Recycled medication may actually be easier for the FDA to police than the current situation in which imported drugs are already a big problem.[44] Starting out with approved products, with a known date of domestic manufacture and original sale, verified by special pharmacists, may be safer and easier to monitor than Internet arrangements from foreign suppliers. Those risky medication purchases are sure to increase unless there is an affordable alternative source of medication for people pushed to the wall by the current high cost of essential medicines.

Whatever the safeguards, recycled medicine, like imported medicine, may pose an additional risk to consumers, but so does going without needed medication or skipping doses to save money. It comes down to the following: in an ideal world, no one would chose to buy a used car, day old bread, clothes from Goodwill stores, or retreaded tires. Although recycling medication may seem like a risky and bizarre idea, new technologies may make it reasonably safe -- or at least safer than no medicine at all for whole groups of people. Throwing away valuable resources when there is apparently not enough to go around is cavalier and unfeeling, not to mention poor public policy. Either medication prices come down, insurance covers medication for all Americans, or we begin a discussion of other options, like recycling.

By no means should we ignore patient safety issues or liability concerns. These are thorny issues, yet new technology offers interesting solutions. We will never know if any plan for medicine recycling can be safely done unless we begin the discussion. Although less preferable than newly manufactured medicine, recycling unused, expensive medicines may be a better alternative than the existing status quo.

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