Recycling Expensive Medication: Why Not?

Jay M. Pomerantz, MD


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

In This Article

Existing Programs

Leftover drugs prescribed for American patients with HIV are already being recycled for use overseas.[16] Aid for AIDS in Manhattan -- a nonprofit group with branches in Italy, Spain and Switzerland -- collects drugs after US patients with HIV switch prescriptions, stop medications, or die. The group passes these very expensive retroviral medicines along to more than 500 people with HIV throughout Africa, the Caribbean, and Latin America. In a less formal program, Dr. Mary Annel, a nun working in El Salvador, treats AIDS patients with leftover medicines, prescribed for American patients, that have been collected and shipped by their doctors (who Dr. Annel has enlisted).[16] Both of these efforts are quite legal; current American law makes it illegal to redistribute medications in the United States, but says nothing about exporting them.

There is also a small, domestic medicine recycling program working on a trial basis in Tulsa County, Oklahoma.[17] It operates under a special state statute and involves unused medications from 50 nursing homes. When a resident dies or changes medicines, the remaining medication is transferred to the county pharmacy for the use of indigent citizens. Only about 25 medications are eligible for the program, and each tablet or capsule has to be in its original individual unit (blister wrapped). After weekly pick up by a small corps of retired physician volunteer drivers, the county pharmacist examines the donations for signs of tampering before releasing the medicine for reuse.

The Texas State Board of Pharmacy also just passed a law (HB 2292) that allows all kinds of healthcare institutions to return prescription drugs to pharmacies. These returns must be certified by the facility consultant pharmacist as sealed in the manufacturer's original unopened tamper-evident packaging and either individually packaged or packaged in unit-dose packaging. The pharmacist in the receiving pharmacy also must examine and ensure the integrity of the product. Liability protection for all participants in proper medication recycling is stipulated within the law.

Without fanfare, hospitals, too, all across the country have long internally recycled unused medications returned from patient floors, whenever the original unit dose packaging is intact.