Later On

A blog written for those whose interests more or less match mine.

America’s Other Drug Problem

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Marshall Allen reports in ProPublica:

Every week in Des Moines, Iowa, the employees of a small nonprofit collect bins of unexpired prescription drugs tossed out by nursing homes after residents died, moved out or no longer needed them. The drugs are given to patients who couldn’t otherwise afford them.

But travel 1,000 miles east to Long Island, New York, and you’ll find nursing homes flushing similar leftover drugs down the toilet, alarming state environmental regulators worried they’ll further contaminate the water supply.

In Baltimore, Maryland, a massive incinerator burns up tons of the drugs each year — for a fee — from nursing homes across the Eastern seaboard.

If you want to know why the nation’s health care costs are among the highest in the world, a good place to start is with what we throw away. Across the country, nursing homes routinely toss large quantities of perfectly good prescription medication: tablets for diabetes, syringes of blood thinners, pricey pills for psychosis and seizures.

At a time when anger over soaring drug costs has perhaps never been more intense, redistributing discarded drugs seems like a no-brainer. Yet it’s estimated that American taxpayers, through Medicare, spend hundreds of millions of dollars each year on drugs for nursing home patients — much of which literally go down the tubes.

“It would not surprise me if as much as 20 percent of the medications we receive we end up having to destroy,” said Mark Coggins, who oversees the pharmacy services for Diversicare, a chain of more than 70 nursing homes in 10 states. “It’s very discouraging throwing away all those drugs when you know it can benefit somebody.”

No one tracks this waste nationwide, but estimates show it’s substantial. Colorado officials have said the state’s 220 long-term care facilities throw away a whopping 17.5 tons of potentially reusable drugs every year, with a price tag of about $10 million. The Environmental Protection Agency estimated in 2015 that about 740 tons of drugs are wasted by nursing homes each year.

This is, of course, part of a bigger problem. The National Academy of Medicine estimated in 2012 that the United States squanders more than a quarter of what it spends on health care — about $765 billion a year.

ProPublica is investigating the types of waste in health care that academics and politicians typically overlook. Our first installment examined the tens of millions worth of equipment and brand new supplies that hospitals jettison.

Today we look at the wasteful, and potentially harmful, ways nursing homes dispose of leftover meds — and how some states, like Iowa, have found a solution.


On a recent Wednesday in Des Moines, Ami Bradwell, a certified pharmacy technician, popped open the lids of several 31-gallon bins full of prescription drugs. In each were hundreds of what are known as “bingo cards” filled with rows of pills in sealed bubbles.

“Metformin — for diabetics,” Bradwell said, holding up a card of large white pills. “It’s not crazy expensive, but it’s in high demand.”

She held up an entire box of the anti-nausea drug Ondansetron. It goes for about $5 a pill, according to the website drugs.com. “Expensive.”

Another card had three large pills stuffed in each chamber, a find Bradwell called “a ‘jackpot’ card. You can’t live without it because it’s a seizure medication.”

Bradwell works for the nonprofit SafeNetRx. Each week the group takes in dozens of bins full of such drugs, as well as boxes mailed in from across Iowa and several other states — pharmaceutical trash that exists because, for convenience and cost, long-term care pharmacies often dispense nursing home patients’ medications in bulk, a months‘ worth at a time.

Should a patient die, leave or stop taking the drug, what’s left is typically tossed. The drugs have already been paid for, by Medicare in most cases, so there’s little incentive to try to recycle them. In some states, such reuse is against the law.

Some of the cards Bradwell examined that day were missing only a few pills. One card had been thrown out even though it only lacked one of its 31 doses of oxybutynin, which reduces muscle spasms of the bladder. The remaining 30 are worth more than $13.

“There are literally millions of dollars of prescription medications thrown away every day in this country,” said John Forbes, an Iowa pharmacist who dispenses SafeNetRx’s recovered drugs to his low-income patients.

Although most states technically allow some leftover drugs to be recycled, Iowa is one of the few rescuing a significant percentage of the drugs from destruction. The state funds the program for about $600,000 a year, said SafeNetRx CEO Jon Rosmann, who calls it a “common sense” solution. In fiscal 2016 the program recovered and distributed drugs valued at about $3.4 million. This year it’s on pace to top $5 million. . .

Continue reading. There’s a lot more, and it is interesting.

Written by LeisureGuy

27 April 2017 at 2:06 pm

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