Surplus drugs, once destroyed, now reach patients in need

August 6, 2013

By Leah Bartos
California Health Report

Several times a month, Jackie Gregg faced a dreaded chore. Gregg, a registered nurse at the Sunny View Retirement Community in Cupertino, would gather the facility’s unused medication and make two piles. One pile, to send back to prescribing pharmacies (few of which actually accept returns.) The other — larger — pile, to be incinerated.

But now, with the help of a Bay Area-based nonprofit aimed at connecting unused medication with patients who can’t afford it, Gregg has added a third pile: donations.

In an effort to both reduce waste and help patients in need, Supporting Initiatives to Redistribute Unused Medicine (SIRUM) has partnered with 150 health care facilities across California, enabling them to make use of their surpluses. Surpluses occur when patients die or are released, or when their prescriptions are changed.

Before SIRUM, Gregg said, it was agonizing to know that viable medication was being destroyed even as so many people couldn’t afford to buy it.

“It just really upset me to take this perfectly good medication that someone else could use and throw it away,” Gregg said.

Since joining SIRUM nearly two years ago, Gregg estimates Sunny View Retirement Community alone has donated at least $10,000 worth of medicine. In total, SIRUM has reported facilitating the donation of $1.45 million worth of medicine since its founding in 2009.

Aware of the high price of prescription drugs — one in three underinsured adults report skipping their prescriptions due to cost — and the $5 billion of medicine wasted nationwide each year, three Stanford alumni saw an opportunity to solve one problem with the other. The SIRUM founders created a peer-to-peer online platform where surpluses of medicine can be redirected to clinics serving medically indigent patients, who receive their prescriptions at no charge.

“The medicine goes directly from donor to clinic, so we really are like the Match.com for unused medicine,” said SIRUM co-founder and director Kiah Williams.

Knowing the busy workdays of medical professionals, SIRUM has strived to make the process as streamlined as possible, providing everything from packing supplies to delivery trucks.

Williams hopes once facilities get in the habit, donating their unused, unexpired medication will become second nature. “It’s a very simple process,” she said. “It’s like adding a recycling bin and reforming the daily habits of health facilities with no extra work.”

California, like most states, has a set of Good Samaritan laws that protect donors from liability and has recently been revised to make way for even more potential participants in SIRUM’s program. Williams says the organization is aiming to double its number of donors, and would like to establish similar programs in other states. Though the changes in the law have also made it easier to participate on the receiving end, at the moment, all the donations from nursing homes across the state are going to the county-run Santa Clara Valley Medical Center. Williams said SIRUM is eager to bring in other counties as well.

Mymy Phu, the supervising pharmacist at the Santa Clara Valley Medical Center, also encourages other counties join SIRUM. For one thing, Phu said, if they remain the only recipient of the donations, she worries that the volume of donations could overwhelm them.

“This is a program worth implementing because to me, this is a win-win situation, especially at the county level,” Phu said. “We have so many patients who walk through our door and need help.”

And, as Phu pointed out, it’s saving public money. In many instances, the donated medicine had been paid for by state-funded programs; the same medication that would have been destroyed and then paid for again with public money for another patient enrolled in state program.

In other cases, the donations fill the coverage gap many experience when it comes to certain types of prescription drugs. For instance, an insurance company may cover one type of drug, but not the formulation or brand that a doctor has determined would be the most beneficial to the patient, due to lifestyle or other underlying conditions.

Quelan To, the pharmacist in charge for the Valley Health Center at Lenzen, says having these particular — often times more expensive — drugs immediately available for distribution has improved their care delivery. She now can give patients their prescriptions immediately, whereas it would have taken days to go through bureaucratic processes.

“They need the meds now; they don’t need the meds three days from now,” To said.

Sometimes, she said, it could be that a patient’s insurance has simply lapsed, and having the donated medication from SIRUM allows them to continue their prescriptions in the meantime of sorting out insurance policies.

“You don’t see that direct impact until it actually happens that a patient comes and you can’t refill their meds because their insurance is not good. But now, since you have those meds, you can just give it to them for now while they go and renew their insurance,” To said.

One of the challenges, To said, is that the pharmacy never knows exactly what they can expect in the next donation, as it is all dependent on what’s leftover at the donating facilities. Additionally, under the law, not all types of drugs can be donated — narcotics, for example, are excluded from the donation list.

Still, To says the program has greatly impacted her work. She recalls one Medicare patient, who had no prescription drug coverage and had to weigh whether to pay for groceries or for his medication.

“It’s just heartbreaking to hear that kind of story. And you’re helpless. You want to help, but what can you do?” To said. “But since we have these meds now and we know it’s free, we can just give it to him.”

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