Recommendations for Home-Generated Pharmaceutical Collection Programs in California

Recommendations for Home-Generated Pharmaceutical Collection Programs in California

DisclosureThe presenter DOES NOT have an interest in selling a technology, program, product, and/or service to CME/CE professionals.

Objectives• Gain a broader context• Assess program types• Compare free-market results

3

International Context

44


55


66


77


88


99


1010


1111


1212


1313


1414


1515


1616


1717


1818


1919


2020


2121


2222


2323


2424


2525


2626


2727


2828


2929


3030


3131


3232


3333


3434


3535


3636


3737


3838


3939


4040


4141


4242


4343


4444

France80% of available


4545

France80% of available$0.12/lb

California Programs

46

4747

4848

4949

5050

5151

5252

5353

5454

5555

56

57

Surveys86% Response Rate

0

20

40

60

80

100

120 112

65

26

38

53

3

102

63

1824

46

3

Known # of programs/sitesPrograms/sites in survey

58

Programs begun before model guidelines (2008)Pre-existing Programs

PharmaciesLaw Enforcement HHW All Other Events (n/a) Mailback Total0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

83%

30%

100%

78%

0% 0%

66%

59

Model Programs

0

10

20

30

40

50

60

70

80

90

100

5

45

613

17

3

97

1812 11

29

0

Model Programs Non-Model Programs

5%

71%

33% 54%

37%

100%

60

Evaluation Criteria• Safety• Accessibility• Cost Effectiveness• Efficacy

61


62

% of Non-Model Pharmacies per CriterionEvaluation – safety (Pharmacies)

Two-key collection bin?Lock bin when full?

Bin is not publicly accessible?Only police collect controlled substances?

Secure drug waste container?Participants access to drugs?

Permission to store longer than 90 days?Maintaining a log?

Log accompanies controlled substances?CDPH-registered hauler?

0% 20% 40% 60% 80% 100%

93%84%

65%2%

32%

25%51%

2%11%

Appropriate Access

Track Responsibility

63

% of Non-Model Pharmacies per CriterionEvaluation – safety (Pharmacies)






0% 20% 40% 60% 80% 100%

93%84%

65%2%

32%

25%51%

2%11%

Appropriate Access


64

% of Non-Model Law Enforcement per CriterionEvaluation – safety (law enforcement)






0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%

0.285714285714286

0.0158730158730159

0.222222222222222

0.0476190476190476

0.285714285714286

Appropriate Access


65

% of Non-Model HHWs per CriterionEvaluation – safety (HHW)






0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%

0.444444444444444

0.5

0.111111111111111

Appropriate Access


66

% of Non-Model Events per Criterion






0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%

0.152173913043478

0.456521739130435

0.0869565217391305

Appropriate Access


Evaluation – safety (Events)

67

% of Non-Model Mail-Back per Criterion






0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%

Evaluation – safety (Mail-back)

Appropriate Access


68


69

Number of program sites (% of total)Evaluation – accessibility

Pharmacies Law Enforcement HHW Events Mailback0%

5%

10%

15%

20%

25%

30%

35%

40%

45%40%

25%

7%

18%

1%

70

Number of potential program sites (% actual sites out of total potential)

Evaluation – accessibility

Pharmacies Law Enforcement HHW Events Mail-back0

5,000

10,000

15,000

20,000

25,000

6,100(2%)

900(7%)

140(13%) n/a

23,160(n/a)

71

Average Number of Access Hours per DayEvaluation – accessibility


5

10

15

20

9

19

3

7

24

8

mailer pickup hours

72


73

Average Cost per PoundEvaluation – cost effectiveness

Pharmacies Law Enforcement HHW Events Mail-back$0

$1

$2

$3

$4

$5

$6

$7

$5.60

$4.56

$2.86

$6.06 $6.54

74


75

Average Pounds Collected per Day of OperationEvaluation – efficacy

Pharmacies Law Enforcement HHW Events Mailback0

20

40

60

80

100

120

140

160

180

2 7.1 2

163

1.2

76

Total Pounds Collected by Program Type (July 1, 2009 to March 1, 2010)

Evaluation – efficacy


40,000

80,000

120,000

160,000

200,000

18,120

194,522

9,349 5,040 898

77

Average Pounds Collected per ProgramEvaluation – efficacy


500

1,000

1,500

2,000

2,500

3,000

3,500

178

3,088

519

110299

78

Free Market Results

79

San Francisco$110,000



Mailer Sale SitesFree Market Results

83

Pharmacy mailer sale sites

(national)

California program/sites

0

5,000

10,000

15,000

20,000

25,000

Walgreens7561

Rite-Aid 4700

Kroger 1900

CVS* 7200

256

Total21,361

* CVS started selling mailers in August 2011 when the collection rate (at right on next slide) was determined.

Mailer Sale Sites and Annual Collection RatesFree Market Results

84

0

5,000

10,000

15,000

20,000

25,000

020406080100120140160180

Walgreens7561

Rite-Aid 4700

Kroger 1900

CVS* 7200

256

74

177

tons

Total21,361

* CVS started selling mailers in August 2011 when the collection rate (at right) was determined.** Includes all programs, presumably including Maine’s 1.2 tons by Apr. 2010 and California’s 0.6 tons by Aug. 2010.

Ontario, Canada Annual Collection Rates (tons)

2002 2003 2004 2005 2006 2007 2008 20090

50

100

150

200

250

300

350

400

26 28 32 44 44 46 63 58

275.577828

Municipal Non-municipal

tons

47% of total

Free Market Results

Collection RatesFree Market Results

United States (mailers)

California Ontario EU average France0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

0%9%

47% >50%

80%

Questions?Burke Lucy(916) [email protected]

mailto:[email protected]

Documents

Recommendations for Home-Generated Pharmaceutical Collection Programs in California