Transcript Slide 1

Pharmaceutical
Disposal Programs:
A Canadian Perspective
International Symposium on Pharmaceuticals in the Home and
Environment: Catalysts for Change
Maine, November 10-11, 2008
Edith Gagnon
Environmental Impact Initiative
Health Canada
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Outline
• Context
• Disposal programs
– Canada
– Other countries
• Other programs
• Next steps
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Context
• The Environmental Impact Initiative (EII) Division
of Health Canada, is researching Best
Management Practices (BMPs) for commodity
groups regulated under the Canadian Food and
Drugs Act (F&DA), including pharmaceuticals
• BMPs aim at reducing the exposure of the
environment to F&DA substances and products,
to prevent direct environmental impacts and
indirect human health impacts
• If necessary, existing Canadian BMPs will be
improved or more appropriate BMPs will be
developed
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Context (2)
• Pharmaceuticals are being found in the
environment
• Consumption versus disposal practices
– Canadian consumers dispose of a large part of their
unused and expired pharmaceuticals in garbage,
toilets, and sinks
• By changing the behaviour of consumers,
environmental contamination can be reduced
– Disposal programs may reduce the levels of
pharmaceuticals entering the environment
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Disposal programs
Program
• Canada
: Province
: Region/municipality/community
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Source: Wikipedia, 2007
Canada
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Alberta ENVIRx Program (since 1988)
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Alberta Pharmacists’ Association
Voluntary
Funded by producers with grants from provincial
government
Collection by pharmacies (up 7% from 2006-07)
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Antibiotics, painkillers, and medications for heart conditions
Encouraged to remove packaging
Sharps was accepted prior to 2000 (27 tonnes per year)
Incineration at Wainwright Regional Waste to Energy
Facility in Wainwright, Alberta
Brochures
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Canada (2)
• British Columbia Medications Return Program (since
1996)
– Post-Consumer Pharmaceutical Stewardship Association
– Recycling Regulation requires brand-owners to provide free
consumer access to return/collection facilities
– Funded by brand-owners
– Enforcement and monitoring responsibility of the provincial
government
• Regulated programs in development in Ontario and Manitoba
– Collection by community and hospital (out-patients) pharmacies
• Up 17% from 2006-07
• Participation of consumers ~20% and awareness ~31% in 2007
– Incineration at Beiseker Envirotech Inc. in Beiseker, Alberta
– Posters and brochures, websites, newspapers
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Canada (3)
• Nova Scotia Medication Disposal Program
(since 90's)
– Pharmacy Association of Nova Scotia
– Voluntary
– Destruction and transport are paid by
manufacturers
– Collection by pharmacies (up 18% from 200506)
• Also the Safe Sharps Bring-Back Program
– Incineration
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Canada (4)
• Prince Edward Island Take It Back
Program (since 2004)
– Island Waste Management Corporation
(provincial crown corporation)
– Voluntary
– Disposal is paid by the provincial government
– Collection by pharmacies
• Also the Don’t Get Stuck Program for sharps
– Licensed hazardous waste disposal facilities
off-Island
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Canada (5)
• Saskatchewan Pharmaceutical Waste Disposal
Program (since 1997)
– Pharmacists' Association of Saskatchewan
– Voluntary
– Pharmacies have to pay for the pick-up of
pharmaceutical wastes
– Collection by pharmacies
• Sharps are also accepted
– Incineration by BioMed
– Posters reminding consumers to return all expired or
unwanted pharmaceuticals, brochures and other
consumer information
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Comparison of Canadian programs
Program
Volume
Collected
Alberta ENVIRx
37 tonnes
0.01 kg/capita
British Columbia
Medications Return
Nova Scotia
Medication Disposal
Costs
Funding
100%
N.A.
Industry and
government
23 tonnes
0.005 kg/capita
96%
$294,185 Industry
$0.006/pill
10.6 tonnes
0.01 kg/capita
100%
$30,695
Government
$0.001/pill
Prince Edward Island 1.3 tonnes
Take It Back
0.01 kg/capita
N.A.%
N.A.
Government
90%
N.A.
Pharmacies
Saskatchewan
Pharmaceutical
Waste Disposal
Pharmacy
Participation
16.4 tonnes
0.02 kg/capita
Note: Weight may include packaging, sharps, etc.
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Other countries
• Australia Return Unwanted Medicines (RUM) Program
(since 1999)
– National Return & Disposal of Unwanted Medicines Limited,
national non-profit company
– Voluntary
– Funded by the government with limited support from industry
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Restricted to collection and disposal costs
Government initial funds: $3 million for 3 years
Federal budget for July 2005: >$6 million for 4 years
Funding review: June 2009
– Collection by pharmacies (up 2.3% from 2005 to 2006)
– Incineration
– Brochures and consumer awareness campaign for health
professionals and consumers
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Other countries (2)
• France Cyclamed Program (since 1993)
– Being restructured to stop the redistribution to destitute people of
France and emerging countries < 5 % (planned for 2009)
– Medicines distribution chain (pharmacies, wholesalers, industry)
– Pharmacies are required by legislation to collect and dispose of
pharmaceutical wastes (since 2006)
– Industry finances external costs and wholesalers provide
transportation from pharmacies to their facilities free of charge
• Collection, transportation, incineration (63%)
• Communication, personnel expenses, humanitarian donation (37%)
– Collection by pharmacies (down 6.2% from 2005-06)
– Incineration with energy recovery (7,000 houses x year)
– TV, radio, poster and comics
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Other countries (3)
• Spain Integrated Waste Management System (SIGRE)
(since 2002)
– Initiative of the Spanish pharmaceutical industry with the
collaboration of pharmacies and distributors
• European Directive 94/62/CEE on the management of packages
– Voluntary
– Funded by industry, based on volume of sales (non-profit)
– Collection by pharmacies (up 16.5% from 2006-07)
• Separation into toxic, non toxic, and recyclable materials
– Recycling or destruction
• Disposal into trash dropped from 42% in 2003 to 8% in 2007
– Logos and website
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Other countries (4)
• Portugal Valormed Program (since 2001)
– Initiative of the Portuguese Associations of the Pharmaceutical
Industry, pharmacists and distributors (European Directives)
– Voluntary
– Funded by members of the pharmaceutical associations,
including community pharmacies, pharmaceutical
manufacturers, pharmaceutical distributors, and chemical and
pharmaceutical importers
• Eco-fee of €0.00504 euro for each package placed on the market
– Collection by pharmacies (up 11% from 2006-07)
– Incineration
• Criticized for incinerating packaging rather than recycling them
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Other countries (4)
• Sweden Apoteket AB Environmental Program
(since 2002)
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Government (the national pharmacy)
Incorporated European Directive on waste into national legislation
Funded by the government (Apoteket AB, non-profit)
Collection by pharmacies (up 12% from 2006-07)
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Prescription, over the counter, recreational drugs, needles
Consumers, care centers, dentists, hospitals, farmers (vet products)
65% to 75% of all unused pharmaceuticals
Participation of consumers ~73% (target ~80% for 2010)
– Incineration (gas is cleaned before being released)
– Campaigns in media, at pharmacies and clinics in order to raise
awareness, transparent plastic bags provided to consumers to
dispose of their products
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Comparison of programs of other countries
Program
Volume
Collected
France Cyclamed 13,169 tonnes
Since: 1993
0.21 kg/capita
Pharmacy
Funding
Participation
90%
Industry, pharmacies and
wholesalers
(4,872,530 euros in 2006)
*0.09 kg/capita
Australia RUM
Since: 1999
377 tonnes
0.01 kg/capita
100%
Federal government
($1 to $1.5 million/year)
Portugal
Valormed
Since: 2001
630 tonnes
0.05 kg/capita
98.5%
Pharmaceutical Stakeholder
Groups (eco-fee applied to
all packaging)
Spain SIGRE
Since: 2003
2,624 tonnes
0.06 kg/capita
100%
Pharmaceutical industry
(eco-fee applied to all
packaging)
100%
Federal government
(national pharmacy)
(1,444,441 euros in 2006)
Sweden Apoteket 1019 tonnes
Since: 1970
0.1 kg/capita
Note: Weight may include packaging, sharps, etc. *Exclude packages
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Other programs
• Aimed at reducing pharmaceutical wastes
– By decreasing consumption and increasing
compliance, e.g.
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Reducing the size of prescriptions
Selecting the most appropriate therapies
Respecting quality of life and treatment costs
Promoting full use of prescriptions
Promoting the use and development of
environmentally-friendly pharmaceuticals
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Next steps
• How do pharmacies, health care facilities
(hospitals, long-term care facilities, nursing
homes, etc.), manufacturers, etc., dispose
of expired, unwanted, unsold
pharmaceuticals (as well as veterinary
drugs), and packaging (direct and external
packaging)?
– Survey Canadian health care sector and
manufacturers
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Next steps (2)
• What are the best environmentally friendly disposal
methods for pharmaceutical wastes (including any
products that may contain residues of pharmaceuticals,
i.e. packaging, sharps, human fluids, etc.)?
– A comparative analysis of final disposal practices for drug
wastes
• Does Canada need a national program and what should
be its scope (regulatory or non-regulatory, targeting
consumers, pharmacies, health care facilities, etc.)?
– Multi-stakeholder consultations with provincial, territorial and
municipal governments; industries; environmental nongovernmental organizations; and consumer associations
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Questions
&
Comments
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Pharmaceutical Disposal
Programs: A Canadian
Perspective
For further information about this presentation or to have a
copy of the paper please contact:
Edith Gagnon
(613) 948-7925
E-mail: [email protected]
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