pharmaceu)cal stewardship

Transcription

1 pharmaceu)cal stewardship in the U.S NYSAR3 conference dr. vivian fuhrman product stewardship ins)tute november 8,

2 who is the product stewardship ins)tute? 2

3 our goal reduce the health & environmental impacts of products across their lifecycle 3

4 product categories appliances with refrigerants framework gas cylinders carpet pes<cides auto switches <res radioac<ve devices solar panels 4

5 other product categories baaeries packaging paint electronics pharmaceu)cals HHW thermostats fluorescent lamps tex<les maaresses phone books medical sharps 5

6 ecological impacts water quality aqua)c environment 6

7 accidental poisonings drug abuse safety 7

8 climate change 8

9 9

10 a solu<on: drug take- back programs on- site receptacles mail- back envelopes must be convenient and sustainably funded 10

11 drug take- back challenges 1. convenience à at pharmacies 2. counter pharma lobbyingà through educa)on ü decision makers ü general public 3. sustainable fundingà through epr legisla)on 11

12 challenge #1: convenience dea rule on collec<on of controlled substances: Flexibility in collec<on of controlled substances Mail- back programs by DEA- authorized en<<es Take- back events by law enforcement agencies con<nue Addi)on of pharmacies as authorized collec)on sites Increase in poten<al collectors will lead to addi<onal permanent collec<on sites 12

13 psi drug take- back pilots 2016 usda- funded pilot in rural ny coun<es ü 4 independent pharmacies ü 1 hospital pharmacy pharmacy receptacles + mail- back envelopes community outreach/educa<on 2017 oklahoma deq pilot across state ü 5 independent pharmacies pharmacy receptacles community outreach/educa<on 13

14 challenge #2: educa)on for ny state 14

15 challenge #3: funding sustainable funding for community take- back 15

16 extended producer responsibility 16

17 state and local EPR laws around the na<on: EPR laws * 24 *while bo<le bills are highly effecbve at recovering beverage containers, this count does not include the 10 state bo<le bills in the U.S. due to the different ways in which the disparate policies shii responsibility to producers.

18 pharmaceu<cals EPR programs in canada and Europe manitoba france established in 2011 established in 1993 canada: 4 programs europe: 15 programs bri)sh columbia established in 1996 portugal established in 2001 Source: Health Products Stewardship Associa<on, 2015; Health Care Without Harm Report, 2013 hungary established in 2005 spain established in

19 pharmaceu<cals EPR in the united states legisla<ve ac<vity at local, state, & federal levels 20 EPR laws today 2 states (ma, vt) 14 coun<es (ca, wa, il, ny) 4 ci<es 19

20 u.s. EPR laws + legisla<on for pharmaceu)cals 20

21 pharms EPR legisla)ve trends 1. combine pharms and sharps law into one bill 2. pharmacy par)cipa)on mandatory vs. voluntary vs. middle ground only large chains of 3+ or 10+ stores 21

22 ny pharms legisla)on ny state bill: sen. hannon sponsored (S.6750) rep. gunther sponsored same as (A.387- b) westchester county bill erie county bill rockland county law

23 ny state pharmacy chain drug take- back bill reasons psi, nypsc + allies opposed bill: relies on mail- back more costly cost burden on and less effec<ve than kiosks retailers/customers instead of drug will not meet needs of rural/upstate manufacturers communi)es that don t have pharmacy chains would preempt local laws that require drug companies to take financial responsibility no mechanism to measure program effec)veness 23

24 ny state pharmacy chain drug take- back bill ~call to ac(on~ contact governor cuomo and tell him why bill a.387- b will not work for ny! ü ü ü ü missing manufacturer responsibility preemp)on of exis<ng local bills neglects rural communi<es does not ensure convenient drug take- back kiosks for all residents phone: web: contact- form write: Honorable Andrew M. Cuomo Governor of New York State NYS State Capitol Building Albany, NY

25 ny state pharms epr bill psi and nypsc: coali<on for strong pharms EPR bill for ny state ü based on best prac)ces ü no preemp)on of local laws ü working with ny assemblyman englebright to introduce 25

26 climate change and EPR Photo courtesy of Alex Cornell design for the environment vs. early obsolescence recycling vs. raw material responsible marke)ng/sales vs. over- prescribing 26

27 thank you! dr. vivian fuhrman senior associate for policy & programs (617)