Drug donation programs are initiatives that collect unused, unexpired medications from various sources and redistribute them to uninsured and low-income patients who need them. These programs can help reduce the cost burden of prescription drugs, improve health outcomes, and prevent environmental pollution. However, not many states have implemented effective drug donation programs, and some of the existing ones are underutilized or face challenges. In this article, we will explore how drug donation programs work, what benefits they offer, and what steps can be taken to expand and improve them.
The problem of prescription drug waste and affordability
Prescription drugs are essential for treating many health conditions and improving the quality of life of millions of Americans. However, a significant amount of prescription drugs go to waste every year, either because they are left unused, expired, or disposed of improperly. According to a 2016 study, an estimated $11 billion worth of unused medications are thrown away annually in the U.S., mostly by health care facilities, pharmacies, and individuals. This not only represents a huge economic loss, but also poses a potential threat to the environment and public health, as some drugs can contaminate water sources or be misused by others.
At the same time, many Americans struggle to afford their prescription drugs, especially those who are uninsured or underinsured. According to the National Health Interview Survey, about 8% of adults in the U.S. who took prescription drugs in 2021, about 9 million people, did not take them as prescribed because of cost, and uninsured adults were more likely to skip medications than those with insurance. This can lead to worse health outcomes, increased hospitalizations, and higher health care costs.
How drug donation programs can help
Drug donation programs are a potential solution to both the problem of prescription drug waste and affordability. These programs take unopened, unexpired medications from health care facilities, private residents, pharmacies, or prisons that pile up when patients are discharged, change drugs, or die, and re-dispense them to uninsured and low-income patients who qualify for the program. The donated drugs are usually screened for safety and quality before being redistributed, and the recipients are usually charged a minimal fee or nothing at all.
Drug donation programs can offer several benefits, such as:
- Saving lives and improving health: Drug donation programs can provide access to life-saving or life-improving medications for patients who otherwise could not afford them. For example, a drug donation program in Colorado, run by Open Bible Medical Clinic and Pharmacy, filled 1,900 prescriptions for 200 low-income and uninsured adults last year, mostly for chronic conditions such as diabetes, hypertension, and asthma. Many of these patients reported significant improvements in their health and quality of life after receiving the donated drugs.
- Reducing health care costs: Drug donation programs can also reduce health care costs for both patients and the health care system, by preventing or delaying the need for more expensive interventions, such as emergency room visits, hospitalizations, or surgeries. A 2019 study estimated that drug donation programs in Iowa saved the state’s Medicaid program $2.3 million in 2017, by providing medications to patients who would otherwise rely on Medicaid for their health care needs.
- Protecting the environment: Drug donation programs can also help protect the environment, by diverting unused medications from landfills or incinerators, where they can release toxic substances or greenhouse gases. A 2018 study found that drug donation programs in Nebraska prevented the emission of 1,686 metric tons of carbon dioxide equivalent in 2016, by reusing or recycling unused medications instead of burning them.
The challenges and opportunities for drug donation programs
Despite the potential benefits of drug donation programs, not many states have implemented them, and some of the existing ones are underutilized or face challenges. According to the National Conference of State Legislatures, 44 states already have laws allowing drug donations, but only 17 states have active programs as of 2020. Some of the barriers and challenges that hinder the development and effectiveness of drug donation programs include:
- Lack of awareness and participation: Many potential donors and recipients are not aware of the existence or eligibility of drug donation programs, or do not trust their safety or quality. Some health care facilities or pharmacies may also be reluctant to participate in drug donation programs, due to concerns about liability, regulation, or logistics. Therefore, more education and outreach efforts are needed to increase the awareness and participation of drug donation programs among various stakeholders.
- Lack of funding and resources: Many drug donation programs are run by charitable pharmacies, nonprofits, or governments, and rely on grants, donations, or volunteers to operate. However, these sources of funding and resources may be limited, unstable, or insufficient to meet the demand or expand the scope of the programs. Therefore, more sustainable and diversified funding and resources are needed to support the operation and growth of drug donation programs.
- Lack of standardization and coordination: Drug donation programs vary in size, structure, and operation, depending on the state laws, regulations, and policies that govern them. Some states have centralized programs that collect and distribute donated drugs statewide, while others have decentralized programs that operate locally or regionally. Some states have specific requirements or restrictions on the types, sources, or recipients of donated drugs, while others have more flexible or general rules. These variations can create confusion, inconsistency, or inefficiency among drug donation programs, and limit their potential impact or reach. Therefore, more standardization and coordination are needed to harmonize and optimize the practices and outcomes of drug donation programs.
To address these challenges and opportunities, some states are seeking to expand and improve their drug donation programs, by introducing new legislation, creating new partnerships, or adopting new technologies. For example:
- Colorado Senate Majority Leader Robert Rodriguez, a Democrat, said he plans to introduce a bill next year to create a drug donation program to help the estimated 10% of state residents who can’t fill their prescriptions because of cost. The bill would allow individuals, health care facilities, and pharmacies to donate unused medications to a central repository, which would then distribute them to eligible patients through participating pharmacies.
- California signed a legislation last year that allows expansion of the state’s first and only drug donation program, Better Health Pharmacy in Santa Clara County, to San Mateo and San Francisco counties. The program, which receives donated drugs from nursing homes, hospices, and individuals, has dispensed over 300,000 prescriptions to more than 30,000 patients since 2015, saving them over $40 million in drug costs.
- SIRUM, which stands for Supporting Initiatives to Redistribute Unused Medicine, is a nonprofit that uses an online platform to connect drug donors and distributors across the U.S. The platform allows donors to upload their inventory of unused medications, and distributors to request the medications they need for their patients. SIRUM then arranges the shipping and tracking of the donated drugs, and provides quality assurance and regulatory compliance. SIRUM has facilitated the donation of over 1.5 million prescriptions to over 200,000 patients since 2009.
Drug donation programs are a promising and innovative way to address the problem of prescription drug waste and affordability, by providing access to life-saving or life-improving medications for uninsured and low-income patients, while reducing health care costs and environmental impacts. However, more efforts are needed to expand and improve the availability and effectiveness of drug donation programs, by increasing awareness and participation, securing funding and resources, and enhancing standardization and coordination. By doing so, drug donation programs can help millions of Americans achieve better health and well-being.