During a 2004 campaign stop at a nursing home in Coventry, state Rep. Raymond J. Sullivan Jr. was taken aside by a member of the staff. He showed him “blister pack after blister pack” of unused medicines, he said, prescriptions that had been left behind by residents who had either died or switched drugs.
All of the medicines – which included popular brand names such as Lipitor – were slated to be flushed down a toilet, said Sullivan, D-Coventry and West Greenwich.
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He knew there was a need to examine the waste in the way prescription drugs were being dispensed. But the visit made him realize the issue was bigger than he thought.
“If this was happening at this one facility in my district, then it’s got to be happening all over the state,” he recalls thinking at the time. “And of course, it was.”
Now, armed with new rules based on legislation that Sullivan sponsored, the state may finally have a way to put the medicine to good use.
A pilot program that went into effect late last month allows for unused prescription drugs to be transferred from nursing homes or assisted-living residences to community health centers.
The medicines can then be re-dispensed within the state to residents considered medically indigent – people without insurance or with little ability to pay for medicine and health care.
The pilot, which will remain in effect until January 2007, allows nursing homes, pharmacists and patients to participate on a voluntary basis. Pharmacists must ensure the drugs are safe, determining whether they have been tampered with and if they have been stored properly.
With the regulations, Rhode Island is following the path of a number of states that have enacted similar laws, which follow U.S. Food and Drug Administration regulations that allow states to transfer drugs from nursing homes and assisted-living facilities, but which forbid unused medication from being redistributed once they are taken home by consumers.
In Oklahoma, the program has recently expanded its scope, going from the pilot stage to a statewide plan, said state Rep. Darrell Gilbert, House sponsor of Oklahoma’s legislation.
Like Rhode Island, Oklahoma’s laws allow for the drugs to be transferred from nursing homes to community health care facilities, such as county pharmacies, Gilbert said.
While the program has led to the redistribution of nearly $1.5 million worth of prescription drugs in Oklahoma, Gilbert said there was apprehension expressed about it initially. Pharmacists worried about the liability of re-dispensing medications, while nursing homes worried about potential extra costs. As a result, at the inception of the pilot program, only the county pharmacy in Tulsa was eager to participate.
But after language was put into the law removing liability for all participants in the voluntary program, Gilbert said the health care community was more willing to participate.
Sullivan, who said he had spoken to Gilbert while working out kinks in his bill, said the same liability issues arose during hearings for the Rhode Island legislation.
In the regulations approved by the General Assembly, no criminal or civil liability will fall on the Board of Pharmacy, residents who donated the drugs, charitable clinics or other facilities who reuse the drugs or any pharmacist operating in conjunction with the clinic.
Other provisions of the new regulations prohibit the donated drugs from being resold and any dispenser of the donated products from seeking reimbursement for participation.
With the pilot program now under way, Sullivan said he is looking to make other communities aware of it, increasing participation enough to bring the program statewide in 2007.
“This is a big first step in putting drugs, hopefully, in the hands of the people that need them most,” Sullivan said.
