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Pharmaceutical Disposal Programs: A Canadian Perspective Maine, November 10-11, 2008. International Symposium on Pharmaceuticals in the Home and Environment: Catalysts for Change. Edith Gagnon Environmental Impact Initiative Health Canada. Outline. Context Disposal programs Canada

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Pharmaceutical Disposal Programs: A Canadian PerspectiveMaine, November 10-11, 2008

International Symposium on Pharmaceuticals in the Home and Environment: Catalysts for Change

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


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Canada

  • Alberta ENVIRx Program (since 1988)

    • Alberta Pharmacists’ Association

    • Voluntary

    • Funded by producers with grants from provincial government

    • Collection by pharmacies (up 7% from 2006-07)

      • 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 2005-06)

      • 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

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

      • 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)

    • 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)

      • 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

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.

      • 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 non-governmental 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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