Lessons Learned from the Reverse Distribution Industry and Implications for National Consumer Take-Back Programs 5th Annual Maine Benzodiazepine Study Group Conference & 4th Annual Unused Drug Return Conference Improving Patient Safety through Informed Medication Prescribing and Disposal Practices November 1, 2007 Portland, Maine Mark Harvey Director of Operations EXP Pharmaceutical Services Corp. © 2007 EXP Pharmaceutical Services Corp.

Industry Overview What is a Reverse Distributor? –Returning Potentially Creditable Pharmaceuticals –Waste Determination and Management at Reverse Distributor’s Facility –Assisting Current Customers in Waste Management and Education by: Initial training of Pharmacy staff by Reverse Distributor personnel Processing report data that includes reasons for credit ineligibility Non-compliance incident reports

Regulatory Challenges –DEA: Memorandum of Understanding Allow Bay Area pilot program –USPS: Packaging & Labeling Acceptable Materials –State: MWMA (Medical Waste Management Act) LTC Homes SB966 (signed by Governor Schwarzenegger)

Differing Opinions –Materials Collected: Non-Controlled Substances Controlled Substances Medical Waste –Type Of Program: Drop-Off vs. Mail-Back –Type Of Treatment: Incineration Hazardous Waste Treatment

Financing –Who?: Consumers? Waste Water Agencies? Retailers? Insurance Companies? Local, State or Federal Government? Manufacturers? –How?: Surcharge On Prescriptions? Higher Utility Bills? Higher Insurance Rates? Higher Taxes? –How Much?: Per Pound? Per Script? Per Mailer?

Implications –Reduces Teen Pharming –Increases Patient Safety –Environmental Impact –Child and Elder Safety

Partnerships –Waste Water Agencies –City and State Government –County Health –Public/Private Organizations –BAPPG (Bay Area Pollution Prevention Group) –Save The Bay (NGO) –Pharmacies –EPA –USPS –DEA –DHS –DTSC

Questions? Mark Harvey Director of Operations Warm Springs Blvd Fremont, CA Phone: