1. © Product Stewardship Institute, Inc. Update: PSI National Dialogue on Medical Sharps June 2, 2009 Product Stewardship Forum

2. © Product Stewardship Institute, Inc. The Sharps Issue 2 Sharps are used to deliver critical medications to patients (as well as for blood glucose testing) People, pets, livestock No disposal system for sharps used outside healthcare setting – most go to trash Exposes waste workers, others to potential needle- stick injuries Chances of disease transmission relatively small, but costs can be very high

3. © Product Stewardship Institute, Inc. Dialogue Goal 3 To maximize the safe and environmentally sound collection and disposal of waste sharps by developing a nationally coordinated system that is financially sustainable.

4. © Product Stewardship Institute, Inc. Dialogue Focus 4 This project is focused on sharps generated outside the traditional health care setting, including households, hotels, casinos, restaurants, airports, and other public venues. Sharps used for people and their pets are included. Agricultural sharps are not included.

5. © Product Stewardship Institute, Inc. Sharps & Product Stewardship: The Fun Parts 5 “Source reduction”? Patients have no choice; demographics Bans w/o plans Assigning/sharing responsibility - Device mfrs? Pharma mfrs? Waste industry? Many new stakeholders – what is EPR, anyway? CA bills 2008, 2009

6. Dialogue Participants 6

7. © Product Stewardship Institute, Inc. Dialogue Participants 7 – Device Mfrs: BD, UltiMed, Terumo, Covidien – Pharmaceutical Mfrs: NovoNordisk, Sanofi-Aventis, GSK, Hoffman-La Roche – Waste/recycling industry: Chrysalis Environmental Solutions, Health Waste Solutions, Sharps Compliance, Stericycle, Waste Management – Organizations: Coalition for Safe Community Needle Disposal, NACDS, NCPA, Association of Diabetes Educators

8. © Product Stewardship Institute, Inc. Dialogue Update 8 Action Plan Meeting #1 o Data o Projects Data are limited Sharps should not go to trash, but most do Impacts are difficult to quantify, but can be severe Current collection programs typically under-funded Effectiveness (performance goals) and sustainability (including financial) most important

9. © Product Stewardship Institute, Inc. Dialogue Update 9 Meeting #2 o Develop model state program (including financing) o Roles for all stakeholders, even if not direct financial contribution Meeting #3 o Refined roles; $ responsibility on companies o PSOs; voluntary v. legislated o Reviewed cost data o Asked PSI to facilitate developing MA Demonstration Project

10. © Product Stewardship Institute, Inc. What’s next? 10 Seeking commitment for Demonstration Project in MA CA legislation this year? MA legislation next year? Still plugging away…

11. © Product Stewardship Institute, Inc. Funders 11 Becton, Dickinson, and Co. – Diabetes Care MA Department of Public Health Waste Management, Inc. Sponsorships for meeting costs: UltiMed; Waste Management, Inc.

12. © Product Stewardship Institute, Inc. For more information 12 Sierra Fletcher Associate--Policy and Programs (617) 236-4886 Sierra@productstewardship.us PSI Email List: MedicalSharps@list.productstewardship.us