1. PSI National Dialogue on Waste Pharmaceuticals Product Stewardship Forum June 2, 2009

2. © Product Stewardship Institute, Inc. Spring 2009 Goal of the Pharmaceuticals Dialogue Reduce the amount of pharmaceuticals that become waste. Develop and implement a nationally-coordinated system for the safe, practical, legal, and environmentally protective management of waste pharmaceuticals.  Focus: waste pharmaceuticals generated from households, or as household waste (including pets). 2

3. © Product Stewardship Institute, Inc. Spring 2009 Process  Research/stakeholder interviews  2 meetings  4 workgroups  Research  Source Reduction  Collection/disposal  Regulations 3

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5. © Product Stewardship Institute, Inc. Spring 2009 5 Federal Government  U.S. Department of Transportation  U.S. Environmental Protection Agency  U.S. Food and Drug Administration  U.S. Postal Service  Office of National Drug Control Policy (observers)  Offices of Congressmen Inslee and Moran

6. © Product Stewardship Institute, Inc. Spring 2009 Pharmaceutical Companies/Waste Industry 6  AstraZeneca  BD Medical  GlaxoSmithKline  Generic Pharmaceutical Association  Hoffman-La Roche  Johnson & Johnson  King Pharmaceuticals ( and Alpharma)  Purdue Pharmaceuticals  Schering-Plough  Capital Returns, Inc.  Clean Harbors, LLC  Enserv West  EXP Pharmaceuticals  Heritage Environmental Services  Integrated Waste Control, LLC  PharmWaste Technologies  Sharps Compliance, Inc.  Stericycle  Veolia Environmental Services  Waste Management

7. © Product Stewardship Institute, Inc. Spring 2009 Pharmacies/Pharmacists/Healthcare Groups 7  American Pharmacists Association  Avalere Health, LLC  California Retailers Association  Healthcare Without Harm  Healthcare Distribution Management Association  Kaiser Permanente  Maryland Hospitals for a Healthy Environment  National Association of Chain Drug Stores  National Community Pharmacists Association  National Association of Consultant Pharmacists  National Association of Medical Device Reprocessors  PharmEcology Associates  Teleosis Institute

8. © Product Stewardship Institute, Inc. Spring 2009 Water, Environment & Public Health 8  Alliance for the Great Lakes  American Water Works Association  Association of State Drinking Water Administrators  Association of State and Interstate Water Pollution Control Administrators  California Product Stewardship Council & Northwest Product Stewardship Council  Clean Water Action  Earth 911  Environmental Working Group  IL/IN Sea Grant  Natural Resources Defense Council  National Association of Clean Water Agencies  National Association of Drug Diversion Investigators  National Safety Council  New England Interstate Water Pollution Control Commission  Oregon Poison Control  Save the Bay  Washington Citizens for Resource Conservation  Women’s Health and Environment Network

9. What is the size of the problem? The Problem Disposal Options for Waste Pharmaceuticals Household Trash Disposal Flushing (13 Substances) Take-backs Source Reduction Reduce Regulatory Barriers to Cut Cost, Ensure Safety, Enhance Environment Preferred Disposal Facilities

10. Clear & Consistent Message 10

11. © Product Stewardship Institute, Inc. Spring 2009 Facilitating Cost-effective Take-back 11 Comments to DEA Comments to EPA – UWR Change Input on Inslee/Moran bill Upcoming call to discuss next steps

12. © Product Stewardship Institute, Inc. Spring 2009 Trash vs. Take-back Some ready to move, some want more information Complex questions to answer: – What are people most likely to do? – Excretion v. disposal? – Impact on poisonings/diversion? Ultimate disposal options – Preferred disposal for envt/safety – Capacity – Upcoming calls 12

13. © Product Stewardship Institute, Inc. Spring 2009 Source Reduction Convene a summit to bring the “front end” and the “back end” of the problem together. Potential strategies: -use samples differently -dispense smaller quantities -improve patient compliance -more accurate dosing -choose drugs according to ecotoxicity 13

14. © Product Stewardship Institute, Inc. Spring 2009 PSI Letters of Support Maine Oregon Washington 14

15. http://www.takebacknetwork.com

16. © Product Stewardship Institute, Inc. Spring 2009 For more information PSI webpage: http://www.productstewardship.us/pharmaceuticals Sierra Fletcher, Associate-Policy and Programs (617) 236-4886 Sierra@productstewardship.us 16