Edith Gagnon

1
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

2
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
  (FDA), including pharmaceuticals
• BMPs aim at reducing the exposure of the
  environment to FDA 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
Source Wikipedia, 2007
6
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 Dont 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 gt6 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
  lt 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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QuestionsComments
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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
• [phone]
• E-mail edith_gagnon_at_hc-sc.gc.ca