Pharmaceutical Sales Management Newsletter Vol. 1 Issue 7 - PowerPoint by rst60617

VIEWS: 13 PAGES: 27

More Info
									    Green Pharmacy Campaign
                    Helping Communities
             Safely Dispose of Unused Medicines




                            www.teleosis.org



Teleosis Institute | 1521B 5th Street | Berkeley, CA 94710 | (510) 558-7285
Why Green Pharmacy?
 Of the 4 billion prescriptions to be filled in the US in 2007, the elderly
    population will waste more the $1 billion of drugs1
   On average, 40% of prescription medicines are not used by patients
    and are flushed or thrown away.2
   There are no city, state, or national programs available to safely recycle
    these medicines.
   Stored medications in the home are rapidly becoming a major source of
    accidental poisoning of small children, the elderly, and even pets3.
   Medication errors result in more than 700,000 emergency room visits
    each year.4
   Drugs flushed down the toilet or thrown in the trash will eventually
    end up in our drinking water!

* Information sourced from the Community Medical Foundation for Patient Safety
The Problem
                                      Global Pharmaceutical Sales, 1998-2005

                        $700
Total Global Sale US$




                                                                                                 $602
                        $600                                                             $559
                                                                                $497
                        $500
                                                                      $427
                                                             $390
                        $400                        $356
                                           $331
                               $298
                        $300

                        $200

                        $100

                         $0
                               1998      1999      2000     2001     2002     2003     2004     2005


                                       Source: EyeforPharma (http://wiki.eyeforpharma.com)
Global Pharmaceutical Sales
by Region, 2005
  World
                     2005 Sales        % Global         % Growth Year-over-
  Audited
                     (US$B)            Sales            Year (Constant $)
  Market
  North America $265.7                 47.0%            5.2%
  Europe             $169.5            30.0%            7.1%
  Japan              $60.3             10.7%            6.8%
  Asia, Africa
                     $46.4             8.2%             11.0%
  and Australia
  Latin America      $24.0             4.2%             18.5%
  Total IMS
                     $565.9            100%             6.9%
  Audited
                  Source: EyeforPharma (http://wiki.eyeforpharma.com)
Emerging Evidence
 March 2008 Investigation by the Associated Press:
   Traces of pharmaceuticals — including antibiotics, anti-
    convulsants, mood stabilizers and sex hormones — were found in
    the drinking water supplies of 24 metropolitan cities, affecting 41
    million Americans. 5
 2002 Report from the U.S. Geological Survey:
   80% of the waterways sampled included common medications such
    as acetaminophen (24%), the hormone estrodial (16%), Ditiazwm –
    a blood pressure medication (13%), Codeine (11%), and antibiotics
    (10%).6
A Growing Problem
 U.S. EPA Office of Research and
 Development’s Strategy Plan 2000 named
 pharmaceuticals and personal care products
 (PPCPs) as one of the top five “emerging”
 contaminants affecting human and
 ecological health7
 The increase in drug use coincides with an
 increase in the amount of medications that
 enter into and contaminate the environment
How Do Pharmaceutics Enter The
Environment?
 54% of people throw medicines into the trash8
 35% of people flush medicines down the toilet8
 95% of antibiotics are excreted unaltered into the
  environment9
          90% come from agricultural uses

 Wastewater treatment cannot remove medicinal
  compounds
Health of Ecology vs.
Ecology of Health
 How the environment effects us!
 Research found that a mixture of 13 common
  medications found in drinking water inhibits cell
  growth and causes negative changes in human
  embryonic cells10
 More research is needed!
 Precaution is required!
Green Pharmacy Pilot Program
 Free and safe disposal for unwanted medicines
    Launched in May 2007
    15 active take-back sites in the Bay Area
    Community recycling events
    Collected over 1000 pounds of unwanted medicines
    Pilot study documents all returned medicines


 Educates the public and health professionals
  Educational brochures: Green Pharmacy Program; Drugs In Our Water
  Symbiosis Journal: Pharmaceutical Pollution Prevention Issue
  Teleosis Website & Newsletter
Purpose of Green Pharmacy
 Reduce pharmaceutical pollution
 Provide environmentally safe disposal solutions
 Assess the quantity and value of household pharmaceutical
  waste
 Document which medicines are most commonly unused
 Engage all stakeholders
  (manufacturers, health professionals, government, consumers, waste haulers, etc.)
 Promote cradle-to-cradle product stewardship
 Develop a program that can be replicated nationwide
 Foster a model health that uses personal wellness strategies
  in minimizing pharmaceutical waste
Preliminary Data
from 6/1/07 to 12/31/07

 690            Pounds of drugs collected
   101,359      Estimated number of returned pills, capsules, tablet
   $400,000     Estimated retail value of unused medicines
   60.43%       Prescriptions
   39.14%       Over-the-counter
   2.15%        Controlled substances (turned away)
         Percentage of Medications Wasted
      52%       Over-the counter medicines were unused
      45%       Prescription medications
Preliminary Data
from 6/1/07 to 12/31/07
 Reason for Return Medicines
    Expired/outdated                 72.14%
    Patient died/moved away          15.74%
    Patient didn’t want to take it   4.88%

 Origin of Returned Drugs:
    Pharmacy                                  46.22%
    Doctor’s office                  30.85%
    Hospital or clinic                        5.67%
Preliminary Data 2007
Top 10 Therapeutic Agents Returned:
  1)  CNS agents (central nervous system)   22.62%
  2) Nutritional products                   14.29%
  3) Psychotherapeutic agents               12.51%
  4) Gastrointestinal agents                8.99 %
  5) Cardiovascular agents                  8.77%
  6) Respiratory agents                     6.00%
  7) Anti-infectives                        6.00%
  8) Alternative medicines                  5.69%
  9) Hormones                               4.60%
  10) Immunologic agents                    2.85%
Preliminary Data 2007
Top 10 Brand Name/Generic Drugs Returned:
1)  Acetaminophen
2) Aspirin
3) Tylenol
4) Vitamin E
5) Prednisone
6) Ibuprophen
7) Warfarin
8) Topamax
9) Etodolac
10) Gabapentin
6


5
                                                                                      4.8
                                                                             4.4
4                                                                     4
                                                             3.6
                                                    3.2
3                                          2.9
                                  2.6
                         2.3
2               2.1
       1.9

1


0
    1992     1994     1996     1998     2000     2002     2004     2006   2008     2010
Pharmaceutical Expenditures
and Cost of Waste 2008
 Pharmaceutical Expenditure $243 Billion Dollars


 Costs of Collected Waste Based on Green Pharmacy
  2008
 Cost to dispose              $ 70 Million Dollars
 Average Retail Value         $ 7.8 Billion Dollars

 Potential Cost of All Available Pharm Waste in The US
 Cost to Dispose              $610 Million Dollars
 Potential Retail Value       $ 71 Billion Dollars
     Pharmaceutical Expenditures and Cost of Waste

    $400

    $350

    $300

    $250

    $200

    $150

    $100

     $50

       $0
        2007            2008    2009        2010            2011     2012           2013

   Pharmaceutical Expenditure     Cost of Waste Collected          Cost of Total Waste Generated



Projections are based on Green Pharmacy 2007 Preliminary Report 14
Cradle to Cradle Medicine
 In theory, waste occurs when the prescription isn’t
  effective
 If we get to the point where we have no leftover drugs,
  will that lead to improved therapeutic outcomes?
 Will learning about what is unused will improve the
  quality of medical care?
    Christian Daughton, PhD Senior Scientist EPA
Green Pharmacy Program
 A proactive, voluntary holistic stewardship
  program
 Cradle-to-Cradle Product Stewardship
 All sectors involved with the production,
  distribution, prescribing, marketing, and
  consuming of medicines should be involved
  with proper disposal.
Cradle-to-Cradle
Product Stewardship
 Manufacturing Sector
   Pharmaceutical Manufacturing
   Reduce ecological footprint
   Reduce packaging, extend expiration dates
   Green Chemistry
 Health Care System
   Hospitals
   Primary Care
   Hospice
   Pharmacies
Cradle-to-Cradle
Product Stewardship
 Government and Law Enforcement
 Waste Management Agencies
 NGO- Environmental Organizations
 Consumers
 Who pays
   Pharmaceutical Industry
   Waste management industry
   Advanced Recycling Fee
   Medical Profession
What Physicians Can Do
 Only prescribe the amount of medicine you would like
    your patient to take.
   Review and regularly reassess the patient’s total
    consumption of medication
   Consider environmental impact when prescribing
    medications
   Learn more about which drugs have large environmental
    impacts
   Educate consumers about the importance of proper
    disposal of pharmaceutical waste
   Educate patients about the value of health promotion and
    healthy lifestyle
    What We All Can Do!
   Dispose of unwanted medications at take-back sites or events
   Do NOT dispose of any medication down the toilet or in the trash
   Purchase drugs in small amounts, limiting expired medications
   Ask for medications with low environmental impact
   Encourage your provider to take-back unwanted drugs
   Share the message of safe disposal with family and friends
   Commit to wellness strategies to reduce your reliance on
    medications
References
   1. Morgan. T.m (2001) The economic impact of wasted prescription medication in an outpatient
    population of older adults.” J. Family Practice Vol. 50 pp 779-781
   2. Maine Benzodiazepine Study Group, University of Main, Center on Aging (2006) Paper on
    Unused and Expired Medicines presented by Mathew Miraeles
   3. Minnesota Poison Control System, Hennepipn County Center, “Seniors and Medication Safety”
   4. Houston Chronicle (2006) Everyday medicines, big Risks” October 19, 2006, B2
   5. Donn, J, Mendoza, M & Pritchard, J. AP Probe Finds Drugs in Drinking Water, 2008
   6. Kolpin, Dana et al. Pharmaceuticals, hormones and other organic wastewater contaminants in
    US streams, 1999-2000: a national reconnaissance. Environmental Science and Technology. 2002;
    26: 1202-1211
   7. Daughton C, Ternes T. Pharmaceuticals and personal care product in the environment: agents of
    subtle change? Environmental Health Perspectives. 1999;107(Suppl 6): 907-943.
   8 Boehringer S. What’s the Best Way to Dispose of Medications? Pharmacists’/Prescriber’s letter
    (2004).
   9. Choi, C.O. Pollution in Solution, Drug-Resistance DNA as the Latest Freshwater Threat.
    Scientific American. Jan 2007: 22-23.
   10. Pomati, F et al, Effects of a Complex Mixture of Therapeutic Drugs at Environmental Levels on
    Human Embryonic Cells, Environ. Sci. Technol., 40 (7), 2442 -2447, 2006
Green Pharmacy Campaign
         Helping Communities
  Safely Dispose of Unused Medicines
       Joel Kreisberg, DC, MA
            Executive Director
              Teleosis Institute
                (510) 558-7285
           DrKreisberg@teleosis.org
              www.teleosis.org

								
To top