How to Reduce Pharma Drug Waste in Florida

Sharon Roberts AttorneyAccording to the Florida Department of Environmental Protection, properly managing pharmaceutical waste products produced by different types of medical facilities can pose a real challenge. Not only do medical facilities need to comply with all required hazardous and solid waste regulations, but they must also ensure compliance with regulations from the Department of Health and the Board of Pharmacy, the Department of Transportation ( with particular attention to the Pipeline and Hazardous Materials Safety Administration). This particular waste stream also needs to conform to the Drug Enforcement Agency, the regulations set forth by the Occupational Safety and Health Administration as well as those standards set by local publicly owned water treatment facilities. Owing to the vast number of regulatory bodies that medical facilities are subjected to, in addition to staying up to date on the most current standards and guidelines, reducing the amount of pharmaceutical drug waste produced by the facility is one way to approach this mountain of regulations.

With this in mind, the Florida State Department released a set of guidelines to encourage waste reduction at these types of facilities.

 

Drug Sample Reduction:

To reduce the amount of sample drugs that go to waste, the document suggests the following: : 1. Ensure that drug reps sign in and list what they leave behind. This will help to maintain an accurate inventory of drugs on hand.

2. Only accept sample drugs you know will go to use soon.

3. Do not accept drugs with an expiration of less than 1 year.

4.Ensure that drug products are rotated on the shelves.

5. Consider moving to a voucher system (as many clinics already have) in order to eliminate samples.

Hospital drug waste reduction:

Some of the information originally appeared in; “Practice Greenhealth’s Managing Pharmaceutical Waste – A 10 Step Blueprint for Healthcare Facilities in the United States available at: http://cms.h2e-online.org/ee/hazmat/hazmatconcern/pharma/

 

1.Lifecycle matters

a. Do not accept drugs with less than one year dating unless that is all that is available and the drugs will definitely be used.

b. Choose products that have less packaging, (particularly P-listed drugs). Packaging must be handled as hazardous if it comes into contact with a P listed drug.

c. Choose products without preservatives, especially Thimerosal or phenylmercuric acetate which must be handled as hazardous waste.

d. Choose single dose containers that don’t need preservatives.

 

2. GET the Maximum use out of OPENED CHEMOTHERAPY VIALS

3. LABEL DRUGS FOR HOME USE Medications must be returned to the pharmacy for destruction when the patient is discharged unless there is a discharge prescription from the doctor and proper labeling for the container(s). Because this causes delays in the discharge process, the prescriptions are often abandoned by the patient. a. Consider including pre-authorized discharge orders for maintenance medications. b. Produce labels in the units to avoid waiting for prescriptions from the pharmacy.

4. PRIME AND FLUSH IV LINES

a. Pharmacies should prep all chemotherapy IVs with saline before dispensing.

b. Ensure that nurses flush the tubing after administration to ensures that the patient receives the complete dose and decreases the chance of employee exposure.

c. Flushed IV lines can be managed as trace chemotherapy waste.

5. Review THE SIZE OF the CONTAINERS in relation to how they are used

a. Implement a survey of drugs that are routinely wasted because the prepared product is too large for complete administration.

b. Try purchasing different dosage formulations of these drugs to permit varied dosages to patients.

c. Inform your General Purchasing Organization if the appropriately sized product is unavailable.

 

Although minimizing drug waste does not absolve a medical entity of their responsibilities in properly following various protocols for medical waste disposal, but reducing the amount of waste to manage can have its advantages.