County may force drug companies to pay to get rid of your pills

SEATTLE - The King County Board of Health wants to create a program for residents to easily get rid of their unwanted medications, and it's expecting drug manufacturers to pay for it.

More King County residents die each year from prescription drug overdose than all illegal drugs combined, the Board of Health reports. Drug overdoses have surpassed car crashes as a leading cause of preventable death in the county, with the majority of overdoses involve prescription opiates.

"I don't think any single thing will cure the problem, but we know most abusers get those drugs from a friend's or family member's medicine cabinet," said King County Councilmember Joe McDermott, chair of the Board of Health.

The board is considering a regulation requiring drug producers selling medications for residential use in King County to provide and promote secure medicine return systems approved and overseen by Seattle & King County Public Health at no cost to the consumer.

"It's a reasonable requirement on drug companies," McDermott said. "Producers are making these drugs and there's no secure way of disposing of them."

The county's Hazardous Waste Management Program will initially pay for 200 uniform boxes to be placed in pharmacies and police stations where consumers can drop off unwanted medications anytime. Still, the majority of costs will fall on drug producers who will pay for collection supplies at drop-off sites; prepaid mailers for disabled or homebound residents; and collection events. Manufacturers would cover the cost to transport collected medicines and dispose of them by incineration. They would also pay for program promotion and evaluation, administrative costs and fees to Public Health to cover annual review and oversight.

McDermott estimates the program would cost drug manufacturers about 5 cents per prescription.

Drug manufacturers who do not comply with the new rule and regulation would face fines of up to $2,000 per day.

"Given the cost of drugs and the profits within the drug industry, I'm not concerned that drug companies can't afford this or that it will drive up the cost of the product," McDermott said. "That can easily be accommodated within the cost of doing business."

A similar requirement was enacted in Alameda County, Calif., in July 2012, but drug manufacturers have since filed a lawsuit claiming the local government interfered with interstate commerce.

We reached out to several local drug manufacturers but none were willing to comment on this issue.

Caleb Banta-Green, a research scientist at the University of Washington's Alcohol and Drug Abuse Institute, said the program could make a difference if it is well promoted. He said in 2008, opiate-related deaths dropped when prescribing decreased.

"It tells you that reducing the supply impacts death rates," Banta-Green said. "Every time a medication is prescribed, a doctor should say, 'Whatever you have not used, return it.'"

Banta-Green found that among a group of 12th graders surveyed in 2012, a third of prescription-drug abusers used their own prescription while 28 percent got the medication from a friend and 9 percent stole them from someone else's home.

Currently, the United States Drug Enforcement Agency only allows law enforcement to collect prescription drugs. But, the agency is in the process of modifying that rule to allow authorized manufacturers, distributors, reverse distributors, and retail pharmacies to voluntarily collect medications.

The United States Food and Drug Administration has previously recommended consumers dispose of drugs by flushing them down the toilet or throwing them in the trash, but this has brought up environmental concerns so that the United States Environmental Protection Agency now recommends prescription drugs be incinerated.

The new King County regulation would apply to prescription and non-prescription drugs, including pills, liquids and creams. It would exclude over-the-counter drugs that are regulated as cosmetics, such as toothpaste, sunscreen, medicated shampoos and vitamins and supplements.

The program has been recommended by the Board of Health's Subcommittee on Secure Medicine and will be up for discussion at a public hearing at 1:30 p.m. May 16.

If the Board of Health approves this rule and regulation, drug producers will have 12 months to submit a "stewardship plan" for drug return and three more months to implement it.