In early 2016, Walgreens launched a safe medication disposal program in the United States, installing kiosks at 600 stores where customers could deposit unwanted pharmaceuticals. That continuous national effort was a first, not just for one of the country’s largest drugstore chains, but for any retailer in the country.
“People talk about safety and opioid abuse, but the other side that’s important is the environmental impact,” said Rick Gates, senior vice president of pharmacy and healthcare at Walgreens. A pharmacist by training, Gates’ responsibilities include collaborating with partners across the industry on patient-centered solutions to deploy through Walgreens’ healthcare providers in their stores.
Walgreens’ partner for the safe medication disposal program, Stericycle Environmental Solutions, won a 2017 Environmental Leader Award for the pharmaceutical takeback kiosks and envelopes. One of the judges called the suite a great example of social responsibility, saying at the time, “[The] program is diverting a waste stream, reducing pollutants in waterways, and addressing a serious opioid abuse epidemic in the United States.”
Recently we caught up with Gates to learn about the start of the program, the regulatory challenges that had to be addressed along the way, and how Walgreens plans to expand accessibility in the future.
What was the impetus for the program?
When I was in stores, patients would try to understand how to safely get rid of medications from their medicine cabinets at home. Throughout time there haven’t been good solutions — things like putting them in coffee grounds or trying to destroy them with fluids so that other people couldn’t use them. It was more about safety than both safety and sustainability.
Speaking as a pharmacist, they’re patients of yours. You see them throughout the year. You want to make sure you can help them. Walgreens, given our leadership and major presence in communities, said we have a responsibility, we should do more. We started exploring how we could help solve this issue.
What are the biggest risks with improper disposal?
People talk about safety and opioid abuse, but the other side that’s important is the environmental impact. A lot of people were informed to flush medications down the toilet. That can get into water supplies. Remnants can get into food products that are using the water. There is concern around where the byproducts of these medications end up.
How did the program start?
We started in 2016, when we announced that we were going to roll out about 600 safe disposal medication kiosks in 45 states, including the District of Columbia. We have a lot of stores within Walgreens and we tried to put them in convenient locations across the nation in a way that was not too far of a drive for patients.
The 45 states came from the regulations. We had to work through a lot of government entities — DEA, FDA, even the Department of Transportation — to come up with a process by which we could have patients return medications, have us get them back to circulation to our partner Stericycle, who then safely destroys them so they aren’t put out into water or into the environment. The regulation side was, quite honestly, the most challenging part of the program roll-out.
When you see the kiosks in our stores, they look like a box and it seems like a simple process, which is what you want for consumers. But I don’t know that I’ve had to go through as a complex of a process to try to come up with what, in our minds, is the right thing to do for patients.
How did you address those challenges?
We did work very closely with government entities to try to understand the rules and regulations, whether there were any that could be changed and still get a solution that was compliant. They understood what we were trying to do.
At the end of the day, we found a solution with some tweaks to existing rules, and some within states that wouldn’t allow us to at first. Not every state allows us to dispose of medications the way we have designed it for consumers, which is why we only have 45.
What happens to the medication?
It goes into the receptacle and in what is considered safe packaging for us to get it back to Stericycle. We actually have a party from Stericycle as well as our pharmacist there to validate, close it up, and allow it to be taken out of the location, due to the regulations. It goes through a finely tuned process that allowed us to comply with all the rules. The waste then goes to Stericycle, where it is safely incinerated so it does not go out into circulation in any other way. It’s a secure process.
The program is not just for prescription medications, it’s for the disposal of over-the-counter medications as well. We’re trying to make it as broad as possible.
What were the main lessons learned during the development of the program?
Don’t be afraid to ask questions, work with governing bodies, and come up with solutions that still comply. If it’s the right thing to do, they generally say “here are ways to think about it” or “here are different approaches you could use to still be in compliance.” Some are just rules, some are legislation, some can be changed easily and others cannot. You have to weigh all of those things.
Was there a question you asked governing bodies that produced an unexpected answer?
The most interesting one was, “At what point are medications that patients have at home considered hazardous waste?” As an example, if patients were to hand the medication to pharmacy staff, we have to treat that as hazardous waste. If they, as consumers, put it into the receptacle that is then duly emptied with Stericycle and ourselves, it’s considered consumer waste and treated separately. Those are the type of rules that you’re trying to work through.
Is there an underlying business case for the program?
It doesn’t have a true business case outside of trying to do right by patients and communities. The sheer numbers, the fact that we’ve collected more than 155 tons of unwanted medication in first 18 months of the program, goes to prove that there is a need in the marketplace.
Others in the industry in the supply chain have been willing to step up and help. We have been working with AmerisourceBergen, Blue Cross Blue Shield Association, Pfizer, and Prime Therapeutics to help us expand the availability. We’ll end up with close to 1,500 kiosks in the next few years.
Are there other initiatives at Walgreens around medications and the environment?
There are options where medications are put into compounds that will deactivate them so they will not leach out into the environment. We offer those solutions in all our stores, not just where we have the kiosks.
What does the future look like for the program?
We’re working with our partners to expand the program. Our goal is to end up with 1,500 kiosks with 300-plus tons of unwanted medications taken out of circulation in the next two years.
At that point we need to see what the demand shows, and if we need to continue to expand or come up with other options for consumers. From a CSR perspective, it’s a great way to support the health and wellbeing of our communities, and we’re always looking other ways of reducing our environmental impact.
The Environmental Leader Conference & Energy Manager Summit takes place May 15 – 17, 2018 at the Denver Marriott Tech Center. More information here.