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National Conference of State Legislatures (NCSL) http://www.ncsl.org/IssuesResearch/Health/StatePrescri ptionDrugReturnReuseandRecycl in/tabid/14425/Default.aspx Retrieved July 1, 2010.

Issues & Research » Health » State Prescription Drug Return, Reuse and Recyclin



## State Prescription Drug Return, Reuse and Recycling Laws

Updated November 2009; material added March 15, 2010 NCSL has identified and tracked state legislation to cre ate prescription drug “recycling,” “repository” or "re distribution" programs for unused medication. While details of the laws vary, mos t allow the return of prescription drugs in single use o r sealed packaging from state programs, nursing homes and other medical facilitie s. The medicines are then redistributed for use by need y residents who cannot afford to purchase their prescribed drugs. So me states include provisions for the financial terms of t he donations or regulating resale. Virtually all laws include some restriction s designed to assure purity, safety and freshness of the products. Unless otherwise noted, all programs require:



###  All donated drugs must not be expired and must have a verified future expiration date. [see consumer guidelines ]



###  Controlled substances, defined by the federal Drug Enfo rcement Administration (DEA) usually be excluded and proh ibited.



###  A state-licensed pharmacist or pharmacy to be part of the verification and distribution process.



###  Each patient who is to receive a drug must have a val id prescription form in his/her own name. At least 38 states and Guam have enacted such laws a nd programs to date. Not all laws or programs are oper ational. See state table below for further details and definitions.

Drugs for Cancer: The enacted program designs in six states, Colorado, Florida, Kentucky, Minnesota, Nebraska and Wisconsin, focus on accepting and distributing cancer-related pre scription drugs. A program is referenced in Michigan bu t may not be operational.

Legislative History: 1997-present (Enacted laws i n bold) In 1997, Georgia passed the first known state law permitting reuse within a long-term care facility. In 1998 Louisiana began a pilot program without statutory authority. In 2000, Connecticut enacted the second of the earliest laws; in 2001 Oklahoma and Montana authorized long-term-care based programs; in 2002, New Jersey and Virginia enacted authorizing language; in 2003 Ohio and Florida authorized a program; in 2004 Massachusetts and Louisiana enacted similar laws; Michigan permitted the Department of Corrections to redistribut e drug products. In 2005, the following 21 states considered legislation o n this topic : Arkansas , California , Colorado , Connecticut, Georgia, Indiana , Iowa , Kentucky , Maine , Massachusetts, Michigan, Minnesota, Nebraska , Oklahoma , Pennsylvania, Rhode Island , Virginia , Washington, West Virginia, Wisconsin and Wyoming. In 2006, the following 25 states considered legislation o n this topic: Alabama, Arizona , Florida, Georgia , Illinois, Louisiana , Maryland , Massachusetts, Michigan, Minnesota, Missouri , Mississippi, Nebraska , Ohio, Oklahoma , Pennsylvania, Rhode Island, South Carolina, Tennessee , Vermont, Washington, West Virginia, Wisconsin. In 2007, the following 15 states considered legislation o n this topic: Alabama, Colorado , Illinois, Maine , Massachusetts, Minnesota, Mississippi, New Mexico, New York, North Dakota , Oklahoma, Pennsylvania, Rhode Island , South Carolina, Texas and Wisconsin. In 2008, Kansas added a reuse program, signed into law 3/20/08; Minnesota expanded an earlier program; Pennsylvania created a cancer reuse repository. Ten other states , including Alaska, Illinois, Massachusetts, Nebraska, New Mexico, New York, Oklahoma, South Carolina and West Virginia considered leg islation that was not passed. [Revised 4/09] In 2009 , New Mexico created a reuse program within the Corrections Depart ment; Virginia expanded its program to allow both

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hospitals and clinics to dispense donated drugs. Addition al laws passed in IA, ID, MT, NE, NV (2), OR, VA (4) and WY.
In 2010: Pennsylvania Senate OKs bill allowing jails to recycle unu sed medicine - Pittsburgh Tribune-Review

The state Senate this week approved legislation allowing jails to re distribute their unopened prescription medicines. I t's a cost-cutting measure that's already being done at the Armstrong County Jail in Rayburn. Read More Evidence of Effectiveness: It is still too early to know the overall impact these p rograms will have on offsetting the costs of caring for the uninsured in emergency rooms and clinics. But hopes are high in some states. For example, betwe en March and December 2007, Iowa’s drug recycling program collected 319,000 dosage units worth an estimated $292,000, a ccording to the Associated Press. The main obstacles: lack of awarene ss about the programs and added work for repository sites accepting the donations. 

### Practical Guidelines for Consumers Hoping to Donate Drugs

Most state programs described in this report have sub stantial restrictions on who can donate, and what types of prescription products may be donated. Very strict safety rules als o apply, intended to protect the patient that ultimatel y obtains and takes the drug. See the state law table below for specific exampl es or language. In many states, all donations must meet standards such as:



###  Only certain, professionally-designated persons can make a donation. For example the Kansas law states, "Health facilities and pharmacies;" Connecticut, Pennsylvania and Rhode Island have similar limitations. Other states do allow pa tients to donate directly, for example, Arizona, Florida and Iowa.



###  Pills in opened or partly used bottles are never accept ed. Generally the packaging must be intact, meeting an exact standard such as the Kentucky law, "Upon inspec tion, the drug must be in its original, unopened, sealed , and tamperevident unit dose packaging."



###  Old drugs are never accepted. Expiration dates must b e visible, and usually at least six months later than t he date of donation. (Many prescription products carry an expiratio n date approximately one year after the original date o f the purchase)



###  Commonly, donated drugs must be delivered to a specif ic type of medical or pharmacy facility. Some may require the donor to sign a form or waiver.



###  Usually financial compensation is prohibited. Donations may be tax-deductable if paid for by the individual patie nt and taxpayer. Beyond donation programs, patients and oth er individuals may not sell any prescription drugs - suc h transactions are strictly regulated by State Boards of Pharmacy and ot her state and federal laws.



###  If your goal as a consumer is simply to protect your local water supply or clean out your medicine cabinet, t hese programs will not meet your needs.



###  If you wish to participate, check with a local pharmacy o r prescriber for practical advice on what may work in y our situation, in your state. Disclaimer:

NCSL provides material about state laws as general in formation, primarily for policymakers. No information in th is report is intended as personal legal or medical advice; NC SL is not responsible for any such uses or application of material in this report.



### Recent Resources

 NCSL Article: "Donating Unused Drugs" - State Legislatures Magazine, July/August 2008.



###  Kansas sets up program to redistribute unused meds , AP news article: May 5, 2009.

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 Hurdles Facing Unused Prescription Drug Repositorie s : State-legislated programs for the donation of unuse d drugs have seen limited success. Scientific American, January 2 9, 2009.



###  Massachusetts: "Opportunity to Save Millions Missed " - Rep. Bard Jones newsletter, 12/30/09.


### State Programs - Alphabetical Order

The state table below includes two categories: 39 stat es with some enacted and/or operational program and 4 additional states with restricted purpose programs or policies. For the det ails of each law, please click the hyperlinked state nam e or see the state’s website. This chart reflects the language enacted int o law on the dates indicated; recent enacted laws are updated as of May 2009. States may have additional regulations or executive agenc y guidelines that clarify or modify the terms described below. STATE Bill #; Year DESCRIPTION; HISTORY



### Arizona
HB 2382 Rep. Groe (2006) What Rx : Accept only in original sealed & tamper-evident unit do se packaging. Rx Board will issue list of unacceptable products. Who can donate : Person, manufacturer or health care institution. Who accepts : Pharmacy, hospital, nonprofit clinic that volunteers to participate. Donated to : Only state residents who meet eligibility standards se t by Board. Restrictions : Expiration must be more than 6 months from donation date. Recipient must sign waiver form about the source and non-liability. Program Status : Final Regulations promulgated, effective 6/6/08; Progr am not operational as of August 2009.



### Arkansas
HB 1031 Rep. Mahony (2005) What Rx : Accepts drugs only in their original sealed and tamper- evident packaging.

Who can donate : Nursing facility by the clinic pharmacy. Who accepts : Charitable clinic pharmacies. Donated to : Appropriately screened and qualified indigent patient s who are not eligible for Medicaid but cannot afford private health insurance. Restrictions : The charitable clinic pharmacy cannot accept controlled substances. No product of which the integrity cannot be assured is accepted for re-dispensin g. Program Status : Signed into law by governor as Act 132, 2/15/05. Sc heduled effective date: August 2005; Program currently operational.



### California
SB 798
Sen. Simitian (2005) What Rx : Drugs that are received and maintained in their unopen ed, tamper-evident packaging.

Who can donate : Licensed health facilities, licensed pharmacies, and dru g manufacturers that are legally authorized under federal law to manufacture and sell ph armaceutical drugs. Who accepts : Local ordinances established by counties that elect t o create such a repository and distribution program. Donated to : Persons in need of financial assistance to ensure acce ss to necessary pharmaceutical therapies. Restrictions : Must be ensured that drugs rec eived have not been in the possession of any individual member of the public. Program Status : Signed into law by governor as Chapter 444, 9/30/05; Program not operational as of August 2009.



### Colorado
SB 07-231 Sen. Tochtrop (2007) What Rx : Unused cancer drugs or medical devices.

Who can donate : Cancer patients or the patients' family. Who accepts : Health care facilities, medical clinics or pharmacies that elect to participate in the program. Donated to : Eligible health care facilities, medical clinics or pharmacie s for use under the program as well as eligible patients. Restrictions : Cancer drugs or medical devices needs to be prescrib ed by a practitioner, as defined in section 12-22-102 (27), C.R.S., for use by an eligible patient and is dispensed by a pharmacist. Program Status : The Act took effect 8/8/07; Program currently oper ational.

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Connecticut
HB 6002 Rep. Lyons (2000) What Rx : Drug products.

Who can donate : Long-term care facilities. Who accepts : Vendor pharmacy or the Department of Social service s for drug repackaging and reimbursement. Donated to : Eligible patients. Restrictions : Prescription drug products that are not controlled s ubstances, sealed in individually packaged units, returned to the vendor pharmacy within the reco mmended period of shelf life for the purpose of redispensing such drug products, determined to be of a cceptable integrity by a licensed pharmacist. Program Status : Signed by governor 6/21/00; Program currently opera tional.



### Florida
SB22A (2003)

HB 371 Rep. Harrell (2006) What Rx : Unused cancer drugs or supplies in its original, unopen ed, sealed and tamper-evident unit dose

packaging. Who can donate : A person, health care facility, hospital, pharmacy, dru g manufacturer, medical device manufacturer or supplier, wholesaler of drugs or supp lies, or any other entity may donate. Who accepts : A physician's office, pharmacy, hospital, hospice, or health care clinic that participates in the program. Donated to : Residents, except those Medicaid-eligible or under any other prescription drug program funded in whole or in part by the state are ineligible to participat e. Restrictions : All drugs submitted to the program will be administered by a pharmacist to determine the drugs and supplies are not adulterated or misbranded. Additiona lly a cancer drug may not be accepted or dispensed under the program if such drug bears an expiration dat e that is less than six months after the date the dru g was donated. Program Status : Fla. Stat. §409.908. The act took effect July 1, 2006; Program currently Operational.


### Georgia
HB 430 Rep. Cooper (2006) What Rx : Unused prescription drugs, but not those defined as controlled substances.

Who can donate : Any person, including a drug manufacturer or any hea lth care facility, may donate prescription drugs to the drug repository program. Who accepts : Any pharmacy, hospital, or nonprofit clinic that elects to participate in the drug repository program and meets criteria for participation in the progr am. Donated to : Medically indigent persons who are residents of Georg ia. Restrictions : Only drugs in their original sealed and tamper-evident unit dose packaging may be accepted and dispensed. The packaging must be unopened, except tha t drugs packaged in single unit doses may be accepted and dispensed when the outside packaging is opened if t he single unit dose packaging is undisturbed. Drugs donated by individuals must have an expiration date that is more than six months from the date the drug is donated. Program Status : The state-wide program required by this Code section was to be implemented no later than January 1, 2007.



### Guam Chapter 5 (2004) What Rx : Prescription drugs, non-prescription drugs, over th e counter drugs, medical supplies, and other items

that are identified, dated, and transported to the M edicine Bank in accordance with accepted and required standards established by Guam law, Federal law and/or F ederal guidelines to include the United States, Food and Drug Administration. Who can donate : Any pharmacy, wholesale prescription drug distributo r, pharmaceutical company, institutional facility, or practitioner, as well as, charitable, religious, or nonprofit organizations. Who accepts : Medicine Bank, created at Community Health Centers a nd various institutional facilities that are government owned and operated. Donated to : Eligible individuals in need as defined by the Guam MIP law or the Medicaid Poverty Guidelines. Restrictions : No medication which has been previously dispensed by a practitioner to a private citizen will be accepted. Materials received which are not prescription m edicines such as over-the-counter medicines, home

## 5 health equipment, medical supplies, and any other items, will also be carefully inspected upon receipt. They must be judged fit for use before being distributed or will be properly disposed of in accordance with Guam law. Program Status : Signed into law, 2004 as §5103 & 5104.



### Hawaii
HB 2005 final Rep. Say (2004) What Rx : Prescription drugs previously dispensed or distributed by a pharmacy for administration to patients in

an institutional facility by personnel of the institutional fac ility may be returned to the pharmacist. Who can donate : Patients or personnel of an institutional facility with unu sed drugs. Who accepts : Institutional facilities or repositories of the state of Hawaii. Donated to : Pharmacists. Restrictions : The prescription drugs should be returned only to th e original dispensing pharmacy. Also, prescription drugs from individual members of the public are not accepted for reuse. Program Status : This act should take effect on July 1, 2004, and will sunset on July 1, 2010; Program not operational as of August 2009.



### Indiana
HB 1251 Rep. Becker (2004) What Rx : Unused medications.

Who can donate : Health facilities with unused drugs. Who accepts : Pharmacy or pharmacist who initially dispensed the medi cation. Donated to : Pharmacists, hospitals, health care facilities or practitio ners. Restrictions : Requires the office of Medicaid policy and planning (of fice) to review the process of returning unused medication. Program Status : Statute Sec. 1 - 6 effective 07/01/04; Program not operational as of August 2009.



### Iowa
HF 724
Human
Resources (2005) What Rx : Prescription drugs and supplies.

Who can donate : Any person may donate prescription drugs and supplie s. Who accepts : Medical facilities or pharmacies that elect to participa te in the program and meetthe requirements established by the department. Donated to : Drugs may be donated to individuals or may be distributed to another eligible medical facility or pharmacy for use. Restrictions : Must be inspected to assure the prescription drug o r supplies have not been adulterated ormisbranded. The drug must be in its original sealed an dtamper-evident packaging. Program Status : The bill was approved and signed by the governor on May 3, 2005. NABP reports "rules in development establishing a Drug Donation Repository." As of 12/07. Dept. of Public Heath Regulations ARC 5563B ( C hapter 109 ) Effective March 2007; Program currently Operational. The Iowa Prescription Drug Corporation is a not-for-pro fit organization that administers programs designed to help ease the financial burden of the high cost of pres cription medications for uninsured and under-insured Iowans. The corporation contracts with the Iowa Dept . of Public Health to operate the Iowa Prescription Dru g Donation Repository Program. Web site: http://www.iowapdc.org/Drug%20Donation.htm ; Toll Free: 1-866-282- 5817; Email: info@iowapriority.org

. [updated 9/09]



### Kansas
HB 2578
House Appropriations
Comm. What Rx : Unused medications; excludes controlled substances.

Who can donate : Residents of adult care homes and donating entities t hat volunteer to participate in the program. Who accepts : A qualifying center or clinic in consultation with a pharma cist. Donated to : Medically indigent residents of Kansas. Restrictions : The medications must come from a controlled storage unit of a donating entity and be in its original packaging or tamper-evident packaging. Drugs pu rchased under Medicaid or SCHIP do not apply. Program Status : Signed into law by governor on March 20, 2008. ( KS Article 5/5/09); Program currently operational.


### Kentucky
SB 23
Sen. Denton What Rx : Cancer prescription "Legend" drugs or supplies needed to administer such drugs.

Who can donate : Health facilities and pharmacies. Who accepts: Donations can be made on the premises of a health fac ility or pharmacy that elects to participate in the program and meets requirements specified by the cabinet by an administrative regulation promulgated by

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(2005) the cabinet.

Donated to : Individuals who meet the eligibility criteria specified by an administrative regulation promulgated by the cabinet or eligible health facility or pharmacy fo r use under the program. Restrictions : The legend drug cannot be classified as a controlled substance. Upon inspection, the drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging. In addition, the legend drug or supplies must be prescribed by a physician, advanced re gistered nurse practitioner, or physician assistant and dispensed by a pharmacist. Program Status : Signed into law by the governor on March 18, 2005; P rogram not operational as of August 2009.



### Louisiana
HB 1402 Rep. Walker (2004)

Louisiana
SB 19
Sen. McPherson (2006) What Rx : Prescription drugs.

Who can donate : Any person, including a drug manufacturer, hospital, h ealth care facility, or governmental entity. Who accepts : Charitable pharmacies. Donated to : Appropriately screened and qualified patients. Restrictions : Drugs must be in their original sealed and tamper-evid ent packaging. In addition, donor shall execute a form stating the donation of the drugs. The pharmacy should retain that form along with other acquisition records. Program Status : A pilot program began in 1998 without statutory autho rity. HB 1402 Signed into law as Act 811 of 2004; Program effective August 15, 2004.

What Rx: Unused portions of or surplus prescription drugs that are within the expiration date.
Who can donate: A hospital, health care facility, or governmental entity enrolled in the Medicaid program. Who accepts: Charitable pharmacies.
Donated to: Medically indigent residents of Louisiana.
Restrictions: Drugs must be in their original sealed and tamper-evid ent packaging. Pharmacists of the charitable pharmacies should determine if the drug is not adulterated or misbranded and is safe to dispense. Program Status: Signed into law by governor as Act 643 of 2006, 6/29 /06; Program currently Operational.



### Maine
HP 105 Rep. Watson (2005)

HP 327/
LD 411 Rep. Perry (2007) What Rx : Unused prescription drugs.

Who can donate : Drug manufacturers, drug wholesale or terminal dist ributors, hospitals, health clinics, federally qualified health centers, Indian health centers and rural health centers and assisted living facilities licensed by the department. Who accepts : Pharmacies, hospitals, health clinics and federally qualifie d health centers, Indian health centers and rural health centers. Donated to : Qualified residents of Maine, which include family income below 350% of the federal non-farm income official poverty level and n ot receiving benefits from Mainecare. Restrictions : The program will only accept prescription drugs that are unopened and packaged in tamperevident unit dose packages or that are unopened injec table, aerosol or topical medications. Program Status : Signed into law by governor as Chapter 20, 5/31/05. A 2007 law, Special Act Chapter 27 , signed 6/27/07, provided $300,000 funding for the Mi ane Drug Enforcement Agency to establish a pilot program for retun of unused prescription drugs by mail, "consistent with the Main Drug Return Implementation Group established by Public L aw chapter 670 of 2003.

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Maryland
SB 1059
Sen. Teitelbaum (2006) What Rx : Prescription drugs or medical supplies.

Who can donate : Any person. Who accepts : Board approved drop-off sites and/or repositories w hich meets specified criteria. Donated to : A needy patient who is a resident of Maryland, as i ndicated by the individual’s health care practitioner. Restrictions : The drugs must be in their original unopened and seal ed packaging; or packaged in tamperevident unit dose packaging and unadulterated. The don or must sign a statement that indicates the donor is t he owner of the drugs and are voluntarily offering them t o the program. Controlled dangerous substances may n ot be donated. Program Status : Signed by governor as Chapter 287, 5/2/06. Effectiv e July 1, 2006; Program currently Operational.



### Massachusetts Ch. 111, Section
25I (2004) What Rx : Unused medications.

Who can donate : Residents or consultant pharmacist in a health care f acility. Who accepts : Health care facilities. Donated to : Eligible residents of Massachusetts. Restrictions : The donated medication should be sealed in unopened, individually packaged units and within the recommended period of shelf life. Excluded are schedule I or II controlled substances as defined in MA chapter ninety-four C. Program Status : Signed by governor in 2004; Program currently Operat ional. Opinion article : Massachusetts: "Opportunity to Svae Millions Missed " - Rep. Bard Jones newsletter, 12/30/09. 

### Michigan
Public Act 329 of
2004 Rep. Pumford (2004) What Rx: Drug repostory program for corrections. A separat e cancer program is referenced in Michigan but

may not be operational. Who can donate: The Michigan Department of Corrections (DOC) is permitte d to return and reuse medications. Restrictions/Analysis: The DOC estimates that redistributing unused medication s would save approximately $800,000 per year, but the actual exte nt of the savings would depend on both the costs of the redispensed medications and the frequency with which the y otherwise would have been discarded. The DOC’s estimate, however, did not assume that only unitpackag ed medications could be reused. This provision likely would diminish potential savings. Link to analysis of HB 6021 | Bill summary by House Fiscal Agency, 2004 Program status: HB 6021 by was signed as Public Act 329, effective September 23, 2004. The p ublic program may not be operational.



### Minnesota
Statute 151.55 (2007) What Rx : Cancer drugs or supplies.

Who can donate : A pharmacy, medical facility, drug manufacturer, or wh olesale drug distributor, can donate if the donated drugs have not been previously dispensed. In addition, any individual over the age of 18 may donate. Who accepts : Pharmacies or medical facilities on the premises that v olunteer to participate in the program. The medical facilities or pharmacies need to be licensed and in compliance with all applicable federal and state laws and administrative rules. Donated to : Any Minnesota resident who is diagnosed with cancer is eligible to receive drugs or supplies. The drugs will be distributed upon a priority base. Restrictions : Drugs must be in its original, unopened, tamper-evident unit dose packaging and not adulterated or misbranded. The donation must also be accompanied by a cancer drug repository donor form that is signed by the person making the donation or that person's autho rized representative. Program Status : Statute effective 2007; Program Operational as of August 2009. SF 2941 expanding terms for a state repository and reuse of u nused drugs program. (P assed Senate; passed House; signed into law as Chapter 327 of 2008, 5/15/0 8) |


### Mississippi What Rx : Prescription drugs.

Who can donate : The State Board of Pharmacy; the State Department of Health; the Division of Medicaid; any

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Miss. Code Ann. § 43-13-503 (2004) person, including a drug manufacturer, or health care f acility or government entity.

Who accepts : Any pharmacy, hospital, nonprofit clinic or health care professional. Donated to : Individuals who meet the eligibility standards or to oth er government entities and nonprofit private entities to be dispensed to individuals who meet the elig ibility standards. Restrictions : Only drugs in their original sealed and tamper-evident packaging may be accepted and dispensed. Program Status : The drug repository program shall be fully implemented not later than July 1, 2005; Program not operational as of August 2009.



### Missouri HB 898,
SB 1160
Sen. Shields (2004)

Missouri
HB 1687 Rep. Mark Wright (2006) What Rx : Sealed and unopened prescription drugs.

Who can donate : Any person or entity may donate prescription drugs. Who accepts : Any pharmacy, hospital, or non-profit clinic that elects to participate in the program. Donated to : Eligible Missouri residents. Restrictions : Prescription drugs must be in their original sealed and tamper-evident unit dose packaging. Prescription drugs donated by individuals should bear th e manufacturer's lot number and an expiration date tha t is more than six months from the date the prescription drug is donated. Program Status : The act was effective 8/28/04; Program currently op erational.

What Rx: Prescription drugs.
Who can donate: Any person, including but not limited to a prescription d rug manufacturer or health care facility, may donate prescription drugs to the prescripti on drug repository program. Who accepts: Any pharmacy, hospital, or nonprofit clinic that elects to participate in the prescription drug repository program and meets the criteria for participat ion established by rule of the department pursuant to
section 196.984.
Donated to: People who are residents of Missouri and who meet the eligibility requirements of the program, or to other governmental entities and nonprofit private en tities to be dispensed to persons who meet the eligibility requirements of the program. Program Status: Approved by governor 07/12/2006. Appears to be n ot yet operational as of 4/09.



### Montana
SB 288
Sen. Christiaens (2001) What Rx : Unused prescription drugs.

Who can donate: Long-term care facilities. Who accepts: Provisional community pharmacies. Donated to: Qualified patients for transfer free of charge or at a reduced charge to those individuals. Restrictions: Drugs defined as a dangerous drug or a drug designa ted as a precursor to a controlled substance cannot be accepted. Program Status : This act was effective 10/1/01; it was to be fully im plemented by 1/1/05; Program currently operational.



### Nebraska
LB 756
Sen. McDonald (2003)

LB 331 What Rx : Cancer drugs.

Who can donate : Any person or entity, including, but not limited to, a cancer drug manufacturer or health care facility. Who accepts : Any physician's office, pharmacy, hospital, or health clinic that elects to participate in the program and meets criteria established by the departmen t for such participation. Donated to : Eligible Nebraska residents. Restrictions : The drug needs to be in its original, unopened, sealed, and tamper-evident unit dose packaging, except that a cancer drug packaged in single unit dose s may be accepted and dispensed if the outside packagin g

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(2005)

LB 1116 (2006) is opened but the single-unit-dose packaging is unopened

.

Program Status: The Act, RRS Neb. 71-2424 et seq., became operative on 9/15/03.

In addition, LB 1116 of 2006 clarified the program, inclu ding eliminating a restriction on the number of doses that can be donated; allowing donation of injectible canc er drugs and requiring donation forms to incljde the name of the original patient. (Signed into law 3/13/06)



### Nevada
SB 327
Sen. Wiener (2003) What Rx : Prescription drugs.

Who can donate : A public or private mental health facility may return a p rescription drug that is dispensed to a patient of the facility, but will not be used by that pat ient. Who accepts : A dispensing pharmacy. Donated to : The drug will be used to fill other prescriptions for pa tients in the pharmacy facility. Restrictions : The drug cannot be a schedule II drug specified in or pursuant to chapter 453 of NRS. The drug must be dispensed in a unit dose, in individually sealed doses or in a bottle that is sealed by the manufactu rer of the drug. Program Status : The act becomes effective on July 1, 2003; Program currently operational.
New Hampshire What Rx :

Who Can Donate : Program Status : State law, N.H. RSA §318.58 authorizes a reuse prog ram. It is not operational as of
December 2009.


### New Jersey
Title 24 Assemblyman Conaway (2007) What Rx : Prescription drugs.

Who can donate : Unopened, unexpired prescription drugs dispensed to, but not used by, a patient within a licensed health care facility, may be reused at the faci lity in accordance with regulations issued by the State Board of Pharmacy. Restructions: Must be unopened and unexpired. Program Status: This provision was not operational as of 12/2007 according to the National As sociation of Boards of Pharmacy; No program in operation as of Aug ust 2009.



### New Mexico
SN 82
Sen. Beffort (2009) What Rx: Unused medication

Who can donate: A corrections facility that has a registered or licensed nurse. Who accepts: A pharmacy operated by, or under contract with, th e Corrections Department .
Restrictions: Product "has not been altered, defaced or tampered with and include the identity, strength, expiration date and lot number of the prescription drug ; and the prescription drug was dispensed in a unit-dos e package or unit-of-issue package." Program Status: Signed into law by governor as Chapter No. 2009-236 , 4/7/2009; Program currently operational.



### New York
S 2803-e
Sen. Golden (2007) What Rx : Unused medication.

Who can donate : A resident or consultant pharmacist or his designee in a residential health care facility. Who accepts : The pharmacy from which the medication was purchase d. Donated to : Eligible New York residents. Restrictions : The medication must be unopened in the original manufa cturer's packaging and must be in tamper evident packaging. Program Status : The new law was referred to the NY Health Departme nt on 1/9/08.

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North Dakota
HB 1256 Rep. Weisz (2007) What Rx : Legend drugs, devices, or supplies.

Who can donate : Any person or entity. Who accepts : Practitioners or pharmacies that meets the criteria established for participation in the program. Donated to : Eligible patients. Restrictions : A drug donated, prescribed, or dispensed under the program must be in the original, unopened, sealed, and tamper-evident unit dose packaging, excep t a drug packaged in single-unit doses may be accepted and dispensed if the outside packaging has been opened and the single-unit-dose package is unopened. Program Status : Signed into law by governor in April 2007; Program curr ently operational. Patients may find out if a prescription is available by v isiting www.nodakpharmacy.com . A drug donor form can be printed online. To find participating pharmacies and ava ilable drugs, devices and supplies, residents can visit www.freemedsnd.com , sponsored by the North Dakota Board of Pharmacy a nd the North Dakota Pharmacists Association. [updated 9/09]



### Ohio
HB 221 Rep. Schuring (2003) What Rx : Prescription drugs.

Who can donate : Any person, including a drug manufacturer or health c are facility. Who accepts : Any pharmacy, hospital, or nonprofit clinic that has el ected to participate in the program and meets certain eligibility requirements established in rules ad opted by the Board. Donated to : Individuals with a prescription issued by a health care professional authorized to prescribe drugs. Restrictions : Drugs must be in their original sealed and tamper-evid ent unit dose packaging. Program Status : Signed by governor 1/6/03; Program currently operat ional.



### Oklahoma
HB 1297 Rep. Gilbert (2001)

SB 1640
Sen. Johnson (2006) What Rx : Unused prescription drugs.

Who can donate : Drugs may be transferred from residential care homes , nursing facilities, assisted living centers, public intermediate care facilities for people w ith mental retardation (ICF/MR) or pharmaceutical manufacturers. Who accepts : Any pharmacies operated by a county, pharmacy oper ated by a city-county health department or a pharmacy under contract with a city-county health de partment, a pharmacy operated by the Department of Mental Health and Substance Abuse Services or a charita ble clinic for the purpose of distributing the unused prescription medications. Donated to : Oklahoma residents who are medically indigent. Restrictions : Prescription drugs defined as controlled substances w ill not be accepted. Program Status : This act became effective 11/1/06; Program current ly operational.


### Pennsylvania
SB 638 Sen. Wonderling (2008) What Rx : Unused cancer drugs

Who can donate : health care facility, health clinic, hospital, pharmacy or physician's office. Who accepts : Authorized participating pharmacies, designated by the Cancer Drug Repository Program of the State Board of Pharmacy. Donated to : Needy residents, as dedfined in "Income eligibility crite ria and other standards and procedures for individuals participating in the program, determined by th e Department of Public Welfare and the Pharmacy Board. Restrictions : Unit dose medication must be maintained by a health c are facility, health clinic, hospital, pharmacy or physician's office rather than an individu al patient, as "part of a closed drug delivery system. " Expiration date must be at least six months in the fu ture. A pharmacy "may charge a handling fee", to be determined by the Board of Pharmacy. Regulations to b e drafted within 90days of effective date. Program Status: signed into law by governor as Act No. 14 on 5/13/08; effective date 7/12/08; Program not operational as of August 2009.

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Rhode Island
HB 5107 Rep. Sullivan (2005)

HB 5850 (2007) What Rx : Unused prescription medication.

Who can donate : Nursing homes, assisted living centers and prescription drug manufacturers. Who accepts : Authorized participating pharmacies. Donated to : Medically indigent Rhode Island residents. Restrictions : The packaging of the medication should not be opened, except cancer drugs packaged in singleunit doses. Program Status : The program was scheduled to begin 1/1/06. In 2007 HB 5850 extended the implemention date to 4/1/07 and required notification to all nursing h omes of the new program; Program not operational as of August 2009.



### South Dakota
HB 1165 Rep. Glenski (2004) What Rx : Unused unit dose drugs.

Who can donate : Patients in hospice programs, nursing facilities, or assis ted living facilities. Who accepts : Hospice programs, nursing facilities, or assisted living facilities. Donated to : Eligible patients. Restrictions : The drugs are provided in the manufacturer's unit d ose packaging or are repackaged by the pharmacy in a hermetically sealed single unit dose contain er. Program Status : Signed by governor 2/19/04; Program not operational as of August 2009.



### Tennessee
HB 3560 & SB
3660 Sen. Haynes (2006) What Rx : Unused prescription medications; controlled substanc es are excluded.

Who can donate : Nursing homes or hospice services programs. Who accepts : Charitable clinic pharmacies. Donated to : Tennessee residents who are indigent. Restrictions : Drugs only in their original sealed and tamper-eviden t packaging should be accepted. Program Status : The act took effect 7/1/06; Program currently oper ational.



### Texas
SB 1896
Sen. Lucio (2007) What Rx : Unused drugs; controlled substances are excluded.

Who can donate : A pharmacist who practices in or serves as a consulta nt for a health care facility or a licensed health care professional responsible for administration of drugs in a penal institution. Who accepts : Pharmacies. Donated to : Eligible patients. Restrictions : Drugs must be sealed in unopened tamper-evident pac kaging and either individually packaged or packaged in unit-dose packaging. Program Status : Signed into law by governor 6/15/07; Program current ly operational.



### Utah
58-17b-503 Rep. Last (2005) What Rx : Unused drugs.

Who can donate : A pharmacist may accept back and redistribute any un used drug, or a part of it, after it has left the premises of the pharmacy. Who accepts : n/a Donated to : n/a Restrictions : The drug must have been prescribed to a patient in a nursing care facility, an ICFMR, or state prison facility, county jail, or state hospital; the drug m ust have been stored under the supervision of a licens ed health care provider according to manufacturer recomm endations; the drug should be in a unit pack or in the manufacturer's sealed container; the drug should have been returned to the original dispensing pharmacy; the drug should have initially dispensed by a licensed pharmacis t or licensed pharmacy intern; and back and redistribution of the drug complies with Federal Food and Drug Administration and Drug Enforcement Administration regulations. Program Status : This law became effective on July 1, 2005; Program not operational as of August 2009



### Vermont What Rx : Any unsold or unused prescription drugs and medical supplies that the facility or distributor cannot

sell or otherwise use.

## 12

H.711 Rep. Canfield (2005) Who can donate : Any health care facility and wholesale drug distributor.

Who accepts : Any participating pharmacy, hospital, or nonprofit clinic

. Donated to : Vermont residents who meet the eligibility standards. Restrictions : Drugs or medical supplies must be in their original se aled and tamper- evident unit dose packaging to be accepted and dispensed, except for drugs packa ged in single unit doses when the outside packaging is opened if the single unit dose packaging is undisturbed. The board of pharmacy shall allow donation of only those drugs bearing an expiration date that is less th an six months beyond the date the drug is donated and shall allow drugs to be dispensed only when the expiration date is more than one month from the date of dispensing. Program Status : 01/24/2006.


### Virginia
HB 154 (2002)

HB 1854 Del. Eisenberg (2005)

HB 2682 Del. Eisenberg (2009) What Rx : Prescription drugs.

Who can donate : Hospitals are authorized to donate drugs that were o riginally dispensed to hospital patients, but have been returned. Who accepts : Pharmacies. May be redispensed by clinics (2005) and hospitals (as of 2009 law) Donated to : Indigent patients, without charge. Restrictions : The pharmacist-in-charge at the pharmacy shall be res ponsible for determining the suitability of the product for re-dispensing. A re-dispensed prescript ion shall not be assigned an expiration date beyond the expiration date or beyond-use date on the label from t he first dispensing and no product shall be re-dispensed more than one time. No product shall be accepted for re-dispensing by the pharmacist where integrity cannot be assured. Program Status : H 154 signed 4/6/02. HB 1854 Signed by governor as Chapter 68, 3/24/05; Program currently Operational. 2009 HB 2682 signed as Chapter No. 114, 2/5/09. Statute: Va. Code Ann. 54-3411.1



### Wisconsin
SB 56 Sen. Fitzgerald (2003)

Wisconsin
AB 845 Rep. Underheim (2004)

Wisconsin
AB 197 Rep. Vukmir (2005) What Rx : Prescription drugs.

Who can donate : State prison pharmacies. Who accepts : State prison pharmacies. Donated to : Any patients in any state prison. Restrictions : The prescription drug should never have been in th e possession of the patient to whom it was originally prescribed. The prescription drug is returned in its original container. A pharmacist determines that th e prescription drug has not been adulterated or misbrand ed. Program Status : Approved by governor 8/20/03.
What Rx : Cancer drugs or supplies.
Who can donate : Any person or entity. Who accepts : Medical facilities or pharmacies that elects to participa te in the program and meets requirements specified by rule by the department.
Donated to : Individuals who meets eligibility criteria or to another e ligible medical facility or pharmacy for use under the program.
Restrictions : The cancer drug or supplies needed to administer a cancer drug must be in its orig inal, unopened, sealed, and tamper-evident unit dose packaging or, if packaged in single-unit doses, the single-unit-dose packaging must be unopened. Program Status : Enacted April 6, 2004. What Rx : Expands Wisconsin’s Rx recycling cancer drug reposit ory to

## 13 include prescription drugs and supplies for all other chr onic diseases such as diabetes. Program Status: Signed into law by governor as Act 16, 7/5/05.


### Wyoming
HB 194 Rep. Hastert (2005) What Rx : Prescription drugs.

Who can donate : Any person or entity, including but not limited to a dr ug manufacturer, physician or health care facility. Who accepts : Any physician's office, a pharmacy or health care f acility that elects to participate in the program and meets criteria established by the department. Donated to : Wyoming residents. Restrictions : Drugs shall be accepted or dispensed under the drug donation program only if they are in their original, unopened, sealed packaging or, if the outside pa ckaging is opened, the contents are single unit doses that are individually contained in unopened, tamper evid ent packaging. Program Status : Signed by governor as Chapter 158, 3/2/05; Program currently operational.



### Restricted Purpose State Programs or Policies

North Carolina Specific guidelines are being developed for a drug reposit ory/return program. ♦


### Oregon Repository not permitted. Return and reuse is permitte d only in long-term-care pharmacies where drugs have

remained in the control of facility staff and are package d in tamper-resistant containers. ♦



### South Carolina Repository/donation not permitted. Return and reuse of medications are allowed with pharmacist's professional

judgment. ♦ 

### West Virginia Return of unit-dosed non-controlled substance drugs allo wed. ♦ Notes:
♦ = Facts confirmed or obtained from National Association of Boards of Pharmacy: 2009 Survey of Pharmacy Law

.



### Definitions:

Controlled Substances: generally a drug or chemical whose manufacture, posse ssion, and use are regulated by a government. It may include illegal drugs and prescription medications.The federal goverment sets the standard for controlled su bstances; states may modify regulation by, for example, requiring additional res trictions on certain individual products. For complete lists, refer to the Controlled Substances Act and "Schedules I through V" detailed at Sec. 812. Schedules of controlled substances , online at http://www.usdoj.gov/dea/pubs/csa/812.htm#a Legend Drugs: any drug that requires a prescription. This may be a c ontrolled substance (narcotic) or a non-narcotic drug.

Authors: Richard Cauchi, Program Director; Karmen Hanson, Progr am Principal. Additional research for online edition: Andrew Thangasamy, Staff Researcher (2009); Yeasol Chung, Health Intern (2008) for the NCSL Health Program, Denver. For periodic updates of this report: http://test.ncsl.org/default.aspx?tabid=14425

APPENDIX A: AP News: Kansas article, May 5, 2009

Kansas sets up program to redistribute unused meds

## 14

KANSAS CITY, Mo. (AP) -- A new effort in Kansas to r edirect some types of unused medications to safety ne t clinics is off to a slow start, but supporters are confident it will eventually b enefit patients and the state. Under a program approved by the Legislature in 2008, adult care homes, mail service pharmacies and medical ca re facilities can donate unused prescription drugs to clinics and health c enters that serve the uninsured and poor. When the law took effect in January, the state joined at least 37 states with similar laws or programs, acco rding to the National Conference of State Legislatures. The organization and success of those programs vary widely. A program sta rted in Missouri in 2004 never got off the ground. The Kansas program got its first donation in April, when Prescription Solutions of Overland Park, a mail-order ph armacy, gave about $250,000 of unused medicines that will eventually go to 3 6 clinics in 30 cities. So far, the focus has been on notifying qualified donor s and clinics and organizing the logistics, said Robert Stile s, director of primary care for the Kansas Department of Health and Environm ent. The state also is trying to arrange clearinghouses where drugs could be stored. "We are hearing a lot of interest," Stiles said. "It's st ill early. But it's such a great idea, to use medicines t hat are usually thrown away. I think it will be popular."

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