During this episode of CHPA Chat, hear from CHPA’s Vice President of State & Local Government Affairs, Carlos Gutiérrez and Stacy Thompson, Chief of Staff for the Public Affairs Company as they explore Extended Producer Responsibility (EPR) laws, their impact on the affordability of consumer healthcare products, and how consumers can participate in existing drug disposal take-back programs.*
*This podcast was recorded in November 2021
- Episode Transcript
Anita Brikman: Drug take-back laws, it's something CHPA and the consumer healthcare products industry have been dealing with for almost a decade. Meanwhile, the number of drug take-back locations across the country is greater than ever before, but is it working? What is the best solution for preventing drug abuse and diversion and what's best for the environment? Let's talk about it on CHPA Chat.
Speaker 2: Welcome to CHPA Chat, conversations in the consumer healthcare industry with Anita Brikman.
Anita Brikman: Hello, everyone, and thank you for checking out CHPA Chat. Today we're talking extended producer responsibility, often called EPR. This is the idea that a manufacturer of a product is responsible for the life of that product from the time it's made until the end of its life. Now, this is common with tires, batteries, mattresses, electronics, thermometers, you name it. These laws are quite common in Europe and Canada. And the idea is that the consumer has an avenue for disposing of a product at the end of the product's life, typically at the same place where he or she bought it. So EPR continues to grow here in the United States, especially as state and local government seek to limit flows into their landfills. And EPR has even extended in recent years to consumer healthcare products, particularly pharmaceuticals. These laws are often referred to as drug takeback and they require the drug makers to pay for the disposal programs.
Anita Brikman: Is this necessary? Do programs work? And do consumers actually use them? Those are some of the questions we hope to answer in today's podcast with a great lineup of guests. Carlos Gutierrez, CHPA's Vice President of State and Local Government Affairs joins us. He is CHPA's chief state lobbyist and has been point on this issue since the industry started dealing with these laws in the US. I'm also joined by Stacy Thompson, Chief of Staff for the Public Affairs Company. She has led a coalition of pharmaceutical companies and trade associations in managing a drug disposal education campaign in Cook County, Chicago, in partnership with the Cook County Sheriff's Department, that is really a model of how industry and local authorities can work together. Carlos, Stacy, thanks for being with me.
Carlos Gutierrez: Hi, Anita. Thanks for having me.
Stacy Thompson: Thank you, Anita.
Anita Brikman: All right. I mentioned this started in Europe and Canada. How long has this been an issue here in US, Carlos?
Carlos Gutierrez: To be honest, advocates of takeback have been trying to get government to adopt these policies for several years. I'd say going back 15 to even 20 years. They didn't have a lot of success getting state legislatures to adopt for many years, so they changed their strategy and went local. They started going county to county, city to city, and were really pushing for localities to pass these ordinances. The first came in 2012, that was Alameda County, California. And that really created a domino effect. Following that, King County and Snohomish County in Washington, San Francisco County, and about 22 other, near 30 localities in California, ultimately passed these ordinances. What that created was this upward pressure for state lawmakers to act.
Carlos Gutierrez: If you've got your largest cities, your largest counties, a ton of counties that are adopting this, it makes better sense for the state to do something statewide. So then we saw the State of Washington, Oregon, California, and New York, all pass statewide laws. There's also one in Massachusetts that is really targeted to opioids and does not impact consumer healthcare products, but those are the four core that, that we deal with. And there's been several other states that continue to look at it, debate it, and we're anticipating other states to take it very seriously this coming year.
Anita Brikman: You mentioned opioids. Is it the issue of drug abuse? Is it an environmental concern? What drives some of these local municipalities to act?
Carlos Gutierrez: It's been my experience that it's all of the above. It started out as an environmental issue. It was some fringe groups that were really pushing this. They didn't really get very far. Then the game changer, I think, was around 2010 when the opioid crisis really started to hit the country. And you saw law enforcement groups and drug abuse prevention groups team up with the environmental organizations in suggesting that drug takeback might actually be a good solution for diversion of medicine, particularly medicine and medicine cabinets. So, that got a lot of momentum. That's what we saw when we started seeing the localities pass and Washington State and California, eventually New York.
Carlos Gutierrez: Now I think it's the concept of extended producer responsibility really is driving it. We're starting to see legislation that's being filed that's not only for returning the product, but also what are we doing about the packaging that that product is sold in? And so this idea, extended producer responsibility is really driving the conversation now of late. So it started with environment, went to what I call public safety and drug abuse. Now it's back on environment.
Anita Brikman: Wow. That makes a lot of sense. Stacy, we mentioned in the intro that there was a unique program in Cook County, second largest county in the United States where Chicago is. How does that work and how is it different than some of these other take-back mandates?
Stacy Thompson: Yeah, you're right, Anita. In 2017, the Cook County lawmakers considered passing a drug take-back law. But what we did is the industry partnered with the Cook County Sheriff's Office, and together we've been educating residents about proper disposal of medication. So we created the Cook County MEDS Disposal Initiative. We wanted to make sure that people knew there are locations where they can take unused or unwanted medications, but also that there are proper ways to store and dispose of those medications. For instance, they shouldn't flush their unused medications. Throughout the county, there are over 88 medication drop sites that are run by the Sheriff's Office. There's 32 medication disposal sites that are provided by municipalities and other law enforcement agencies. And then there's another 130 or more take-back sites that are offered by local pharmacies, CVS, Walgreens, and others. So with that, there's over 250 locations to drop your unused medications. We knew that access wasn't an issue.
Stacy Thompson: There's also special days like DEA Take Back Day events in the spring and fall. But in 2017, there wasn't an easy tool or resource for finding a medication disposal site near you. So we created a website. It has an interactive map of all of the medication drop sites in the county. And so now an individual can just go to cookcountymeds.org and enter their address, or use the map on our site to find the most convenient disposal site that's near them. Also, our program is a little bit different because we realized that to be most effective, we'd need to partner with other community organizations. So we partnered with the nurses, the Academy of Family Physicians, the Pharmacy Association, voluntary health organizations, faith groups, local leaders, and others, just to help us spread the message.
Stacy Thompson: Now in Cook County, we have over community partners that we work with. And every year we're out doing events at health fairs and senior fairs, community festivals, attending flu vaccine clinics, working with libraries, all of these activities, just to provide information about disposal resources to residents of Cook County. And then we also work with them on social media and other media to help raise awareness of the program.
Anita Brikman: Is it working? How do you measure success of something like that?
Stacy Thompson: Yes, it is working. There's a couple of ways. We conduct an annual survey. The great news is that each year we have seen an increase in residents awareness in a number of very important things, including we now see significant changes in, stated just importance of awareness about the issue and how to properly dispose of medications. We also have seen a reduction of stored unused medications in your home. So people aren't just hanging onto those medicines that they don't need, or that are expired. And then we've seen a large reduction in the number of people who are flushing that. Actually has decreased by about a third over the past four years, which is great news. And then we've seen an increase in returns to the pharmacy in the four years. So we've almost doubled that number based on the data from our survey. So, it is definitely working.
Anita Brikman: That is great news. Let's go back to nationwide. Is there some locator tool that people can access online to see if there is a take-back location near them, Carlos.
Carlos Gutierrez: There is. A consumer can find that at myoldmeds.com. It is a fully functional website that will have a map of the United States. You can enter your zip code and it will populate for you the closest locations of drop-off bins for medications around your area.
Anita Brikman: Stacy, do you agree that the infrastructure is there, it's more about educating people that these locations exist nearby versus mandating new ones?
Stacy Thompson: Absolutely. Like I said earlier, when we started this in 2017 in Cook County, we knew that the infrastructure was there, we knew there were all of these drop sites, but it was just making sure that people understood where they were. And so that's why the Cook County MEDS site was so important. And that's why I think myoldmeds.com was... The locator tool that's within that site was created in the last maybe year or year and a half, Carlos. But those are such important resources for people to be able to find a convenient place near them, which we know again, if you go to myoldmeds.com, you'll see there's definitely a place near you to conveniently drop your old or unused medications.
Anita Brikman: Let's go back to EPR and the packaging of consumer healthcare products. We're talking about medicines here, we're not talking about tires or mattresses or some of these other industries. These are products that sometimes have to be packaged in a certain way for safety concerns, et cetera. Is that resonating with state lawmakers or are they still expecting industry to make improvements and reduce their use of plastics, et cetera?
Carlos Gutierrez: I think the answer is yes to both. I think it is resonating to an extent they understand the complications around consumer healthcare packaging. They also still want this to be innovating and really try and figure out ways to make more sustainable packaging. So we have seen a number of these EPR laws for packaging. What we're starting to see is that rather than... Even drug takeback. Rather than creating EPR for specified industries or specified categories of products, they are going for these larger framework bills, something that just passed in Maine, something that just passed in Oregon. The first two statewide EPR laws in the country, they're making them broad enough to where in the future, if they wanted to bring in pharmaceuticals or if they wanted to bring in mattresses or what have you, that they can easily add them into that broader framework.
Carlos Gutierrez: So we're sort of, I think, seeing a shift. We may see fewer drug take-back laws be introduced, but that doesn't mean interest in and requiring manufacturers to pay for extended producer responsibility for pharmaceuticals. It doesn't mean that that's going away. It's just shifting in the way it looks.
Anita Brikman: Let's talk about proof. Is there proof that drug takeback works? We heard from Stacy about the positive results in Cook County. Is there evidence that it does lessen drug diversion or that the environment is improved as a result of drug take-back programs? I would open that up to Carlos and Stacy as well.
Carlos Gutierrez: From my perspective, it's a very interesting question and it's highly, highly debatable. Pharmaceuticals in water, they're in trace amounts, and we're talking minute amounts, parts per trillion. So the ability to measure a difference after a law passes is so incredibly hard, that it's very tough to prove whether or not this law had any impact on the water quality, for instance. In terms of drug diversion, I think all you got to do is look north to Canada. They've had a drug take-back law there for a number of years. They are still unfortunately struggling with drug diversion. They're still struggling with opioid addiction, hospitalizations as a result of that. So, I have scoured the web for proof that this is actually a viable solution to both problems, and I have yet to find that.
Carlos Gutierrez: That said, I think what the advocates say is, "Look, we don't have a lot of control over global climate change. We don't have a lot of control over these global policies that are being put in place or not being put in place. Here's something that we can do. And whether it has a major impact on the policy itself is debatable, but let's do it anyway." I think that's what we're starting to see around the country.
Anita Brikman: Are you experiencing that kind of sentiment, Stacy?
Stacy Thompson: I agree with everything Carlos just said. There are a couple of data points that we look at in Cook County specifically, just to see if the program is being effective. One is the Cook County Sheriff's Office weighs all the medications they collect from their drop boxes across the county. That number has increased every year with the exception of 2020, which clearly can be attributed to COVID-19 and to the pandemic. But also our annual survey shows that there's continued growth and awareness and proper disposal. And we've seen increase in utilization of our website. Our web traffic increased 42% this year and we've had millions of visitors. So it's hard to believe that these types of just awareness programs aren't being helpful. Specifically being able to measure that outcome related to opioids and diversion, I think is challenging to do, but I have to believe that we're having a positive impact on what we're doing.
Carlos Gutierrez: Stacy makes a good point about weight. The Drug Enforcement Administration does these biannual Drug Take Back Days, one in the spring, one in the fall. They've been doing it since 2010. And I just read earlier today that they just finished their fall take-back event in late October, and they collected 745,000 pounds around the country. What they do is they partner with local law enforcement agencies around the country for four hours on a Saturday, no questions asked, they'll collect any medications that a consumer might bring in from their medicine cabinet. And so 745,000 pounds and what they said was going back to 2010, when they first started this whole program, they've collected 15 million pounds. So to Stacy's point, that is unwanted, undesired, probably expired medication. Getting it out of medicine cabinets, I'm sure has some benefit for the community, and that's what these programs have been doing
Anita Brikman: Well, that is good news. Carlos, I know because I sit next to you in the CHPA offices that you're rarely there because you're always on the road. The 2022 outlook, what do you envision as far as this type of legislative activity?
Carlos Gutierrez: Well, I don't think it's going to stop. This year we had Illinois, Hawaii, Rhode Island and Massachusetts all file legislation in 2021. It did not pass in all of those states. And so it's going to be reconsidered in 2022. So we expect those same states. I would also add to the mix, maybe Connecticut. I know they've done some interim work on extended producer responsibility in general, and they have talked about pharmaceutical drug takeback as part of that solution. A state that you'd be really surprised about is probably Oklahoma, the advocates of product stewardship. There's an outfit out of Massachusetts called the Product Stewardship Institute. They have been working really hard in Oklahoma, trying to develop these coalitions to eventually bring that idea to that state.
Carlos Gutierrez: Now, I think the politics in Oklahoma are still favorable, but whenever I talk about this issue, I always say this is not a blue state versus red state issue at all anymore. It's not a Democrat versus Republican. If anything, it's more older generation versus younger generation. An older lawmaker may be a little bit more tolerant of the status quo, whereas a younger lawmaker be them a liberal, be them a conservative, has a different view on issues of the environment. And so in states where there are term limits and where there's a lot of turnover, you tend to have a lot younger of a lawmaker. And as a result, you're going to find a lot more progressive type pieces of legislation filed on all matters related to the environment, drug takeback included.
Anita Brikman: Carlos, Stacy, thank you so much for such a fantastic and interesting conversation on extended producer responsibility, EPR, and its direct impact on the consumer healthcare products industry. That's another episode of CHPA Chat.
Speaker 2: Thank you for joining us here at CHPA Chat. For more information and to hear our entire catalog of shows, please visit chpa.org.
The views expressed in this podcast are solely those of the speaker and do not necessarily represent the opinions of the Consumer Healthcare Products Association.