E-DRUG: Recycling of medicines in the US
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A colleague recently sent me a copy of an article from Scientific American of Feb 2009 called "Spreading the Health" in which they discussed the recycling and reissue of drugs in the USA. The drugs have to be in tamper-proof packs and only complete packs are acceptable. Apparently legislation is in place to remove any liability of the pharmacists who re-dispense re-cycled drugs if something untoward was to happen.
The drugs are issued to patients who have no or limited health insurance. Some states will accept "donations" from anyone and others only accept them from fellow professionals or known institutions.
Still others do not have any programme.
Readers will know that there has been much debate on these pages (as
recently as February 2008) regarding donations and re-used drugs. The outcome is almost always negative based on the fact that there is no
guarantee that the medicines have been treated or stored correctly once dispensed.
I am surprised that there is such a scheme at all and by the fact that it is happening in the US and since 1997!
At the moment I only have a link to an abstract but the full article is well worth reading:
http://www.sciamdigital.com/index.cfm?fa=Products.ViewIssuePreview&ARTICLEID_CHAR=D6099E81-3048-8A5E-1020ECE4715B8D14 [repair link]
I am interested to hear what others think of this scheme and its ramifications.
[Double standard again: if you are poor, whether in the US or in other countries, you are regarded as a second-hand citizen. Very disappointing. Moderator]
Regards
Brian Gunn
Dr Brian C Gunn
Section Head of Research
Directorate of Rational Use of Medicines
MoH, Oman
gunnbc@hotmail.com
E-DRUG: Recycling of medicines in the US (2)
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While I understand the intent of the Moderator, the fact is that we
accept double standards even within the double standards. For example,
is it not double standard to accept that d4T/stavudine is a standard
element of antiretroviral therapy in the developing world, while it
would be difficult to find a doctor in the West who would touch this
drug with a bargepole. The WHO guidelines still recommend a second-line
combination of ddI and tenofovir, a combination which is contra-
indicated in the West.
I must say I find it difficult to support the approach which seems to
say: "better they die than we give them recycled drugs." If they are
informed of the situation (are many people in Africa aware of the
problems with d4T?) and the risks, seems to me we should support it,
and (like clinical trials in developing countries), find ways to
regulate it.
Sorry, I've made this point before in this forum, so I know there is
little support for it (quite the reverse!). But 'needs must go who the
devil doth drive...').
Now, if you folk can come up with a way so that this approach is no
longer needed, I'll support you all the way! But please don't just
wring your hands and wish it away...
[It was not the moderator's intention to start a discussion on choice of therapies (cheap vs. expensive?). Of course one should not accept less than optimal therapy, when there is documented differences in benefit/risk profile. However, I cannot understand how collecting used medicines can help getting better therapy for chronic diseases to people. Moderator]
Chris
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Chris W. Green (wartaaids@gmail.com)
Jakarta, Indonesia
Tel: +62 (21) 846-3029
Blog: Adventures with HIV in Indonesia
<http://indohiv.blogspot.com/>
chrisg@rad.net.id