Pharmacist Bob Grisnick notices the stressed faces of his customers when they ask how much it will cost to buy their medicine.
So it pains him when, days later, he sees different customers throwing that same medicine away. These days, that happens a lot, the I-Team has found.
Grisnick’s pharmacy, Southrifty Drug in Southampton, is home to Operation Big Red Box, a program that disposes of unused medicine safely when customers bring it in. Grisnick and partner Thomas McAbee started Operation Big Red Box so that people with extra non-narcotic medicine could dispose of it safely rather than flush it into the water supply or leave it around the house.
But they never dreamed of the sheer quantity of wasted medicine local residents would bring in.
“We take back 1,200 pounds of drugs every time in little bottles,” said Grisnick ,of Operation Big Red Box, which disposes drugs for about a dozen pharmacies twice a year. “It’s thousands and thousands of dollars that are being incinerated.”
The National Community Pharmacist Association estimates that 200 million pounds of medicine are thrown away a year. Lots of that gets flushed down toilets and winds up in the water supply, experts say. Other unused medicines, both addictive and non-addictive, can be swallowed by children or by adults who get confused, experts say.
Community pharmacists lay the blame on the increased popularity of mail-order prescriptions. Those local pharmacists readily concede that mail-order has cut a huge hole in their revenue as more customers get their drugs in the mail.
But they also say mail order pharmacies often send prescriptions in 90-day supplies, and with automatic refills, so that even after a patient no longer needs a prescription, it keeps coming.
Joseph Burrascano, a doctor who is also one of Grisnick's customers, said he wound up with a lot of extra medicine when his prescription changed after he had already ordered a 90-day supply by mail.
He stopped by Grisnick's pharmacy to dispose of his extra pills.
“Those pills are probably $12 each, and that's 180 pills,” he said of the two bottles he dropped in the mailbox.
The Pharmaceutical Care Management Association, an industry group that represents mail-order drug programs, disputes that mail order is causing waste. They say most drugs are wasted when changes are made in the first few months of a new prescription. In those months, they say, most people still pick their medicine up from a brick-and-mortar drug store.
They also point out the convenience of having medicine shipped to directly to patients -- especially for elderly and very sick patients.
Ilene Corina, who runs the Long Island-based patient advocacy group PULSE of NY, said most people who wind up with excess drugs are not affected enough to lobby to change the system. She said people who can’t afford drugs might be more offended by wastefulness, but there has not been a great public outcry. Studies show that about one in four Americans report that they have either not filled a prescription or skipped a dose because they could not afford it
“We need some kind of uproar," Corina said. "Especially from the people who can’t afford the medications. And sadly the people who need the medications and can’t afford them are sick.”
New York Assemblyman John McDonald, an upstate Democrat who is a pharmacist, said there are things that can be done to prevent medicine from being wasted.
In New York, McDonald successfully sponsored a bill that requires pharmacies contact patients every 180 days to make sure they are still taking medicine being sent. He hopes other states will follow suit.
He said pharmacies that mail prescriptions should require a signature to make sure someone is receiving the drugs. And that when a patient is first prescribed a medicine, it should be a 30-day supply. The 90-day mail orders should come only once the patient and doctor know it is working.