A team of Stanford University students and graduates has created a system to recoup unused prescription drugs and redirect them to uninsured patients.
The Web-enabled system will start to make a dent in the billions of dollars in unused medicine that is wasted annually in the United States, according to State Sen. Joe Simitian, D-Palo Alto.
The Stanford team hosted Simitian Friday, Feb. 24, in a celebration of the university-based nonprofit startup SIRUM (Supporting Initiatives to Redistribute Unused Medications) at Stanford's Haas Center for Public Service.
Simitian sponsored legislation to ease regulatory hurdles to the drug transfers after hearing about the medical waste problem in 2005 from then-Stanford University medical student Josemaria Paterno.
But it took the legwork and engineering talents of a larger Stanford team to make the drug transfers user-friendly for medical workers charged with disposing of unused prescription products.
Nursing director Deane Kirchner of Lincoln-Glen Manor & Nursing Facility in San Jose, the first donor to the SIRUM system, said the level of waste has been a constant frustration for her in her 24-year medical career.
"As a new charge nurse I would keep track of extra medications I had on hand because orders had changed, or they'd finished their antibiotics and there was extra left over," Kirchner said.
"We could keep them for 90 days in case the patient needed them again, and after that we'd have to get rid of them. We used to flush them, and record it on the medical dispositions sheet.
"Now we don't flush them -- we ship them off to be incinerated -- but the result is still the same -- we're still wasting all these medications."
SIRUM's system enables Kirchner to list available unused medications on a Web form for a potential match with recipients in need. When a match is found, the system generates a Fedex label and packing slip, making it easy to document and donate.
Stanford engineering graduate Adam Kircher, who has designed database matching systems, took on the medical supply chain challenge in the research for his master's degree in industrial engineering.
"More than $100 million of usable medications currently go to waste in California health care facilities, but one-third of California's uninsured forgo prescription drugs due to cost," Kircher said.
So far, $600,000 worth of medications have run through the SIRUM system, according to the group's finance director, Kiah Williams.
"Our new goal is to recruit 100 new facilities and donate $1 million in wholesale value in one year, and we feel we're ready to reach that scale," Williams said.
Costs so far have been underwritten by grants. But SIRUM is looking toward a sustainability model in which donors would potentially pay a fee that is still less than the cost of incineration and recipients would pay a fee that is less than the cost of the drug, staff members said.
SIRUM cannot accept donations of excess pharmaceuticals from individuals, staff members said.
In the heavily regulated prescription drug industry, the system is designed to ensure that medications "come from safe institutions and go to other safe institutions to be used for folks who need it," Williams said.
Simitian said he introduced additional legislation Friday to further facilitate SIRUM's system by expanding the donor base and recipient pool and allowing pharmacy-to-pharmacy exchanges.
"There's no reason why hundreds of millions of dollars over time shouldn't be saved at the national level, and hundreds of thousands of individuals helped," he said.
"The public 'gets' this. People put their lives at risk -- skipping their daily doses -- because they don't have the dollars to access the medications that folks across town are flushing down the toilet."
The original request to Simitian, from then-medical student Paterno -- now a third-year medical resident at Massachusetts General Hospital and an advisor to SIRUM -- came through Simitian's annual "There Oughta Be a Law" contest.
More than 39 states have established Good Samaritan laws to protect donor and recipient organizations involved in medicine donations, according to SIRUM's website.