Zach Wendling
LINCOLN — One Nebraska lawmaker’s efforts to increase recycling have led her to explore a program to donate and reuse prescription drugs and tackle rising medication costs.
Freshman State Sen. Jana Hughes of Seward is looking to join forces with Iowa nonprofit SafeNetRx, which collects, inspects and distributes non-expired and safe medications to patients at or below 200% of the federal poverty line.
SafeNetRx receives donations from more than 200 facilities and individuals in all 50 states, including at least one Nebraska pharmacy in Gretna.
However, SafeNetRx distributes medicine only within Iowa, and Nebraska would need to change its laws to allow reciprocal distribution.
“The more options they have to get it back out the door, the better,” Hughes said.
‘Sickening’ to destroy good medicine
The nonprofit has been looking to expand medication distribution to other states in addition to Nebraska, according to CEO Jon Rosmann, though the Cornhusker State is a “logical partner” due to proximity and similarities in geography and demographics.
Most Nebraska pharmacies participate in a drug disposal program that collects and ships drugs to be destroyed. According to the Nebraska Pharmacists Association, the program is funded by nearly $300,000 in state appropriations and $700,000 from the Nebraska Environmental Trust over three years.
The program seeks to prevent drugs from going into landfills or water systems and includes all unused drugs, including non-expired meds.
“It is just sickening that we are destroying perfectly good medications,” Hughes said.
Hughes has been examining ways to increase recycling in general, and donated medicine would be an extension of those efforts, she said. She envisions pharmacies having one bin for redistribution and another for destruction, similar to how collection efforts work for trash and recycling.
States look to ‘join forces’
Rosmann said his nonprofit is designed to address two pervasive problems: patient affordability and pharmaceutical waste.
About 75% of unused medicine accumulates in long-term care and institutional settings, he explained, and “it only makes sense” to tap into those sources. Since the drug repository program began in 2007, it has grown to be the largest in the nation and has been supported by Republicans and Democrats alike in Iowa.
“It’s a problem that is very pragmatic, and it’s a solution that Midwesterners can see as being a very logical solution,” Rosmann said.
SafeNetRx has served more than 134,000 patients, and it has collected, inspected and made available $105 million in donated medicine through its dispensing network, according to the organization’s most recent annual report.
With a budget of roughly $1 million, SafeNetRx annually brings in $25 million to $30 million of donated medicine, Rosmann said. The nonprofit returns $12 million to $15 million to patients at or below 200% of the federal poverty line.
“The return is massive. The impact on patients’ lives is massive,” Rosmann said. “And the opportunity to join forces and create something really remarkable that our Midwest can be proud of, that’s not lost on us as well.”
SafeNetRx has multiple layers of inspections and checks donations to see whether they are:
- Sealed in tamper-evident packaging.
- Non-expired.
- Non-controlled substances.
Pharmacists also confirm that medications do not require refrigeration and show no signs of tampering or deterioration. To date, according to SafeNetRx, there have been zero patient safety issues.
Nebraska pharmacists could have “immediate access” to SafeNetRx’s real-time inventory for their patients, Rosmann said, “as soon as it’s legal.”
Filling health care gaps
Early in the 2023 legislative session, one of Hughes’ constituents in York encouraged her to look at SafeNetRx, and she and her staff were able to get the ball rolling after the session.
Hughes; her legislative aide Matt Howe; State Sen. Merv Riepe of Ralston; Matthew Schaefer of Mueller Robak; and Haley Pertzborn and Amy Holman with the Nebraska Pharmacists Association toured SafeNetRx in Grimes, Iowa, on Oct. 30. Iowa Rep. John Forbes, D-Urbandale, who is a pharmacist, joined as well.
During the tour, the group saw $20 million worth of inventory, which Riepe said has some impact and size that could benefit Nebraska.
Schaefer said he represents a number of health care entities that support the drug donation idea.
Hughes described a situation where a patient who can’t afford meds may eventually land in the emergency room, a more expensive path of care. Riepe, a former hospital administrator, said some patients may take daily meds every other day in hopes of extending the prescription, though this can have major implications on a patient’s entire health.
“It’s not going to be a profitable thing,” Riepe said. “It’s just going to fill the needs of some people.”
Next year’s likely legislation could be referred to the Legislature’s Health and Human Services Committee, of which Riepe is a member.
“If it’s available and it’s all clean and neat and orderly and legal and everything else, it’s a blessing to have it get to those people that do in fact need it,” Riepe said.
‘Helping more Nebraska patients’
Pertzborn, an executive fellow for the Nebraska Pharmacists Association and an Iowa native who previously volunteered for SafeNetRx, said patients must adhere to the requirements of their medications, such as when they should be taken. She graduated from Iowa’s Drake University in May and is now a Nebraska pharmacist.
“It’s just so positive, and everybody’s so passionate about it and the patients they help,” Pertzborn said. “They just have some of the best stories, and I want to bring that to Nebraska.”
A partnership could provide cost savings for the state, both Pertzborn and Hughes said, and help shore up health care gaps. Pertzborn said a partnership could be a “best-case scenario.”
“There’s just not a better feeling than helping your patient and getting them the meds they need and making sure they’re happy with their health care,” Pertzborn said. “At the end of the day, the only thing that’s happening is we’re just helping more Nebraska patients.”
Hughes said she and her staff are finalizing details for legislation for a partnership at little to no cost to the state. This could include some already appropriated drug destruction funds or grants, she said.
“I think this would garner a lot of support,” Hughes said. “I don’t know why anybody would not, especially if we can really figure out the funding.”