In 2018, Senate Bill 862 would have required participation in a drug disposal program by pharmacies that dispense Schedule II and III controlled substances; do not dispense primarily by mail, common carrier, or delivery service; and are not located within a hospital. The legislation was passed by indefinitely in Senate Education and Health committee with a letter from the Senate Clerk requesting that the JCHC study the subject matter contained in the bill. The JCHC Executive Subcommittee and members approved the study for 2018.

After receiving approval by Commission members during the work plan meeting, JCHC staff researched the topic and found that while unused and inappropriately stored or disposed of medicines may pose a variety of health risks and environmental risks, use of disposal methods nationally that meet Federal DEA standards or recommended by the EPA/FDA remains highly limited. In Virginia, a recent task force’s recommendations for improving appropriate medicine disposal and collection by consumers highlighted the need for additional funding and increasing consumer outreach and education.

Other states and municipalities have established a variety of medicine take-back programs, ranging from those directly funded by governments to those funded by pharmaceutical manufacturers and overseen by the state or local government (known as an “Extended Producer Responsibility" [EPR] model). Washington State established the first statewide EPR model covering all controlled and non-controlled pharmaceuticals, with manufacturers responsible for establishing and fully funding the program. A “program operator" contracts with manufacturers to implement the program and the State’s Department of Health reviews, approves and monitors implementation of the program.

Four policy options were presented for consideration by members of the Joint Commission on Health Care, with an additional fifth option added by a JCHC member during the November decision matrix meeting. The JCHC approved two options:

• Introduce legislation to amend § 54.1-3319 of the Code of Virginia to add counseling on medicine disposal to the list of topics on which pharmacists may counsel persons who present a new prescription for filling

• Introduce legislation (Uncodified Act) directing the Board of Pharmacy to work with stakeholders to determine ways to enhance public awareness of proper drug disposal methods, including existing community-based disposal and collection opportunities