Why It's Important to Get Rid of Unused Medication

The best time to dispose of old meds is Oct. 28: 

National Drug Take Back Day

Consumer Reports /  Ginger Skinner

Last updated: October 26, 2017

When it comes time to dispose of your leftover or expired medicines, you might be tempted to just toss unused pills into the trash—20 percent of people get rid of their meds this way, according to a recent Consumer Reports Best Buy Drugs nationally representative survey of more than 1,000 Americans.

But discarded drugs can contaminate landfill soil and the water supply, according to a study published in 2014 in the journal Environmental Science. And pills can be fished out of the garbage by kids and even pets.

A far better way to dispose of old and unused meds is to drop them off at National Prescription Drug Take Back Day, this Saturday, Oct. 28.

Throughout the U.S., from 10 a.m. to 2 p.m., you can drop off unused pills and liquid medications at designated police departments, fire stations, health clinics, and other facilities in your community for proper disposal. (This doesn’t include inhalers or syringes; see below for how to dispose of those.)

To find a collection site near you, visit TakeBackDay.DEA.gov or call 800-882-9539. Drop-off is free and anonymous.

A Safer Way to Clear Out Old Opioids

To help reduce prescription drug abuse, the Drug Enforcement Administration, in conjunction with the Secure and Responsible Drug Disposal Act of 2010, launched Take Back Day seven years ago. Since then, this twice-yearly event has collected more than 900,000 pounds of medications.

Take Back Day goes a long way toward “eliminating the possibility of a family member or stranger removing your drugs from a medicine cabinet with the intent to misuse or abuse them,” says DEA spokesman Melvin S. Patterson.Many people keep old or unused pills such as opioids in their cabinets because they don’t know how to dispose of them, Patterson says.

Recent research bears that out: According to a survey published last June in JAMA Internal Medicine, 60 percent of people who had been recently prescribed an opioid—Vicodin, Percocet, and others—reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of the drugs.Meanwhile, deaths from the use of these drugs have reached epidemic levels—91 people die every day from an opioid overdose, according to the Centers for Disease Control and Prevention.

“Anyone participating in Take Back Day is a welcome part of the solution to a significant problem,” Patterson adds. “It gives everyone an opportunity to take part in ridding our communities of old, unwanted, and potentially harmful drugs.”

The drugs you turn in on Take Back Day are all incinerated—never redispensed or put into landfills, Patterson says.

Other Ways to Dispose

If you can’t participate in Take Back Day this Saturday but still have unused meds to get rid of, follow these steps:

Buy an envelope and mail back your meds. Costco, CVS, and Rite Aid pharmacies sell postage-paid envelopes for a few dollars that allow you to mail any prescription pills or liquids, including opioids and over-the-counter medications, to a disposal facility to be incinerated. (Do not send inhalers or syringes.)

Drop off at a free kiosk in CVS or Walgreens. As part of its initiative to address opioid misuse, CVS this week announced that it plans to offer free, anonymous, secure drug disposal kiosks at 750 pharmacy locations across the U.S. Walgreens already also offers safe drop-off at in-store kiosks. (Medications are incinerated.) To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

Toss meds in the trash (only if you can’t purchase a mail-back envelope or get to a CVS or Walgreens kiosk). Doing so can contaminate the soil and water supply, so this is not an ideal solution. If you must throw drugs away, first conceal pills (from kids and pets) by mixing them in a bag or another container and mix them with an unappealing substance, like used coffee grounds or kitty litter. Then seal up the container and toss the item into the trash.

Last resort: flushing. This is not ideal because trace amounts of flushed meds can end up in drinking water and possibly harm aquatic life. Our survey found that 17 percent of people said this was their typical disposal method.

The Food and Drug Administration suggests flushing certain drugs, like dangerous opioids, when they are no longer needed, because they could be deadly if accidentally taken by someone else, particularly children.

Disposing of Syringes and Inhalers

You won’t be able to dispose of needles, syringes, or inhalers at National Take Back Day. And it’s not recommended that you throw these items into the trash.

For inhalers, contact your local trash and recycling facility for proper disposal instructions.

For needle disposal, go to safeneedledisposal.org or call 800-643-1643 to find drop-off locations near you. You’ll also find information on pharmaceutical company mail-back programs.

Do Expiration Dates Matter?

Drug manufacturers are required by law to stamp an expiration date on medication bottles, cartons, and tubes; it’s the date the manufacturer can guarantee maximum safety and potency based on testing.

Our medical experts say you can keep most prescription and over-the-counter drugs for about 12 months past the expiration date, with critical exceptions. The antibiotic tetracycline should never be taken after that date, because as tablets break down they can become toxic and cause kidney damage. It’s especially important to keep nitroglycerin and other liquid meds, like insulin and epinephrine (i.e., EpiPens) up-to-date. They lose potency after the expiration date, so they might not work as well or at all in an emergency.

Editor’s Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Is It Too Soon to Get the Flu Vaccine?

Costco, CVS, and Walgreens have started advertising the flu vaccine in the summer months, but for some, it might pay to wait before you vaccinate

Consumer Reports / Julia Calderone / September 09, 2016

If you’ve visited your local Costco, CVS, Walgreens, or other stores recently, you might have noticed advertisements for this year's flu vaccines.

Is it a good idea to get the shot now, before flu arrives? Or will that undermine its effectiveness in January and February, when flu season is in full swing?

The Centers for Disease Control and Prevention recommend that most people get vaccinated as soon as the shot becomes available (which can be as early as late July). That way, you’ll be protected when flu season typically starts around mid-October, and when it peaks from December through February. 

Early vaccination is an especially good idea for children six months to 8 years old because, unlike the rest of us, they need two doses of the flu vaccine given 28 days apart, says William Schaffner, M.D., a professor of medicine at Vanderbilt University School of Medicine and a consultant to the CDC’s Advisory Committee on Immunization Practices. So if they get their first shot in early September and their second in early October, they’ll likely be protected by the time the flu arrives.

On the the other hand, two groups of people might benefit from waiting a little bit before getting the shot: people 60 and older and those who have a compromised immune system due to conditions such asautoimmune disease, HIV, or those undergoing chemotherapy treatment.

That’s because in those people, research suggests there’s about a four-month window after getting the vaccine when the body is best able to fight the virus. 

After that, for at least some people in those groups, the immune system’s virus-fighting ability begins to wane.

Schaffner emphasizes that this evidence is not definitive, and that even with declining protection the flu vaccine still seems to provide some protection after four months. Still, he says, people who are older or have underlying chronic diseases might want to wait until late September or early October to be sure that their protection will cover the entire influenza season, which can extend into March, or even dribble into early April.

It doesn't matter whether you get the flu vaccine from your primary care doctor or your local pharmacy, Schaffner says. They’re both perfectly safe places to get it. The most important thing is that you get it. 

Expensive pill to swallow

CBS This Morning
DECEMBER 1, 2015

Consumer Reports investigates prescription drug sticker shock

Americans spent $374 billion on prescription drugs last year, but only 17 percent of people shop around for a lower price. Consumer Reports found that some people spend up to 10 times more than is necessary for common medications. Consumer Reports prescription drug editor Lisa Gill joins "CBS This Morning" to discuss the results of its national survey.

http://www.cbsnews.com/videos/consumer-reports-investigates-prescription-drug-sticker-shock/

Use Medicare’s Muscle to Lower Drug Prices

The Opinion Pages | EDITORIAL

By THE EDITORIAL BOARDSEPT. 21, 2015

A poll last month by Consumer Reports found that a third of the patients who take prescription drugs are paying significantly more this year, forcing many to cut back on other necessities or load up on credit card debt. Another poll in August by the Kaiser Family Foundation found that about a quarter of those surveyed said they had trouble paying for prescription drugs.

Many of the people most affected by rising drug prices are older patients on Medicare, who often live on modest incomes, are in poor health, and take four or more prescription drugs. One way to reduce drug costs for this population is to reverse the policy set by the 2003 Medicare Modernization Act, which created Medicare’s prescription drug program.

At Republican insistence, that law barred the federal government from negotiating with drug manufacturers. It relied on bargaining by private insurers that manage drug benefits for Medicare patients, like UnitedHealth, Aetna and CVS Caremark, to wring discounts from the drug makers. That wasn’t enough.

CreditDavid Ahntholz for The New York Times

The drug makers point out that what Medicare spends on drugs has been rising more slowly than had been projected over the past decade. But that is mostly because enrollment grew more slowly than expected and many widely used brand-name drugs lost their patent protection and were replaced by low-cost generics. 

While drug prices paid by insurers are usually discounted from the list price, those prices can still be very high. Medicare, with its enormous buying power, could drive costs down more. This is important because the newest, most expensive drugs for high cholesterol, hepatitis C, cancer and other ailments are needed by a large number of the elderly and disabled people enrolled in that program. Those high prices then result in high co-payments and other cost sharing for its beneficiaries.

Hillary Rodham Clinton, Senator Bernie Sanders of Vermont and the Obama administration have voiced support for federal government intervention in Medicare price negotiations, but they have been so vague that it is impossible to discern exactly what they would do.

Massachusetts is considering allowing state officials to set price caps on some of the most expensive medications, and bills have been introduced in several states to require greater transparency from drug companies on how they set prices, a prerequisite for determining whether the pricing is reasonable.

The Congressional Budget Office has long concluded that curbing Medicare drug spending requires that federal officials have stronger tools, like the power to offer preferential treatment to drug makers that offer big discounts. Medicaid, the state-federal insurance program for the poor, has ways to get big rebates from drug manufacturers; Medicare should be given such powers as well.

Congressional Republicans would no doubt balk at having the federal government negotiate Medicare drug prices, but the public is clamoring for action, and it’s the right thing to do.

Follow The New York Times Opinion section on Facebook and Twitter, and sign up for theOpinion Today newsletter.

Should you get vaccinated at a pharmacy?

Consumer Reports

Here’s what to know before you go
Published: July 14, 2015 06:00 AM

You’re picking up a few household items at the pharmacy and spot a sign for on-site vaccinations. Would getting vaccinated at a pharmacy be a reasonable move? Yes. It’s a safe, convenient way to keep up to date on your immunizations, and may save you a trip to the doctor. What’s more, pharmacists are trained in immunization technique and practice giving shots regularly.

CVS, Rite Aid, Walgreens, and other chains, as well as some independents, offer more than the flu shot – they also administer Centers for Disease Control and Prevention-approved vaccines, including hepatitis A and B, pneumonia, polio, shingles, Tdap (tetanus, diphtheria and pertussis), and varicella (chickenpox). And many also offer travel immunizations for meningitis, typhoid, yellow fever, and other diseases.

While many pharmacies require no appointment and only ask that you complete a consent form (which includes questions about your medical history and authorizes the release of your health care provider and insurers), rules and vaccine availability vary by state—so call ahead before you drop in.

As at your doctor’s office, most pharmacies will file with your insurance, and under the Affordable Care Act, insurers are required to cover most immunizations for adults and children, so you probably won’t be charged. When in doubt, you or your pharmacist should check first with your insurer. Note, too, that your insurance plan may have age limitations, for example, most plans will not cover the shingles vaccines for adults under age 60. If you’re paying out-of-pocket, know that prices vary depending on the pharmacy, just as they do at your doctor’s office. For example, you’ll pay $85 for the pneumonia vaccine at CVS and Target, but just $73 at Costco pharmacies. And the dual Hepatitis A and B vaccine costs $169 at Target, and $114 at Walmart. Ask your pharmacist to forward information about your vaccinations to your doctor's office so that it can be added to your medical record.

An added perk for getting vaccinated at the pharmacy: CVS, Walgreens, and other chains offer loyalty programs (it’s free to sign up) that earn you rewards for each vaccination you get, and those reward points add up to discounts on other store purchases. Sign up online or at the pharmacy counter.

If you are uninsured or paying out-of-pocket, many of the same statewide free health clinics and community health centers that provide preventative care offer free or low-cost vaccinations. Find a clinic near you.

—Ginger Skinner

Prescription Price Sticker Shock Is Now A Common Consumer Ailment

By Laura Northrup August 13, 2015

Maybe this has happened to you: you’re at the pharmacy, picking up a refill of a prescription that you or a family member have been taking for a long time. It’s a routine errand until you get sticker shock: the copay has suddenly shot up. You didn’t change insurance, it’s still the same year, and the drug is the same: how can a price change so dramatically so quickly?

Our colleagues down the hall at Consumer Reports heard about this phenomenon and investigated how widespread the problem is, and how to deal with sudden drug price spikes. They learned that drug prices have been rising dramatically in the last few years, especially for generics. Insurance plans normally place drugs on tiers according to how much they cost or simply don’t include them on the list of covered drugs (the “formulary”) at all, as CVS/Caremark recently did with Viagra and some other pricey brand-name medications.

An old, inexpensive drug that has been on the market for decades might be Tier I and have a very low copay or even none at all. More expensive drugs might be on higher tiers or not on the formulary at all. What’s been happening recently is that a drug will sometimes increase in price significantly with no warning.

“For whatever reason, raw material shortage or some other problem, literally overnight we’ll see a dramatic increase,” an independent pharmacist in Texas told Consumer Reports. Pharmacies pass the sudden cost increases on to their customers and to their insurance companies. Some generic drug prices have increased dramatically, like tetracycline, which increased from five cents per pill to $8.59 per pill in just a year.

Consumer Reports recently polled adults who take prescription drugs to find out whether this had happened to them. One-third of respondents said that it had. Most of them (81%) simply paid the higher price at the pharmacy because, well, they needed the refills. Some paid more than $100 per prescription out-of-pocket.

One example: a woman who doesn’t have insurance had to pay $500 for a three-month supply of hydroxychloroquine, a venerable drug for rheumatoid arthritis that used to cost about half that much. She didn’t have a choice, though, and paid the higher price.

After leaving the pharmacy, most people in the poll tried to manage the issue, contacting their insurance company to make sure there was no error, and checking with their health care provider to find out whether cheaper alternatives were available. For many people, a sudden spike in the cost of important medication means skipping payments on other bills or avoiding other medical care.

If this happens to you or to someone in your family, what can you do?

Review your medications: you may be able to drop or change some maintenance medications.

Check the formulary: It should be available on your health insurer’s website, and lists covered drugs and lower-cost alternatives.

Shop around: Check prices between different pharmacies and big-box stores. Some offer cheap generics that other chains don’t, or offer some categories of drugs with no copay as a loss leader to attract new pharmacy customers. Costco fills prescriptions for non-members, and you might find assistance or the lowest price in an unexpected place.

Are you paying more for your meds? [Consumer Reports]

Prescription Drug Savings

Shopping Around Brings Steep Prescription Drug Savings, Report Finds


THURSDAY, March 28 (HealthDay News) — Prescription drug prices at U.S. pharmacies can vary widely, and failing to shop around could result in people overpaying by as much as $100 or more a month on average, depending on the drug, a new study finds.

Researchers at Consumer Reports called more than 200 pharmacies across the United States to get retail prices (out-of-pocket costs) for a one-month supply of five popular medicines that have recently gone generic.

The medicines were: the diabetes drug Actos (pioglitazone); the antidepressant Lexapro (escitalopram); the cholesterol-lowering drug Lipitor (atorvastatin); the blood thinner Plavix (clopidogrel); and the asthma drug Singulair (montelukast).

For a one-month supply of these drugs, there was a $749 difference between the highest- and lowest-priced stores — a more than four-fold difference, according to the study in the May issue of Consumer Reports magazine.

Overall, Costco outlets had the lowest retail prices and CVS had the highest, the report found. Among the specific findings:

A month’s supply of generic Lipitor cost $17 at Costco, compared with $150 at CVS. Prices at Rite Aid and Target were also high.

A month’s supply of generic Lexapro cost $7 at Costco and $126 at CVS. On average, Rite Aid, Walgreens and grocery store pharmacies also charged higher prices.

A month’s supply of generic Plavix cost $12 at HealthWarehouse.com and $15 at Costco, compared with $180 at CVS.

Different business approaches are one reason for the wide price variations, according to Lisa Gill, prescription drugs editor at Consumer Reports.

“It really comes down to a store’s business model. For example, big box stores tend to use their pharmacies as a way to get consumers through the door with the expectation that they’ll buy other things,” she explained in a Consumer Reports news release.

If you want to get the best deals, shop around and always request the lowest price, Gill advised.

“A consumer can’t assume that the price of their prescription medications is set in stone,” she said. “One of the big takeaways is that you have to ask for the best price and see if your pharmacist will work with you. Especially for the independent pharmacies, if they want to retain your business and loyalty, they will help you get the best price,” she said.

Other ways to save money include:

Using generic drugs, which contain the same active ingredients as brand name drugs.

Getting refills for 90 days, not 30 days. Most pharmacies offer price reductions on a three-month supply of a medicine.

Look for other discounts. All chain and big-box pharmacies offer discount generic drug programs, with some selling hundreds of generic drugs for $4 a month or $10 for a three-month supply.

Try shopping in rural areas. The study found that some grocery store pharmacies and independent drug stores had higher prices in cities than in rural locations. For example, a 30-day supply of generic Actos cost $203 at a pharmacy in Raleigh, N.C., compared with $37 at a pharmacy in a rural area of the state.