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. 

4 Ways to Get Insurance to Cover Your Prescription Drugs

Reprinted from Consumer Reports / Ginger Skinner / February 12, 2016

If your medication costs have shot up, ask your doctor for help

If your medication prices seem higher than last year, one culprit might be changes to your insurance company’s “formulary”—the list of drugs covered by your health plan.

During the year, insurance plans may change which prescription treatments they cover, and that’s true especially when it’s time to re-enroll.

Formularies are often developed to encourage people to use the least expensive medications whenever possible. But that list can change if an insurer negotiates a better deal with a drug company, if new research shows the medication isn’t as safe or effective as thought, or a less expensive generic version of the drug hits the market.

Even if your drug is covered on an insurance company’s formulary, the full cost of it may not be. Where an insurance company places a drug on its formulary, the list of drugs is further divided into what is called a ”tier”—and it’s essentially a way to determine how much you’ll pay out of pocket for it, through your co-pay. The higher the tier the higher your share of the costs.

"Consumers need to be on guard because drugs can be taken off a formulary at any time, or moved to a higher tier, which could make a big difference in your share of the costs," says Betsy Imholz, Consumers Union's director of special projects.

Most plans have about four levels, or tiers, of coverage, but in the last few years, more insurers have added a fifth tier by splitting the "generics" tier into two: "preferred" and "nonpreferred." Insurance companies do this to encourage people to choose less expensive medications.

Your copay for a drug in the non-preferred generic tier, for example, may be $15, compared to a preferred generic in the lowest tier, where your copay could be $5 or less. 

Diligently checking your plan's formulary (you can find it on your insurer’s website) can help you avoid getting stuck with paying the full costs of your prescriptions. But if it turns out a drug you're taking is dropped or moved to a higher tier, you have several options:

1. Switch Drugs. Ask your doctor to prescribe a drug on your formulary that may be just as effective and safe for your condition. Most plans will offer one or more alternatives to a medication they no longer cover.

2. Ask for an Exception. "Many people don't realize that just because a drug is not on your plan's formulary does not mean it's unavailable for coverage," says Imholz, "Work with your doctor."

If a drug alternative is not possible, your doctor can file an exception, or "prior authorization," through your health plan, requesting that the drug be covered because it’s medically necessary. If that happens, your plan should approve or deny your request within a few days.

3. Try Step Therapy. Depending on what medication it is, after your doctor files an exception, some plans may require that you agree to “step therapy” first, which is a type of prior authorization. It means trying other lower-cost medications that are appropriate for your condition first. If the lower-cost drug doesn’t work for you, your doctor can ask your insurer to cover the more expensive drug. 

4. File an Appeal. If your insurer still denies your request to cover a drug you need, you can file an appeal. You and your doctor can either complete and file an appeals form provided by your insurer, or write a letter that includes the name of the drug, why you need it covered, and any other supporting documents from your doctor. Your insurer's website will provide more details on the appeals process.

If your plan denies your appeal, you can file for an external, or independent, review with your state’s insurance regulator, which will make the final decision.

If your state doesn’t have an external review mechanism, the Department of Health and Human Services (HHS) or an independent review organization will oversee the process. A decision can take up to 60 days and is free if handled by the HHS, but may cost you to $25 if it’s handled by your state or an independent review organization.


When All Else Fails, Shop Around
Filing an appeal can be a lengthy process, and there’s still no guarantee that your insurer will agree to cover your medication. If you end up having to pay more for your medications out-of-pocket, shop around.

Our secret shoppers have found that prescription prices can vary widely from one pharmacy to the next, even in the same zip code. Costco often offers low prices (you don’t have to be a member) and independent pharmacies may be able to negotiate. And ask your pharmacist if you can save more by not using your insurance; many chains and big-box stores, such as Target, Walgreens, and Walmart, offer hundreds of generics for as low as $4 for a 30-day supply and $10 for a 90-day supply.

When it's time to re-enroll or change insurance plans, before choosing coverage, Imholz recommends checking the formulary to make sure the drugs you need are covered and under which tier.


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

6 ways to reduce the price you pay for prescription drugs

Reprinted from Consumer Reports February 1 at 3:15 PM

Are you paying more at the pharmacy counter? 

Consumer Reports’ Best Buy Drugs experts have ideas 

that can save you time and money.

Ask for a discount. When Consumer Reports had its secret shoppers contact a variety of pharmacies by phone to price a market basket of common medications, they found that asking for the best deal got them occasional discounts. For example, at a supermarket pharmacy outside Des Moines, a shopper was first quoted a price of $75 for generic Actos, a diabetes drug, but after asking whether there was a better deal, she was offered the drug for $21.

Other tactics: Be sure to ask what a medication will cost if you don’t use your insurance (a generic’s price may be less than your co-pay), and ask about any senior, student or other discounts for which you may be eligible.

Shop around. Retail drug prices can differ greatly from one drugstore to the next, even in the same Zip code. For example, in Denver, the grocery store Albertson’s Save-On said its price for generic Actos was $330, but nearby Cherry Creek Pharmacy said it would sell it for just $15.

What about online drugstores? Skip those that are based in other countries, no matter how good the discounts. It’s illegal to order drugs for import from outside the United States, and they may not be safe or effective. If you want to order online for convenience, do so only from big-box stores, chains and independents that you know and trust. And because it’s wise to fill all of your prescriptions at one store (so that the pharmacist can flag potential drug interactions), once you find lower prices on the medications you take regularly, make it your go-to pharmacy.

Consider Costco. In all states, you can fill prescriptions there without being a member. And if you pay for medication out of pocket, you may reap big savings. Consumer Reports’ shoppers found that Costco usually offered the lowest retail prices on drugs. For example, a month’s supply of the antidepressant duloxetine was $220 at a Kmart and a Walgreens in Raleigh, N.C., but only $43 at a nearby Costco.

If you’re a member, you can join the Costco Member Prescription Program for free. That can net you savings of up to 40 percent on brand-name and generic meds (but only if you don’t have drug coverage or if insurance doesn’t cover all of your prescription medications).

Call the independents. The secret shoppers found that independent pharmacies, which are often smaller, can offer extremely low prices on certain medications. You may also have better luck negotiating at independents, which may have more pricing autonomy than chains. To find out whether an independent near you has a better deal on the medications you take, call several to ask for their absolute lowest prices.

Think 90 days. If you take drugs long term, you may be wasting time and paying extra money by making a monthly trip to the pharmacy for refills. Ask your insurance company whether you can get three months’ worth of medicine at a time. If you can, have your doctor write a 90-day prescription.

Skip economy-size OTCs. You probably think you save the most money by buying the largest available containers of over-the-counter drugs. But the shoppers found that the savings on medium sizes were often comparable to the biggest bottles because drugs in economy sizes are more likely to expire before you get a chance to use them all. Small sizes of OTCs were the worst buy of all.

Copyright 2015. Consumers Union of United States Inc.

For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.

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/

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