Despite the economic downturn of the past few years, pharmacy’s commitment to achieving compliant waste management practices has not waned. In past years we have seen increasing regulatory pressure coupled with conflicting regulations causing strains for pharmacy directors who were struggling to ensure proper waste management. In a bid to measure pharmacy’s progress in developing compliant processes in this challenging environment, PP&P conducted our third annual Going Green survey of the pharmaceutical waste process.

Survey Design
In the fourth quarter of 2010, PP&P polled a random, nationwide sampling of health system pharmacy directors. We asked about their pharmaceutical waste practices, costs, regulatory compliance, and commitment. Responses were solicited via e-mail, and we received a total of 343, yielding a confidence interval of 5.13 (95% +/- 5.13) based on the total population of pharmacy directors nationwide.

We intentionally surveyed a random sampling of pharmacy directors, not just readers of PP&P to ensure our data reflects trends across the whole of hospital pharmacy practice. We were pleased to learn that 73% of pharmacy directors nationwide use PP&P as a resource for information on pharmaceutical waste management.

Making Headway
Pharmacy’s commitment to achieving compliant waste practices was not diminished by economic pressure, the continuing lack of clarity surrounding the regulations, or the reported dearth of in-house expertise on this topic. Demonstrating this conviction, those pharmacy directors willing to purchase higher priced items or purchase off-contract to meet environmental objectives held steady this year at 66% and 67%, respectively. Pharmacy directors backed up their growing commitment to achieving compliant practices with clear action: this year saw increases in the numbers of facilities with written policies and procedures, established hazardous waste committees, and further administration support. Simultaneously, spending on waste management grew and more pharmacies are now including a line item in their operating budget for waste management.

While many facilities are confident in their processes for managing controlled substance and hazardous chemotherapy waste, that same confidence does not extend to non-hazardous waste or RCRA-regulated waste where the complexity of the regulations and operational challenges, such as insufficient storage space and budget constraints continue to hinder the adoption of compliant practices. Disposal of items, such as flu vaccines with preservative and used fentanyl patches, in the red sharps bins remains a widespread practice. While a majority of facilities now report disposing of warfarin >0.3 mg packaging in RCRA hazardous containers, too many facilities continue to put this P-listed product in the regular trash.

Pharmacy’s awareness of the challenges they face is an important first step toward improved practices. With the current widespread support of administrators, budget growth, and additional educational resources available, it is time for pharmacy to lead the movement for safe disposal of all pharmaceuticals throughout their organizations.