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ProPublica Investigation Finds Nursing Homes Waste Tons Of Prescription Drugs


There's the problem of drug abuse.


And then there's the problem of perfectly useful drugs thrown away. Every year, nursing homes across the country throw away tons of drugs that patients didn't use. We know the expensive drugs can be recycled because in some places they are.

INSKEEP: Most are not. Reporter Marshall Allen investigated this for the newsroom at ProPublica.

MARSHALL ALLEN: So what happens is these drugs get discontinued for various reasons. Maybe the patient gets discharged. Maybe the drug has some reaction, perhaps they even pass away. And so the drugs are distributed a month at a time on these kind of cardboard blister packs.

And then the rest of that drug becomes excess when it gets discontinued. And so in most nursing homes around the country, they just throw those drugs away. They've already been paid for by Medicare or other payers. And so there's really not a lot of incentive to find something else to do with them.

INSKEEP: So I'm just thinking this through. Somebody dies on May 7. So there's 24 days left in the month, 24 doses of that drug left on that blister pack.

ALLEN: Right.

INSKEEP: Is that actually adding up to a lot of pills?

ALLEN: Yes, absolutely. In Iowa, they actually have a program set up to retrieve these drugs and redistribute them to uninsured or underinsured patients for free. And they're getting about $5 million worth of these drugs this year. They get big Rubbermaid bins, dozens of them every week, from the nursing homes just in the Des Moines area. And they get dozens more boxes sent to them from nursing homes around the state.

INSKEEP: What's happening in places that don't reuse the drugs?

ALLEN: So it's - they're being destroyed in various ways. The least expensive way and probably the most disturbing way they're destroying them is they're flushing them down the toilet. And, you know, it's been told to consumers for years not to flush drugs down the toilet because of the environmental consequences of having our water supply get contaminated. But nursing homes are doing this all the time, largely because it's the cheapest way but also because there's competing regulations.

You know, like the DEA is really concerned about narcotics getting into the wrong hands. And so they really emphasize destroying them on sight. And so a lot of times, that means they flush them down the toilet. They also get thrown into landfills or they'll incinerate them. So they'll take them to big medical waste incinerators around the country and they'll burn them up.

INSKEEP: So one effect is just the environmental damage. Is there also an effect in terms of cost and the cost of insurance for everyone?

ALLEN: Absolutely. I mean, that's a piece of it. These drugs, experts say, might be wasting hundreds of millions of dollars a year, so that's just a part of it. But things like overtreatment, things like fraud, things like people getting unnecessary care, I mean, those are things that are driving up the cost of care for all of us.

INSKEEP: Is this symbolic of a larger problem with health care? It's something we all need. It's something we all value very, very highly. And consequently, there's just tremendous waste because you'd always rather have too much of anything than too little.

ALLEN: It is absolutely endemic in health care. And I went up to a warehouse in Maine, where there's a nonprofit that collects discarded medical supplies and equipment from hospitals. And I saw pallets of brand new equipment and supplies. You'd have boxes of sutures that were hundreds of dollars per box unopened, unexpired, in original condition just being thrown away by hospitals because of purchasing agreements or because of the way their supply chain worked. And so there are, you know, millions and millions of dollars in waste every day in health care in America.

INSKEEP: Marshall Allen is a reporter with ProPublica. Thanks very much.

ALLEN: Thank you. Transcript provided by NPR, Copyright NPR.