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GRBJ—Center launches program to reuse oral cancer medications

The treatment center was approved by the Michigan Board of Pharmacy to operate the program.

GRAND RAPIDS, Mich. — GRBJ—A West Michigan cancer center’s new program is helping lower the cost of cancer treatments and divert oral medication waste.

The Cancer & Hematology Centers of Western Michigan (CHCWM) has launched a Cancer Drug Repository (CDR) program so that qualifying oral cancer drugs can be donated for free use by other Michigan residents in need.

According to a statement by CHCWM, the cancer treatment center recently was approved by the Michigan Board of Pharmacy to operate the program, sometimes called a “drug donation and reuse program.” CHCWM is now one of only a few cancer centers in Michigan running drug repository programs.

CHCWM said the goal of the program is to improve access to cancer treatment for low-income patients, lower patient costs and reduce prescription drug waste.

“We treat all patients, regardless of their ability to pay,” said Dr. Haritha Reddy, a practicing oncologist at CHCWM who helped establish the new program. “The high costs of drugs and the waste that can occur after a drug is dispensed make this program, and encouraging donations to it, certainly worthwhile. Everything we can do as a practice to help our patients combat high drug costs is extremely important.”

The average price of a newly launched cancer drug in 2021 was $283,000 per year, making the cost of drugs a large and increasing portion of cancer care’s financial burden. High drug costs, coupled with situations where oral anticancer drugs potentially go unused, spurred CHCWM to undertake this program for its patients.

Additionally, the program will help divert waste, taking medications that still have value and redistributing them to those in need of treatment. Nationally, researchers at Memorial Sloan Kettering Cancer Center found nearly $3 billion is lost annually to cancer drug waste, as reported by NBC in 2016.

Only 12 states in the U.S. have drug repository programs specific to unused cancer drugs, supplies and devices, making CHCWM’s local program a significant step for West Michigan.

“Our goal is to have 100% of donations prescribed for those in need,” said Kimberly Melgarejo, director of pharmacy at CHCWM. “Our drug repository program has strict quality-control processes to determine eligibility for drug donation and patient use. We’re measuring success based on the difference between donations made and used. We expect to use each eligible drug donated.”

Donations may be accepted by a licensed pharmacist and can be made at any CHCWM specialty retail pharmacy location, Western Michigan-Holland Cancer Center, CHCWM-Muskegon, Lacks Cancer Center at Saint Mary’s and Lemmen-Holton Cancer Pavilion.

According to CHCWM, each donation must meet the following criteria:

  • The item is in its original, unopened, tamper-evident unit dose packaging.
  • There is no evidence that the drug has been adulterated or misbranded.
  • The item has not been previously donated or resold.
  • Medications are not controlled substances under federal or state law.
  • Medications are not part of the U.S. Food and Drug Administration’s REMS drug safety program.
  • Medications, as specified in manufacturer packaging, are stored at controlled room temperature.
  • The original lot number and expiration date of the item are clearly visible.
  • The expiration date of the item is at least six months later than the date on which it is donated.

This new West Michigan program is reflective of a shift in health care as organizations work to find solutions to pricey treatments for residents at all income levels. The American Society of Clinical Oncology recently updated its position regarding drug repository programs, revising its stance last made in 2020. Originally hesitant to endorse them, the society released a new statement regarding drug repository programs.

“ASCO and its members are interested in drug repository programs as a means to alleviate some of the challenges around drug affordability, access and waste after ongoing discussions with various stakeholders and changes to the current policy landscape, which reflect a shift from supporting donation in closed distribution systems to donation in open systems,” the society said, revealing it changed its stance in October 2022. “Although this change bears some added risks, ASCO and key stakeholders acknowledge that these risks can be taken due to the continued cost and access challenges facing many patients with cancer.

“ASCO also acknowledges that rising drug costs remain a concern and a significant burden on individuals with cancer. The society notes that its updated position is a practical solution to increase access to prescription drugs for patients and is in line with its 2017 position statement on the affordability of cancer drugs, which affirmed ASCO’s commitment to supporting and promoting practical policy solutions that ensure patients with cancer have access to and can afford drugs vital to the treatment of their disease.”

Donated drugs will be dispensed subsequent to a valid prescription by the CHCWM specialty retail pharmacy located at 145 Michigan Ave. NE, Suite 3100, in Grand Rapids.

Eligible patients are required to be Michigan residents and must have a verified diagnosis of cancer.

Patients who are uninsured or underinsured for the drug in question will be given priority followed by those enrolled in Medicaid, Medicare or any other public assistance health care program. This new drug reuse program is the latest step for CHCWM, which joined OneOncology in June, bringing CHCWM analytics, clinical technology and national connections to help the center expand its services.

CHCWM has 25 medical oncologists and 55 advanced practice providers caring for patients at four main sites in Grand Rapids, Holland and Muskegon. The practice is a participant in Medicare’s Oncology Care Model and has a Phase 1 research program, START-Midwest, with 60 open Phase 1 trials enrolling approximately 190 patients last year.

This report first appeared in the Grand Rapids Business Journal.

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