The American Society of Clinical Oncology (ASCO) recently released an updated position statement on drug repository programs. The update shifts ASCO’s position to allow donation of oral cancer drug treatments in an open distribution system - which are drugs that have left the supply chain and have been dispensed to patients.
ASCO's previous position statement on the issue was released in 2020. Since then, the Society has been reviewing and monitoring legislation on drug repository programs, which are also known as “drug donation and reuse” 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.
The position statement was revised in October 2022 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. 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’s updated position statement aligns with the position shift of the National Boards of Pharmacy (NAPB), which also moved to allow donation in open systems.1 The Society emphasizes that for any drug donation, pharmacists must use their professional judgement to determine the drug’s integrity and appropriateness for returning to the distribution system.
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. Additionally, ASCO identified waste as a concern in a 2018 Position Statement on Pharmacy Benefit Managers and their Role in Cancer Care.
Currently, a total of 40 states, Guam, and Washington, D.C. have passed legislation establishing prescription drug repository programs.8 Twenty-seven states and Washington D.C. have operational programs. Of the states with statutory programs in place, there are 12 that have established drug repository programs specific to unused cancer drugs, supplies, and devices. These cancer-specific programs are intended to reduce prescription drug waste, reduce drug costs, and increase access to cancer drugs for low-income state residents.
ASCO's statement includes additional information on drug repository policies and programs, including common provisions that cover labeling and packaging, donation and recordkeeping, and dispensing. It also outlines the financial impact of drug repository programs on states and makes recommendations to ensure that state drug repository programs are appropriately and safely implemented.
1. National Association of Boards of Pharmacy. Report of the Task Force on Medication Reuse. https://nabp.pharmacy/wp-content/uploads/2021/02/Task-Force-Report-Medication-Reuse-2021.pdf
8. National Conference of State Legislatures. State Prescription Drug Return, Reuse and Recycling Laws. 2019. http://www.ncsl.org/research/health/state-prescription-drug-return-reuse-and-recycling.aspx