Q&A: Pharmacists Bridge the Gap in Safe Medication Disposal | PQA 2025

Drug disposal programs are vital public health services that promote safe disposal of controlled substances and patient education. In Iowa, a collaboration between public health, the state pharmacy association, and a pharmacy benefit manager incentivized pharmacies to provide disposal products and medication safety education. Using a manufacturer coupon-style reimbursement model, pharmacists were compensated for these services. This model highlights the essential role of pharmacists in medication management and addresses a key public safety gap.

Q&A: Pharmacists Bridge the Gap in Safe Medication Disposal | PQA 2025 / Halfpoint - stock.adobe.com

At the PQA 2025 Annual Meeting, held May 19 to 21 in Tampa, Florida, Drug Topics® sat down with Mitchell Barnett, PharmD, MS, professor of pharmaceutical sciences at Texas A&M University, to discuss the drug disposal program, what lessons can be learned from it to inform efforts in other states, what role community pharmacists play in preventing medication misuse, and how pharmacy-based disposal services can be expanded to address broader issues of medication safety and substance misuse prevention.

READ MORE: Pharmacies Can Drive Medication Safety Through Drug Disposal Programs | PQA 2025

Drug Topics: Can you discuss the drug disposal reimbursement model used to improve medication safety?

Mitchell Barnett, PharmD, MS: The approach that we used was to utilize the existing infrastructure that's already in place in widespread use in almost any community pharmacy in the United States. We wanted to take advantage or leverage that. We wanted to make it as convenient as possible for the pharmacist. Being a former independent pharmacist, I realize how many demands they have upon them, and I didn't want to add to that. I also wanted to provide a mechanism in order for them to get reimbursed for providing this valuable education and service to patients. The model that we came up with, and if you're familiar with watching TV and you see the drug ads, they'll tell you to download a coupon, it was simply that. We stole that idea. It was a manufacturer coupon that either the pharmacy, the patient or another provider could download that the pharmacy then utilized to adjudicate the claim in real time, once that education component was provided to the patient along with the disposal solution,

Drug Topics: What lessons can be learned from the implementation of the program that can inform similar efforts in other states or settings?

Barnett: I think the primary lesson that we learned was that pharmacists and pharmacy technicians are really your biggest advocates for a program like this. We have all kinds of anecdotal information, and actually a study, to back that up. What we showed is that pharmacists really enjoyed providing the service and getting involved, and they also, of course, really enjoyed getting reimbursed for providing this service. I think the primary message that I gleaned from the project was simply that pharmacists and pharmacy technicians really are your best advocates and salespeople for a program like this.

Drug Topics: What role do community pharmacists play in preventing medication misuse through disposal and education programs?

Barnett: Pharmacists are generally the last health care provider involved in the medication chain. In other words, they're the last source or the last person to talk to a patient before they begin their therapy. They're also widely utilized during therapy and also after therapy. I mentioned I was a former community pharmacist. I would get calls all the time, or our pharmacy would, asking, “What can I do with this medication?” What we really wanted to do was to provide an additional, convenient, at home disposal solution for our patients. Iowa, as you might imagine, is primarily a rural state. There's things like the DEA drug take back days and those are wonderful. A lot of pharmacies, including the one that I worked at, had a permanent kiosk. But the thing to keep in mind is that involves the patient storing the medication in their home until they're able to get rid of it. What we really wanted to do was provide that patient with something that they could utilize at home when they were done using that medication to quickly, conveniently and environmentally safely dispose of that medication to get it out of the home,

Drug Topics: How may pharmacy based disposal services expand to address broader issues of medication safety and substance misuse prevention?

Barnett: I'll put in a shameless plug here for the disposal project. It was actually built upon a Naloxone dispensing program that we had begun in the state of Iowa about a year before that. We simply replicated that program. It was very easy. We partnered with a PBM, and I know PBMs can be a four letter word to my community pharmacy friends out there, but this one was really excellent to work with. They fielded all the adjudication claims for our pharmacists out in the field. They provided the logistics, and then they, in turn, cut the reimbursement checks directly to the pharmacy. What I would say is partner with stakeholders. I can't say enough wonderful things about the pharmacists and the pharmacy technicians that I've already mentioned, as well as the Iowa pharmacy Association, other key stakeholders, and certainly the community pharmacy networks out there, were absolutely wonderful to work with.

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