© Product Stewardship Institute, Inc. May 2008 PSI National Dialogue on Medical Sharps Boston, MA...

© Product Stewardship Institute, Inc.May 2008

PSI National Dialogue on Medical Sharps

Boston, MAMay 21-22, 2008


What is the Product Stewardship Institute?

Non-profit, based in Boston, founded in 2000 Membership

44 State members 51 Local agency members 20 Adjunct Council members

Board of Directors: 7 states, 4 local agencies Multi-stakeholder product stewardship network Adjunct Council: business, environmental/organizational

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PSI Full and Affiliate State Members

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Why was the Product Stewardship Institute Created?

Unified voice: State and Local Governments Fiscal relief for government on waste issues Objective data for decision-making Forum for collaboration with industry Nationally coordinated systems/harmonized

regulations

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PSI Projects

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Medical Sharps

Pharmaceuticals

Fluorescent lamps

Mercury Thermostats

Paint

Electronics

Radioactive Devices

Telephone books

Gas Cylinders

Tires

Beverage containers

Packaging

Batteries

Motor oil


What is Product Stewardship?

“Product Stewardship" is a principle that directs all those involved in the life cycle of a product to take shared responsibility for reducing the health and environmental impacts that result from the production, use, and end-of-life management of the product.

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PSI Role in Dialogue

Research

Facilitate/mediate dialogue meetings

Implement projects & initiatives

Evaluate projects

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PSI’s “Agenda”

• Promote product stewardship solutions• Reduce product impacts• Forge partnerships that share responsibility

– Product management– Sustainable financing

• Get results – not just discussion

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Meeting Objectives

• General agreement on:– Stakeholder roles/process– Issue statement– Dialogue goals

• Confirm road map

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Meeting Objectives

• Learn from presentations and research• Explore priority issues and strategies• Establish work groups on 2 priority strategies• Determine next steps

– Meeting date/location– Stakeholder assessment

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Priority Issues and Strategies#1 – Source reduction#2 – Collection, transportation, and disposal

infrastructure#3 – Regulation and enforcement#4 – Sustainable financing#5 – Education, outreach, and risk

communication

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Stakeholder Roles• Authorized to represent company, agency, or organization.• Attend 4 meetings (or via phone).• Active participation between meetings.• Jointly develop agreement.• Ensure your interests/others’ interests are met.• Participation in dialogue does not preclude legislative

activity.• Negotiate in good faith.

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Consensus

• All participants can live with decision and no one will actively block or undermine decision.

• The greater the stakeholder agreement, the greater the likelihood that the agreement will be sustainable.

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Consensus

• Consensus is preferable for broad initiatives: – Technical standards– Policies– Legislation

• Consensus is NOT needed for pilot projects or individual initiatives.

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PSI Medical Sharps Dialogue Meeting 15

MEETING 2

MEETING 3

MEETING 1

AGREEMENTS

START

May 2008 August 2008 November 2008 February 2009

•2 Workgroups•Develop findings•Draft work plans

•Refine draft agreements

•Refine Workgroups •Develop Findings•Draft work plans

•Present Workgroup findings/plans

• Full financing discussion•Discuss additional strategies

• Present Workgroup findings/plans• Discuss additional strategies

• Start to develop draft agreements

MEETING 4

• Finalize agreements

• Develop Implementation Plan

Dialogue Meeting

Workgroup Activity

Road Map


PSI Medical Sharps Dialogue Meeting

Possible Dialogue Outcomes

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• Pilot projects with measurable results• Demonstration project to test comprehensive

program• Model state policies (e.g., procurement)• National standards/requirements



Possible Dialogue Outcomes

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• Business innovations/profitability studies (e.g., reverse logistics potential)

• Model state or federal legislation• Model state or national education campaign• National sustainable financing system for the

management of medical sharps



Possible Mechanisms for Agreements

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• Letter of agreement between those involved in pilot project

• Memorandum of agreement between stakeholders stating intent to perform certain activities



What do we want to avoid?

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• Multiple state solutions

• Unilateral state or federal regulation



Potential Stakeholder Contributions

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• Manufacturers (sharps and pharmaceuticals)• Pharmacy benefit managers/third party payers• Insurers• Retail pharmacies• Government agencies• Public health/other associations• Waste management companies



Potential Contributions: Sharps Manufacturers

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Develop/promote sale of products with safety features Increase public awareness about importance of safe disposal and collection locations Produce/sell approved sharps disposal containers for sale with sharps products Manage and finance safe collection of medical sharps



Potential Contributions: Pharmaceutical Manufacturers

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Develop/promote sale of products with safety features Increase public awareness about importance of safe disposal and collection locations Require self-injected products to be accompanied by approved sharps disposal container Manage and finance safe collection of medical sharps



Potential Contributions: Pharmacy Benefits Managers/Third Party Payers

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Require self-injected products to be accompanied by approved sharps disposal container

Increase awareness of importance of safe sharps disposal and collection opportunities



Potential Contributions: Insurers

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Reimburse costs of sharps disposal containers and collection/disposal of sharps.



Potential Contributions: Retail/Mail Order Pharmacies

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Increase public awareness about importance of safe disposal and collection locations Collect used sharps on site or via mail-back Provide coupon as incentive to return used medical sharps for disposal Promote sale of products with safety features



Potential Contributions: Government

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Oversee manufacturer collection programs Increase public awareness about importance of safe disposal and collection locations Regulation/enforcement to level playing field and maintain fairness



Potential Contributions: Government, cont.

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Require that sale of self-injected products includes safe sharps disposal Provide existing facilities for safe consumer collection convenience Explore tax credits or other opportunities to encourage private sector participation in sharps disposal programs Explore public financing options



Potential Contributions: Waste Management Companies

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Increase awareness of importance of safe sharps disposal and collection opportunities

Provide safe transport and treatment for sharps disposal



Process for Developing Action Plan

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• Draft Problem Statement and Goals• Issues/Strategies• Interviews/input from over 35 stakeholders• Input incorporated into Action Plan • Draft Action Plan/comments• Input on 2nd Draft Action Plan – due 2 weeks• NOT PSI’s Issue Statement and Goals



Issue Statement

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• Sharps are used for self-injection and blood glucose testing by people with diabetes, patients administering their own medications, and injection drug users.

• Sharps used in the “community” typically end up in MSW, recycling, or wastewater

• If not properly disposed of, sharps can pose a hazard to sanitation workers, others



Issue Statement

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• Sharps may also be left in public places

• Sharps may damage or disable equipment

• Problem is expected to increase as number of people with diabetes rises and “biologic” drugs expand markets



Dialogue Goal

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The primary goal of the project is to maximize the safe and environmentally sound collection and disposal of waste

sharps by developing a nationally coordinated system that is financially

sustainable.



Dialogue Focus

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This project will focus on sharps generated outside the traditional health care setting,

including households, hotels, casinos, restaurants, airports, and other public

venues.



Purpose of Presentations

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Educate attendees on basics

Outline current boundaries of knowledge

Illustrate product stewardship

Show potential for collaboration

Portray possibilities



Issue/Strategy Discussions

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Background technical information

Clarify issues and strategies

Additional strategies

Prioritize strategies

Workgroups at end of 2nd day - top 2 strategies

© Product Stewardship Institute, Inc. May 2008 PSI National Dialogue on Medical Sharps Boston, MA...

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