Founded | 2009 |
---|---|
Founder | Adam Kircher, George Wang, Kiah Williams |
Type | Non-governmental organization |
Location | |
Area served | United States |
Website | sirum.org |
SIRUM (Supporting Initiatives to Redistribute Unused Medicine) is a non-profit social enterprise started by three Stanford University students to decrease the amount of medicine going to waste in the U.S. by redistributing unused, unexpired drugs to safety-net clinics and other organizations. They are the largest redistributor of surplus medicine in the United States.
An estimated $5 billion worth of usable medicine goes to waste each year in the United States—yet 1 in 4 adults report difficulty affording prescription drugs. [1] Medication non-adherence in America results in an estimated 131,000 annual deaths, [2] costing up to $528 billion annually. [3] Wasting $11 billion of usable medicine each year has consequences for Americans: it contributes to polluted air and water supplies, and leads to the duplicative purchasing and manufacturing of drugs to meet patient needs—which could otherwise be met by drawing on medication surplus.
Much of the surplus unused medicine wasted each year resides with healthcare organizations, long-term care facilities, pharmaceutical manufacturers and wholesalers. Because these surplus medications remain in institutional settings throughout their life cycles, their integrity is carefully maintained by trained healthcare professionals. Patients who cannot afford to purchase the prescriptions they need could greatly benefit from having access to these safe, unexpired, and unopened medications that otherwise go to waste.
SIRUM leverages technology to connect surplus unused medicine to patients in need. SIRUM provides “recycling” boxes to medicine donors such as long-term care facilities and licensed pharmacies, who package unopened, unexpired medication and ship them directly to community partners such as safety-net providers, nonprofit pharmacies, and drug repository programs. The organizations’ healthcare providers or pharmacists then distribute the donated medication to patients. SIRUM provides an online platform to handle record-keeping, shipping, and other logistics, making medicine donation an easy, enticing option over medicine destruction. [4]
SIRUM operates under Good Samaritan laws that have passed in 44 states. These laws provide legal protection and regulatory guidelines for medicine donation and redistribution, including the establishment of drug repository programs. [5]
As of December 2024, SIRUM has facilitated the redistribution of $280 million worth of medicine, shipped over 40,000 donations through its platform, and helped more than 300,000 uninsured and underinsured patients access life-saving medications. [6]
SIRUM’s work began in California, first connecting a nursing home as a medicine donor with a Santa Clara County recipient facility. SIRUM began expanding to other states in 2014.
In 2015, SIRUM participated in startup accelerator Y Combinator and was featured in the New York Times. [7] In 2019, SIRUM received recognition from United States Agency for International Development (USAID) and the Environmental Protection Agency (EPA) [8] as an innovator in global waste reduction. In 2020, SIRUM was featured on the TED Conference mainstage and selected as a grantee of the Audacious Project, with their initiative to redistribute $772 million worth of prescription medication to 1 million patients. [9]
A pharmacist, also known as a chemist in Commonwealth English, is a healthcare professional who is knowledgeable about preparation, mechanism of action, clinical usage and legislation of medications in order to dispense them safely to the public and to provide consultancy services. A pharmacist also often serves as a primary care provider in the community and offers services, such as health screenings and immunizations.
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.
Prescription drug list prices in the United States continually are among the highest in the world. The high cost of prescription drugs became a major topic of discussion in the 21st century, leading up to the American health care reform debate of 2009, and received renewed attention in 2015. One major reason for high prescription drug prices in the United States relative to other countries is the inability of government-granted monopolies in the American health care sector to use their bargaining power to negotiate lower prices, and the American payer ends up subsidizing the world's R&D spending on drugs.
A prescription drug is a pharmaceutical drug that is permitted to be dispensed only to those with a medical prescription. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.
In medicine, patient compliance describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence, whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role.
An online pharmacy, internet pharmacy, or mail-order pharmacy is a pharmacy that operates over the Internet and sends orders to customers through mail, shipping companies, or online pharmacy web portal.
A pharmacy is a premises which provides pharmaceutical drugs, among other products. At the pharmacy, a pharmacist oversees the fulfillment of medical prescriptions and is available to counsel patients about prescription and over-the-counter drugs or about health problems and wellness issues. A typical pharmacy would be in the commercial area of a community.
Medication costs, also known as drug costs are a common health care cost for many people and health care systems. Prescription costs are the costs to the end consumer. Medication costs are influenced by multiple factors such as patents, stakeholder influence, and marketing expenses. A number of countries including Canada, parts of Europe, and Brazil use external reference pricing as a means to compare drug prices and to determine a base price for a particular medication. Other countries use pharmacoeconomics, which looks at the cost/benefit of a product in terms of quality of life, alternative treatments, and cost reduction or avoidance in other parts of the health care system. Structures like the UK's National Institute for Health and Clinical Excellence and to a lesser extent Canada's Common Drug Review evaluate products in this way.
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication. Today, the main function of a prescription formulary is to specify particular medications that are approved to be prescribed at a particular hospital, in a particular health system, or under a particular health insurance policy. The development of prescription formularies is based on evaluations of efficacy, safety, and cost-effectiveness of drugs.
Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.
The California Health and Safety Code is the codification of general statutory law covering the subject areas of health and safety in the state of California. It is one of the 29 California Codes and was originally signed into law by the Governor of California on April 7, 1939.
Medication therapy management, generally called medicine use review in the United Kingdom, is a service provided typically by pharmacists, medical affairs, and RWE scientists that aims to improve outcomes by helping people to better understand their health conditions and the medications used to manage them. This includes providing education on the disease state and medications used to treat the disease state, ensuring that medicines are taken correctly, reducing waste due to unused medicines, looking for any side effects, and providing education on how to manage any side effects. The process that can be broken down into five steps: medication therapy review, personal medication record, medication-related action plan, intervention and or referral, and documentation and follow-up.
Automatic Generic Substitution is a proposal by the Department of Health (DH) whereby in January 2010 pharmacists could be obliged to substitute a generic version of a medication even if the prescriber had written the prescription for a specific brand, as part of a new deal on drug pricing.
Established in 2002, the Canadian International Pharmacy Association ("CIPA") is a Canadian association of licensed pharmacy businesses offering mail order pharmacy services to Canadian and international patients. CIPA members sell pharmaceuticals and maintenance medications to individuals upon receipt of a valid prescription. In addition to selling Health Canada approved medications from their licensed Canadian pharmacies, CIPA members also have relationships with regulated international pharmacies and inspected fulfillment centres that directly deliver medications to patients. Patients make the choice from where their medications will be delivered, and this is confirmed with them at time of purchase.
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.
Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost, high complexity and/or high touch. High touch refers to higher degree of complexity in terms of distribution, administration, or patient management which drives up the cost of the drugs. In the early years specialty pharmacy providers attached "high-touch services to their overall price tags" arguing that patients who receive specialty pharmaceuticals "need high levels of ancillary and follow-up care to ensure that the drug spend is not wasted on them." An example of a specialty drug that would only be available through specialty pharmacy is interferon beta-1a (Avonex), a treatment for MS that requires a refrigerated chain of distribution and costs $17,000 a year. Some specialty pharmacies deal in pharmaceuticals that treat complex or rare chronic conditions such as cancer, rheumatoid arthritis, hemophilia, H.I.V. psoriasis, inflammatory bowel disease (IBD) or Hepatitis C. "Specialty pharmacies are seen as a reliable distribution channel for expensive drugs, offering patients convenience and lower costs while maximizing insurance reimbursements from those companies that cover the drug. Patients typically pay the same co-payments whether or not their insurers cover the drug." As the market demanded specialization in drug distribution and clinical management of complex therapies, specialized pharma (SP) evolved. Specialty pharmacies may handle therapies that are biologics, and are injectable or infused. By 2008 the pharmacy benefit management dominated the specialty pharmacies market having acquired smaller specialty pharmacies. PBMs administer specialty pharmacies in their network and can "negotiate better prices and frequently offer a complete menu of specialty pharmaceuticals and related services to serve as an attractive 'one-stop shop' for health plans and employers."
Drug disposal is the discarding of drugs. Individuals commonly dispose of unused drugs that remain after the end of medical treatment. Health care organizations dispose of drugs on a larger scale for a range of reasons, including having leftover drugs after treating patients and discarding of expired drugs. Failure to properly dispose of drugs creates opportunities for others to take them inappropriately. Inappropriate disposal of drugs can also cause drug pollution.
An unused drug or leftover drug is the medicine which remains after the consumer has quit using it. Individual patients may have leftover medicines at the end of their treatment. Health care organizations may keep larger amounts of drugs as part of providing care to a community, and may have unused drugs for a range of reasons. The unused drugs should be destroyed utterly to eliminate the toxic effects of undisposed drugs on flora and fauna. The improper disposal of unused drugs could be the reason for the contamination of Surface, Ground and Drinking Water. Discharge of unused antibiotics and disinfectants in the sewage system may ruin the aquatic life or contamination of drinking water.
Drug recycling, also referred to as medication redispensing or medication re-use, is the idea that health care organizations or patients with unused drugs can transfer them in a safe and appropriate way to another patient in need. The purpose of such a program is reducing medication waste, thereby saving healthcare costs, enlarging medications’ availability and alleviating the environmental burden of medication.
Digital medicine refers to the application of advanced digital technologies, such as artificial intelligence, machine learning, and big data analytics, to improve patient outcomes and healthcare delivery. It involves the integration of technology and medicine to facilitate the creation, storage, analysis, and dissemination of health information, with the aim of enhancing clinical decision-making, improving patient care, and reducing costs.