A D.C. Council member is pushing a plan to allow individuals to donate many prescription drugs for use by needy patients.
The proposal sponsored by Brandon T. Todd (D-Ward 4) is for a two-year pilot program in which individuals, health-care facilities and pharmaceutical companies would be permitted to donate unused but unexpired prescription drugs that the D.C. Department of Health would store and redistribute based on requests from health-care workers.
Narcotics would not be eligible for donations under Todd's bill.
"I meet with about 400 seniors every month, and I've heard from a number of them about the fact that prescription drugs can be a huge financial burden for them" because of the co-pays required even of those who have Medicare, Medicaid or private health coverage, Todd said.
As the bill is written, it is unclear whether donors would be able to take a tax deduction for their donations, but Todd's office said that provision may be considered later. A person receiving the donated drugs also may be charged a small fee to offset the Health Department's costs for managing the program.
Maryland, Virginia and approximately 36 other states have enacted laws to establish drug donation programs, according to the National Conference of State Legislatures. However, nearly half of those states' programs are not operational, and many that are up and running remain small, according to a March report by the group.
After a decade, the programs in Virginia have few participating clinics, and Maryland's program runs through only three pharmacies in poor, rural areas, according to state health providers.
The proposal from Todd, which would have to be voted out of the council's Committee on Health to get to the full council, faces some opposition from the city's pharmacy and health experts.
At an Oct. 25 committee hearing, they testified the program could be burdensome and perhaps more expensive than existing free and discounted District programs, if the fees associated with managing donations drove up costs.
Todd and the other council member at the hearing, committee chairman Vincent C. Gray (D-Ward 7), appeared skeptical of the claims by D.C. Pharmacy Board Chair Daphne Bernard and Shauna White, a program manager in pharmaceutical control within the Health Department.
Gray asked several times about the potential safety concerns about the program. But Todd said after the hearing that the committee plans to work closely with both agencies to design a pilot program that addresses their concerns.
Deena Speights-Napata, the executive director of Maryland's Board of Pharmacy, oversees that state's decade-old program, which she said serves a low-income, rural population that greatly needs assistance.
In about the last two years, the program has refocused from 13 pharmacies to three locally owned pharmacies in Aberdeen, Arnold and Cambridge.
Several years' worth of reports on the program show it has faced challenges enrolling participating pharmacies because of shortages in pharmacy staff to oversee donations and the absence of tax incentives.
But while the program has constricted, local pharmacies have been better at building the close relationships needed to provide care to the communities, Speights-Napata said, especially now that the Maryland system allows for redistribution of donated controlled substances.
Speights-Napata said the board hasn't seen a reduction in use of the program despite the recent changes and that it remains effective in serving rural areas. One of the three pharmacies saw about 250 people benefit in 2016, and about $50,000 in prescription drugs were donated, she said.
Virginia's drug donation program, by comparison, is largely without a pulse.
The Virginia Board of Pharmacy is responsible for licensing pharmacies in the state but does not collect data on the drug donation program, said a spokesman for the Virginia Department of Health Professions.
The program is in limited use among the state's free clinics, said Linda Wilkinson, the executive director for the Virginia Association of Free Clinics.
One participating outlet is the Arlington Free Clinic. Donated drugs represent less than 0.5 percent of inventory there, and are usually drugs that the clinic can find elsewhere, said Jody Steiner Kelly, the director of clinical administration.
Of the 60 free clinics that make up her network, there are eight that participate to any extent with the state program, Wilkinson said.
With 99 percent of the network's patients uninsured and suffering from chronic illnesses, Wilkinson said that donations — which can't guarantee a clinic gets a consistent supply of the medications it needs — can only help in providing a "bridge dose," to support a patient just long enough to be able to find a steady source.
Cross Over Healthcare Ministry, a free clinic in Richmond, sees about six donations a week, said chief executive Julie Bilodeau. The drugs typically donated are insulin and anticoagulants that treat blood clots, and they can be useful, Bilodeau said.
"It doesn't take a lot of donations to save a lot, especially if it is [a drug] they can't afford," she said. But she agreed with other Virginia health-care workers that donated drugs they receive and dispense are essentially negligible in their overall operation.
But gauging benefits to patients is only way to look at the impact. Medications often are donated by families who have had loved ones pass away, and it makes them feel good to do something positive, several clinic workers said.
The fact that so many states have set up programs shows that barriers to creating one in the District are not insurmountable, Todd said.
Anita Bonds (D-At Large), who joined Todd in sponsoring the bill, said she, too, backs a pilot program and believes "it can help us to serve residents who often have to choose between purchasing prescription drugs and purchasing other necessities." She said it could be done with accurate labeling and sealing of medications and proper safeguards.
If the pilot program shows the idea isn't feasible in the District, Todd said, that's fine, but he said he wants the information from a test-run of a program to drive that decision.
"I don't buy that we can't institute something," he said.