Keeping harmful medications out of the wrong hands is a constant challenge. But getting safe medications into the right hands is plenty challenging, too, as Rowan Mahon well understands. Before Mahon, 31, began her doctorate in pharmacy at the University of Minnesota, she worked in labs where she was introduced to alarming waste. She graduated from the U in 2020 and is now volunteer managing director of RoundtableRx, a student-founded nonprofit that collects donated, unexpired medications that are then distributed free to patients who otherwise could not afford them. Mahon also works full-time as manager of clinical operations for ActiveRadar , a health care analytics company. She tells us more about her project below.
Q: You became aware of just how much waste exists in medical settings many years ago. Might you say a bit more about that?
A: Before beginning my doctorate in pharmacy at the U, I worked nights as a lab scientist in a blood bank. I was the one who had to dispose of medical waste and I began to think about waste in health care systems in general. I soon learned it was even worse in the pharmacy space, with so many medications thrown out even when they had not yet expired.
Q: How much worse?
A: As an example, there are 325 long-term care facilities in Minnesota, including nursing homes and assisted living facilities, that dispose of an estimated $16 million worth of safe, unexpired medication every year, according to the nonprofit association Care Providers of Minnesota. This was occurring at the same time the cost for medications was becoming more extreme. I was beginning to see how pricing was really impacting people and it was upsetting to me.
Q: So, thank you very much. You did something about it.
A: In 2017, along with fellow student Hannah Van Ochten and others, I helped to create and pass legislation to get the state's first real drug repository program off the ground. It didn't get much attention, but Minnesota lawmakers passed a plan in 2019 to set up a program to take unused medication destined for a flush or the landfill and instead distribute it to people struggling to afford their medicine. RoundtableRx was born.
Q: From where does RoundtableRx receive donated medications?
A: RoundtableRx has built collaborations with seven health care systems representing 33 hospitals and nearly 200 clinics statewide and is currently dispensing medications out of three clinics and one pharmacy across the state. Additionally, RoundtableRx has arrangements in place to receive donated medications from the largest long-term care facilities. We have over $300,000 worth of medication. The thing we're really focused on now is building out partnerships with pharmacies and clinics so we can make that number grow significantly.
Q: It's important to note here that you do not distribute opioids.
A: We never touch opioids. They are not allowed in our program. No opioids. No expired drugs. No insulin, because it requires refrigeration and all of our medications must be kept at room temperature.
Q: But you do offer a lot of needed drugs. Which are most requested?
A: The most urgent need is for medication providing daily maintenance, such as oral diabetes prescriptions. Other big requests are for medications for hypertension and mental health management. And we get a surprisingly large amount of requests for inhalers.
Q: Please take us through the process, from receiving the medications to processing them and so forth?
A: After boxes of medications arrive, we quarantine everything for 24 hours. Our volunteer licensed pharmacists conduct safety checks on all of them to assure that they really are not expired and that the medications are the medications they say they are. They make sure there are no controlled substances and no recalls, and that the tamper-proof packaging truly is tamper-proof, with no evidence of anything being open. The medications are then logged into inventory, then organized by type.
Q: You have managed to do all this with just one employee, a project manager?
A: Yes, aside from our paid project manager, we are all volunteers, including our pharmacists. But we just received $50,000 from the Otto Bremer Foundation and we're planning to use it to hire a part-time pharmacist. Having a dedicated pharmacist on staff will be extremely helpful.
Q: We hear so much about the devastating impact of prescription drug abuse. How are you tackling that with RoundtableRx?
A: All drugs carry a risk and we're operating within a system that is, hopefully, doing its job. Our concern, however, is when people are unable to take their medications as prescribed because they don't have access to them due to lack of health care coverage or funds to pay for them. In 2017, Minnesota's uninsured rate increased from 4.3 to 6.3 percent, leaving approximately 350,000 people without coverage, according to the Minnesota Department of Health. COVID-19 has exacerbated the issue, causing even more individuals to lose coverage and face difficulties affording the medications they need.
Q: How many other states have similar programs?
A: We've modeled ourselves after Iowa, which has had a program for 10 years and has repurposed nearly $18 million of medication. A nonprofit called SIRUM runs programs in California, Georgia and multiple other states and they helped us with our legislation. Wyoming was really helpful in the beginning, as was Oklahoma.
Q: Might you ever be able to accept unexpired medications from the general public?
A: At some point. We are legally allowed to do that now, but there is a lot of work required to do so. Donors are required to talk with a licensed pharmacist, fill out a questionnaire, follow safety requirements and so on. It's a big lift for us to receive anything from the public because safety is our top concern.
Q: What makes you most proud?
A: When I'm sending a medication out the door and I know the patient wouldn't have received the medication without our program. Ours aren't exciting medications, but they're medications that make a difference; inhalers, diabetes drugs. People just get to take the medications they need. That's been extremely powerful to me.