pcpsa 2012 -2016 program plan post-consumer pharmaceutical

PCPSA 2012 -2016 Program Plan

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Prepared and submitted by

Post-consumer Pharmaceutical Stewardship Association


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Post-consumer Pharmaceutical Stewardship Association

1. Product Stewardship Plan ....................................................................................................................... 4

2. Recycling Regulation Requirements ....................................................................................................... 4

3. The Stewardship Association................................................................................................................... 5

4. Stakeholder Consultation [Section 5 (1) (b)] .......................................................................................... 6

5. Medications Return Program- overview ................................................................................................... 7 a) Pharmacies [Section 5 (1)(c)(iii)] ................................................................................... 8 b) Program administrator .................................................................................................... 9 c) Funding .......................................................................................................................... 9

6. Educational Materials and Strategies ................................................................................................... 10 a) Publicity ........................................................................................................................10 b) Printed materials ............................................................................................................10 c) Other resources ..............................................................................................................10

7. Program Performance Measurement ................................................................................................... 11 a) Consumer awareness [Section 5 (1) (c) (iv)] .................................................................11 b) Number of collection points [Section 5 (1) (c) (iii)] ......................................................12 c) Product recovery target .................................................................................................12 d) Promotion ......................................................................................................................13 e) Waste composition studies ............................................................................................14

8. Compliance Process ................................................................................................................................ 15

9. Dispute Resolution [Section 5 (1) (c) (vi)] ............................................................................................. 16

10. Pollution prevention hierarchy [Section 5(1)(c)(viii)].......................................................................... 16

11. Environmental impact throughout product lifecycle [Section 5 (1) (c) (v)] ....................................... 16

12. Waste Disposal Sites ............................................................................................................................... 17

13. Annual Report ........................................................................................................................................ 17

NEW PHARMACY REGISTRATION FORM ................................................................................................. 18 PROTOCOL/AGREEMENT .............................................................................................................................. 19 PHARMACY E-NEWS ........................................................................................................................................ 22 2011 STEWARDS ................................................................................................................................................. 24 POPULATION SURVEY .................................................................................................................................... 26 CONSULTATION SUMMARY .......................................................................................................................... 28 PARTICIPATING PHARMACIES .................................................................................................................... 38

PATIENT MONOGRAM .................................................................................................................................... 48


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Terminology

The following terminology is used throughout the recycling regulation and this document

Collection Sites: Community pharmacies who are registered in the program to

collect unused and expired health products from the public.

Consumer health products: Health products sold to consumers.

Health products: Prescription drugs, nonprescription drugs and consumer

health products.

Member: Brand-owner/steward who is a member of the association

Natural health products: Vitamins and minerals, herbal remedies, homeopathic

medicines, traditional medicines such as traditional Chinese

medicines, probiotics, and other products like amino acids

and essential fatty acids.

Program Administrator: The individual or business who is contracted to manage the

BC Medications Return Program in British Columbia.

Regulation: Recycling Regulation, B.C. 449/2004

Stewards: (i) A person who manufactures a pharmaceutical product and

sells, offers for sale or distributes a pharmaceutical product in

British Columbia under its own brand, or;

(ii) A person who is not the manufacturer of a pharmaceutical

product but is the owner or licensee of a trademark under

which the pharmaceutical product is sold or distributed in

British Columbia, whether or not they own the Drug

Identification Number.

(iii) If subparagraphs (i) and (ii) do not apply, a person who

imports the product in the province for sale or distribution.

Stakeholders: Person or organization whose interests will be or are affected

by the provisions of a proposed plan.


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1. Product Stewardship Plan

This plan is designed to collect and properly dispose of unused or expired health products

from the residential sector. Products included in this plan are:

All prescriptions drugs All dosage forms

Over-the-Counter medications Units sold in oral dosage form

Natural Health Products Units sold in oral dosage form

The Program includes both products clearly attributable to an existing steward, and orphan

products. Orphan products are those that are no longer in production, the steward is no

longer in business or products purchased outside Canada. The Program‟s goals are:

to run a province-wide, industry-administered product stewardship program in

compliance with the Regulation

to ensure that the public is able to return expired and unused health products for

disposal throughout the province

to provide a convenient system for the collection and disposal of expired and unused

health products

to provide the public with information on the location of collection sites

to ensure that collection sites accept products from the public free of charge

to achieve performance requirements or targets established in the plan

to ensure environmentally sound disposal of expired and unused health products.

Since 2000, the program has grown from 575 to 1,025 collection sites across the whole

province and the public has returned approximately 296,836 kg of unused or expired health

products for environmentally responsible disposal.

2. Recycling Regulation Requirements

In accordance with the requirements of their approved stewardship plan, there must be a

review of the program plan every five years. According to Section 6 of the Recycling

Regulation: A producer must review its approved plan and

(a) submit to a director proposed amendments to the approved plan, or

(b) advise a director in writing that no amendments to the approved plan are

necessary,

The BC Medications Return Program has developed and delivered an effective, cost

efficient, environmentally and socially responsible health products return program for

consumers on behalf of more than 140 members.

This Plan describes the current program and the priorities for the next 5-year period in the

context of the approval criteria set forth in the Regulation.


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3. The Stewardship Association Mandate & Purpose

The Post-Consumer Pharmaceutical Stewardship Association (PCPSA) is a not-for-profit

association; meets its obligations, as outlined in the BC extra provincial Society Act, and

files the required reports with the Corporate Property Registry Branch of the Ministry of

Finance and is also registered with Industry Canada since 2000.

The PCPSA has been appointed as the agency to meet producer‟s obligations ashealth

products stewards. PCPSA‟s role is to perform on behalf of each member certain duties

required under the Regulation. As of December 2010, PCPSA‟s membership was

established at 140 members.

The Program is accountable to its members, the general public and the government of

British Columbia, through the Ministry of Environment. The Program is publically

accountable through its Annual Report.

Governance

The Association is a member-based association representing obligated stewards of health

products, as defined in the Recycling Regulation. The Association operates according to the

Bylaws approved by the Board to manage the affairs of the Association. A nine-member

Board of Directors is elected by the members.

The Board members are committed to maintaining a high standard of corporate

governance. The directors have the responsibility for the overall stewardship of the

association, establishing the overall policies and standards for the association. The current

list of the Board of Directors is available on the association‟s website. An Executive

Director reports to the Board and is responsible for operations management, financial

management, communications and general administrative duties. In order to streamline

operations and minimize costs, PCPSA shares an office in Ottawa with Consumer Health

Products Canada.

As required by regulation, PCPSA has operated a province-wide BC Medications Return

Program for prescriptions drugs, nonprescription drugs and natural health products since

April 1998.

The pharmaceutical product category is regulated in Canada under the Food and Drugs Act

and Regulations and the Natural Health Products Regulations. Unlike other programs

developed under the Recycling Regulation (Product Care, Electronics, Oil etc) the BC

Medications Return Program is fully funded by the health product industries.


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4. Stakeholder Consultation [Section 5 (1) (b)]

The producer has undertaken satisfactory consultation with stakeholders prior to

submitting the plan for approval and will provide opportunity for stakeholder input in the

implementation and operation of the product stewardship program.

For the first time ever, stakeholders were invited to attend joint public consultation

meetings for the review of four BC product stewardship plans: Tire Stewardship BC, the

Electronic Stewardship Association of BC, Product Care Association and the Post-

Consumer Pharmaceutical Stewardship Association.

The joint consultation sessions were held as follow:

• Prince George - Wednesday May 25, 2011 – Ramada Inn

• Kelowna - Friday May 27, 2011 – Coast Capri Hotel

• Nanaimo - Monday May 30, 2011 – Coast Bastion Inn

• New Westminster - Tuesday May 31, 2011 – Inn at the Quay

People could register online at bcstewardconsultations.ca and could download a copy of the

product stewardship plans from each agency`s website. PCPSA`s stewardship plan was

posted by May 5th

and available for public comment and the deadline for submission of

written comments on PCPSA‟s plan was June 17, 2011.

Advance notifications were sent out on April 18th

to 329 common stakeholders such as

senior government, stewardship associations, ENGOs including RCBC, regional districts

and municipalities. A notice was also sent to PCPSA`s members, collection sites on May

15th

. A total of 84 individuals participated in the four consultation sessions and eight

written submissions were received by the deadline.

PCPSA‟s presentation at the consultation sessions provided an overview of the Plan as well

as opportunities to ask questions and provide feedback. Appendix 5 provides a summary of

the questions and comments received and where possible, like comments have been

grouped together for ease of response. In doing so, we have tried to maintain the essence of

the public‟s input without distortion.

http://bcstewardconsultations.ca/


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5. Medications Return Program- overview

The collection sites for the BC Medications Return Program are community pharmacies.

Pharmacy managers interested in participating must complete a registration form. Details

on the program are provided to ensure that management and their staffs are knowledgeable

on the program and its operation. All participating community pharmacies receive

information with instructions on the program, order form and containers (Appendix 1).

Once the registration form is completed and faxed to our office, the pharmacist is contacted

by phone to discuss the following points:

The program is for returns from the public.

Large quantities from individuals are acceptable.

All dry health products can be dropped directly into the plastic container, including

blister packs and inhalers in their original package

All liquid products are accepted, they are not to be poured into the container.

This program does not accept sharps, needles and syringes.

All extra packaging should be removed; including personal information.

Once the container is full, the pharmacist contacts the program administrator to schedule a

delivery and pick up. All containers received from a pharmacy are tracked by weight,

pickup date and location and re-packaged for safe destruction through a licensed

incineration facility.

Table 1.Collection in kilograms


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a) Pharmacies [Section 5 (1)(c)(iii)]

The plan adequately provides for reasonable and free consumer access to collection facilities

Since 2000, we increased the number of registered pharmacies from 575 to 1,025,

representing 94.5% of licensed community pharmacies in the province. PCPSA provides

promotional items (posters, brochures, flyers, etc.) for display and has developed a news

bulletin circulated in the spring and fall (Appendix 2). There is no charge to the consumer

to return products. Community pharmacies currently participating in the program can be

easily located by the public on the Association‟s website at www.medicationssreturn.ca or

by accessing the Recycle Council of British Columbia Encyclopedia at http://rcbc.bc.ca/. In

addition:

Pharmacies are a natural, logical and safe site for the public to return health products.

They also offer easy access to those with special needs and varying degrees of personal

mobility.

Pharmacists are very knowledgeable about dispensing health products and do provide

advice on individual medical condition and proper use of health products.

Many of these pharmacies are open during extended hours, offering a convenient place

for consumer disposal year-round.

The following lists provide an example of materials that would be acceptable. Note that this

list is not exhaustive.

Accepted

All prescription drugs

Nonprescription health products

Natural health products

Vitamin and mineral supplements

Not accepted

Sharps, needles or syringes

Cosmetics

Antiperspirants, antiseptic

Skin cleansers

Mouthwashes

Hard surface and disinfectant cleaners

Expired samples from physicians‟

offices

Unused or expired drugs from

hospitals and institutions

Pharmaceuticals from farms and

veterinary products

http://www.medicationssreturn.ca/

http://rcbc.bc.ca/


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b) Program administrator

The PCPSA contracts with a program administrator for the following.

Maintain and update database on participating community pharmacies

Collection of expired and unused health products from pharmacies

Storage and disposal of products

Ensuring all necessary environmental permits and licenses are obtained

c) Funding

To ensure that brand-owners/producers who sell, offer for sale or distribute health

products in British Columbia are covering their share of the costs to the Program.

Funding from the industry covers all expenses incurred in the collection, transportation,

storage, promotion and disposal of products within the BC program.

The cost of operating the BC Medications Return Program is shared between brand owners

of health products (prescriptions drugs and natural health products). Updated lists of

participating brand-owners are also published on the Association‟s website. Yearly reviews

are done to identify and confirm brand-owners/producers selling health products in British

Columbia (Appendix 3).

Prescription Drugs

The fee to brand owners of prescription drugs is based on all products dispensed in British

Columbia in the previous calendar year. The minimum rate is $200.00 + applicable taxes.

Natural Health Products/OTC‟s

The rate to brand owners for over-the-counter drugs and natural health products is based on

sales in previous calendar year at $0.20 per $1,000 of BC sales of affected natural health

products. The minimum rate is $200.00 + applicable taxes.


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6. Educational Materials and Strategies

To ensure citizens know where and how to dispose of unused or expired medications

when necessary.

a) Publicity

The program has posters, brochures, flyers, bookmarks, etc. that can quickly be supplied to

participating pharmacies, special events or other associates such as Regional District Service

offices and municipalities. The brochures provide clear directions on what is accepted and

not accepted, how to return the unused or expired health products and where returns are

accepted in an easy fashion. PCPSA offers its support to health awareness events and health

trade shows with advertising responsible disposal of unused or expired health products.

b) Printed materials

Take-aways: Brochures and point of purchase signage is distributed to pharmacies and other

locations such as clinics and doctor‟s offices through a reorder system by fax, email or

through the website. Brochures are presently available in English, while bookmarks are

available in four languages (English, French, Punjabi and Chinese).

Municipal Garbage and Recycling calendars: PCPSA will continue to promote the

Medications Return Program in the recycling calendar published by regional districts and

municipalities informing residents about municipal services.

Mailouts: PCPSA will provide promotional material to regional districts and municipalities

or other groups/organizations interested in promoting the program.

A News bulletin is currently available on a quarterly basis to our members. We also have a

bi-annual e-bulletin for the community pharmacy managers.

Local Newspapers: PCPSA has produced articles in community newspapers promoting the

Medications Return Program. Other initiatives are taking place during the Pharmacist

Awareness Week and other health related events during the year.

c) Other resources

Web Site: The medicationsreturn.ca website provides the public with information on the

program and locations of collection sites for the disposal of health products. The site also

provides a searchable database of participating pharmacies and details on products accepted

by the program.

As we continue to build our membership base, we are able to utilize our members‟ own

promotional network to advertize the Medications Return Program. These initiatives are

described in Annual Reports.


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RCBC Toll-Free and Recyclopedia: PCPSA has partnered with the Recycling Council of

British Columbia recycling hotline service and sponsored the newly expended on-line

recycling information database called Recyclopedia.

Consumer information: Information on the safe use, storage and disposal is provided to the

consumer at the time of purchase.

PCPSA sends regular updates to regional districts and municipalities including key messages

and logos that can be used to promote safe disposal of unused or expired health products.

7. Program Performance Measurement

The Regulation requires that the plan make adequate provisions for informing consumers

of the producer‟s product stewardship program, the location of collection facilities and

how to handle products in a safe manner as well as the environmental and economic

benefits of participating in the program.

While we agree that recovery rate can provide a way to measure program success, the

recovery/capture rate is not a meaningful performance measure for health products in

determining the effectiveness of this stewardship plan. As a result, PCPSA will evaluate the

success of the program through the following five categories: awareness indicators,

accessibility indicators, quantity collected, promotion indicators and waste composition

studies. The Program has been tracking and reporting on many of these key indicators since

2006.

a) Consumer awareness [Section 5 (1) (c) (iv)]

A consumer awareness survey was developed in 2007 and used again in September 2010,

and shows significant improvements in both consumer behavior and awareness of the

program (Appendix 4: Full report).

Awareness Indicators

Target until 2017: Increase public awareness by 25% and usage of Program

by 10%:

60% of British Columbians are able to identify

pharmacies as a place where consumers may dispose

of unwanted health products.

61% have used the Program to dispose of health

products in the last 6 month.

Performance measures: Measure changes in awareness and behaviour

Strategies:

Year 1

Work with BC Stewards to increase exposure through

communications and other events.


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Promote program through advertising, 3 special events

such as community pharmacy events.

Year 2 - 3 Maintain publicity in annual recycling calendars (12) and

continue to support special events (2).

Year 4 Measure awareness and usage of program with public

survey.

Year 5 To be developed based on results in year 4.

b) Number of collection points [Section 5 (1) (c) (iii)]

Since 1997, the Program has established a comprehensive network of permanent collection

sites where the public can conveniently return health products for responsible disposal. This

network consists of community pharmacies as well as some clinics, hospitals, community

centers and other collections sites with a large volume of consumers‟ returns.

Accessibility Indicators

Target until 2017: Maintain or exceed participation rate of 95 % on a three-

year rolling average.

Performance measure: Report percentage of sites who have returned containers

in the last 24 months

Strategies: Year 1 Contact new licensed community pharmacies on a

quarterly basis; contacts obtained through the College of

Pharmacists in B.C.

Contact existing pharmacies with ownership and/or

manager changes on a quarterly basis.

Contact pharmacies with a significant change in

collection pattern.

Year 2 - 3 Review and adjust to maintain participation

Year 4 Review and adjust to maintain participation

Year 5 Review and adjust to maintain participation

c) Product recovery target

Quantity Collected

Target until 2017 Maintain a minimum collected quantity of 65 tons on a

three-year rolling average.

Performance measure: Report total quantity collected on a yearly basis with

quarterly results by regional districts.

Strategies: Year 1 Promote program at special events (e.g. Pharmacy

Awareness, retailer‟s own promotional initiatives).

Year 2 Continue to work with members and participating

pharmacies to organize special collection events and

publicize program. Promote program in different media.

Year 3 and 4 Continue to work with members and community


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pharmacies with special collection events and publicity

from retailers.

Year 5 To be developed based on public survey results in year 4.

d) Promotion

Promotion Indicators

Target until 2017 Publicity on the Medications Return Program in 25

regional districts or municipalities‟ websites with

recycling sections.

Promotion of program in participating pharmacies and

other sites.

Performance measure: Increase in awareness of Medications Return Program.

Strategies: Year 1 Contract out website development and design.

PCPSA will maintain a website to locate collection sites with easy access to information on the program.

Maintain contact with waste coordinators in regional

districts/municipalities with promotional material (video)

and key messages for their websites/display area.

Indication of program in recycling calendars or with

information distributed directly to households.

Work with pharmacists and their professional

associations to craft messages about the program.

Connect with other health professionals‟ organizations,

such as nurses, physicians and home-care personnel.

Display signage in pharmacy on the BCMRP.

Year 2 and 3 Track traffic to BC page and access to locations.

Work with communication firm for the promotion and

advertising plan development on the program

Connect with pharmacists and help disseminate

information on the program through the Ambassador or

similar initiatives.

Year 4 Follow up on advertising on regional

district/municipality websites and annual calendars.

Evaluate the outcome of our promotional program

through a public survey.


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Evaluate the participation/awareness of pharmacists on

promoting the program to their customer.

Year 5 TBD

e) Waste composition studies

We have joined with the BC Stewards Group to formalize a working partnership with

Regional Districts to conduct detailed waste audits to determine the makeup of the waste

stream. It is anticipated that the reports derived from these audits will be analyzed and used

by stewards as one of many tools to establish the effectiveness of their programs in

accordance with the requirements of the Recycling Regulation. The resulting information

will assist the partners in achieving the long-term goal of zero waste

For the Regional Districts that conduct waste composition studies, these studies should be

statistically significant to establish the presence of health products within the Household

Hazardous Waste categories.

Waste Composition Study

Target until 2017: Decrease the presence of health products in waste

composition studies.

Performance measure: Report amounts of regulated products estimated in

statistically significant waste composition studies.

Strategies:

Year 1

Draft and approve the BC Stewards waste audit proposal.

Year 2 - 3 Establish a partnership agreement for participating in

scheduled waste audits performed in five regional

districts.

Year 4-5 Review and develop a guide for participating in Waste

Composition Study


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8. Compliance Process Compliance process and enforcement measures are central to ensure full compliance of all

obligated parties. For the purposes of initiating actions with the British Columbia Ministry of

Environment; non-compliance is defined as a lack of responsiveness from a brand-

owner/producer after more than two notices on producers‟ responsibilities have been sent

from PCPSA. Exceptions can be made if the Board determines that the producer/brand-

owner is not covered by the regulations (excluded products) or fees are paid by a third party.

In the event that PCPSA does not receive a financial contribution from stewards within the

prescribed timeframe(s), PCPSA management may utilize the following notifications to

underscore the importance of timely submission:

1st contact (60 days prior): Letter is sent to obligate stewards under the Recycling

Regulation, informing them of their responsibilities. PCPSA‟s role is to advise

any potential stewards and offer the approved Medications Return Program as a

way to fulfill their regulatory requirements.

2nd

contact (90 days): A second letter is sent to a steward for lack of reply from

the previous correspondence. At this point in time, PCPSA will point out that they

are liable if their company contravenes the Act.

3rd

contact (120 days): A final letter with a deadline for submitting membership

documents and payments toward the plan is sent by PCPSA. At this point, the

Board will consider each steward on a case-by-case basis to approve final step.

4th

contact: A request for non-compliance actions is sent to the Ministry of

Environment with a copy to the steward.


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9. Dispute Resolution [Section 5 (1) (c) (vi)]

The Recycling Regulation requires that a plan provide for a dispute resolution procedure.

Any person or organization believing that the responsibilities of parties participating in the

Medications Return Program do not meet the program plan should immediately provide a

detailed description of the complaint to PCPSA:

By e-mail to [email protected]

By fax to 613-723-0779

By phone to 613-723-7282

PCPSA will within five days seek to resolve the dispute through a co-operative approach and

voluntary resolution. In the absence of a successful resolution, PCPSA will convene a

threeparty adjudication panel within two weeks. One individual will be chosen by PCPSA,

one individual chosen by the pharmacy and one individual chosen by the complainant (not

the complainant). The panel will consider the dispute and offer a binding decision on all

parties involved. Should the decision not be accepted, legal recourse is available to the

complainant.

10. Pollution prevention hierarchy [Section 5(1)(c)(viii)]

The pollution prevention hierarchy (recycle, recover, residual disposal) requirements outlined

in the Recycling Regulation to reduce the environmental impact of health products are not

feasible without affecting pharmaceutical product safety, efficacy, and quality. Health

products are consumable products. Health products are taken for specific conditions or

symptoms and should be fully consumed unless otherwise indicated by a health professional.

Health products cannot be reused or recycled, as other products covered under this

regulation. Some manufacturers/producers have been able to give excess health products with

adequate shelf life (usually 6 months) for humanitarian use. This unique situation eliminates

or reduces a product that is consumable; however it does not apply to products that have been

purchased by a consumer.

Products collected under this program will be disposed through incineration at government-

approved facilities. A certificate of destruction, as well as 3rd

party verification is obtained.

11. Environmental impact throughout product lifecycle [Section 5 (1) (c) (v)]

Over the last 5 years, members have undertaken environmental initiatives that have improved

the environmental impact of health products. As a performance measure, individual stewards

have also made some changes to product monograms which reflect the program‟s ability to

influence change in a positive manner. Product Monograms (patient medication information


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sheer) are starting to indicate safe disposal options (appendix 7). In addition, since 2010, all

MRP containers have been replaced with reusable 30 L containers.

PCPSA has also partnered with some chains (Shoppers Drug Mart) to distribute paper bags to

help with medicine cabinet clean-up and reduce the impact of pharmaceuticals entering the

environment. This medications return campaign will be evaluated.

12. Waste Disposal Sites

It is not appropriate for health products to be returned with other household hazardous waste

and handled by individuals not used to handling health products. PCPSA prefers that health

products are returned to a pharmacy location. Pharmacies are more knowledgeable in

handling health products and offer a secure environment for safe disposal.

PCPSA only partners with licensed service providers with a proven record of using

established, approved and verifiable procedures for the final treatment and processing of

residuals in compliance with all applicable environmental regulations.

13. Annual Report

On or before July 1 each year the Association shall submit to the Director a report of the

Association‟s activities for the preceding calendar year. The report will document the

performance in relation to the plan. The report will also be available on the Association‟s

web site.

Appendix 1

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NEW PHARMACY REGISTRATION FORM

Pharmacy Name: :_________________________________________________________

(eg: ABC Pharmacy)

Address: ________________________________________________________________

_________________________________________ License Number (12345): _________

City: ______________________, British Columbia Postal Code: ___________________

Phone Number: ( ) ___________________ Fax Number: ( ) ______________

Contact Name: ___________________________ Email: ________________________

Responsible for the BCMRP

Date: ___________________________

I UNDERSTAND THE CONDITIONS AND AGREE TO FOLLOW THEM IN AN EFFORT TO

CONTRIBUTE TO THE SAFE DISPOSAL OF MEDICATIONS. I CERTIFY THAT THE WASTE

COLLECTED AT THIS FACILITY AND PLACED IN THE MMRP CONTAINER IS COMPRISED

ONLY OF ACCEPTABLE PUBLIC WASTE AS DESCRIBED IN THIS DOCUMENT AND DOES

NOT CONTAIN ANY OTHER WASTE.

Signature: ______________________________

Please fax this registration form to 866-783-7432 or e-mail at [email protected] in order to register

your site with the BC Medications Return Program. Keep original signed copy of the agreement on file at the

pharmacy. Your location will be listed at http://www.medicationsreturn.ca/british_columbia_en.php

You will be contacted within a few weeks of receipt to arrange for delivery of program documentation and containers.

For more information contact PCPSA at [email protected]

Thank you for your interest in the BC Medications Return Program. We look forward to working with

you!

mailto:[email protected]

http://www.medicationsreturn.ca/british_columbia_en.php

mailto:[email protected]

Appendix 1

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PROTOCOL/AGREEMENT

1) This agreement applies only to the collection and disposal of pharmaceutical waste generated by the

public—i.e. public waste.

2) Pharmacist will determine if the waste is acceptable or not. Only returned health products from the

public are acceptable.

a) All prescriptions drugs

b) Over-the-Counter Medications; Units sold in oral dosage form

c) Natural Health Products; Units sold in oral dosage form

Including medicated patches

Including topical antibiotics and fungal creams

Examples of dosage forms are:

solids, semi-solids and powders

o caplets, capsules, tablets, granules, mixtures, powders for injection, creams, lotions,

gels, suppositories, etc.

liquids

o solutions, suspensions, syrups, ampoules, etc.

aerosol canisters

o sprays and inhalers ( maximum 10 full canisters per container)

novel dosage forms

o strips, gums, patches, etc

3) All solids should be poured/placed directly in the container; outer packaging is removed.

4) All liquid products are accepted, they are not to be poured into the container. The vial/bottle is placed

directly into the container without any transfer of content.

The MAXIMUM weight for a full container is 23 kg.

5) The vial /bottle (except liquid medications) should be recycled where facilities exist. Where recycling

options are not available, the containers are disposed in the regular waste stream.

6) This program is for returns from the public and not from hospitals, institutions, doctor‟s offices or your

own pharmacy operations.

Appendix 1

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7) This program does not accept sharps, needles and syringes.

8) The Pharmacy shall train and inform its employees in the terms and condition of this program and the

proper handling and disposal of public waste. All employees working at the site must be

knowledgeable about the program offered to the public.

9) Once full the liner must be tied and the lid securely closed. (See instruction sheet)

10) The waste is to be stored at all times in a location where access is controlled, restricted to trained

employees only.

11) To register, complete enclosed registration form or download form at

http://www.medicationsreturn.ca/british_columbia_en.php and fax to 1-866-783-7432.

12) Once registered for the BC Medications Returns Program, you will need to schedule a pickup, please

complete service request form or contact STERICYLE at:

Phone 604-552-1011

1-866-783-7422

Fax: 1-866-783-7432

[email protected]

The Pharmacy shall inform the program administrator (Stericycle) of any change in its operations

that could affect the nature or the origin of the waste collected

http://www.medicationsreturn.ca/british_columbia_en.php

Appendix 1

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Appendix 2 Pharmacy e-news

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PHARMACY E-NEWS

Appendix 3 Participating Stewards in 2011

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2011 STEWARDS Abbott Laboratories Limite

AA Pharma Inc.

Abbott Laboratories Limited

Abraxis BioScience Inc.

Actelion Pharmaceuticals Canada Inc.

Advantage Sales and Marketing Canada

Aeterna Zentaris Inc.

Afexa Life Sciences Inc.

Alcon Canada Inc.

Amgen Canada Inc.

Amway Canada Corporation

Apotex Inc.

Ascendia Brands (Canada) Ltd.

Ashbury Biologicals Inc.

Astellas Pharma Canada Inc.

AstraZeneca Canada Inc.

Avon Canada Inc.

Axcan Pharma Inc.

Baxter Canada

Bayer HealthCare, Consumer Care

BELLUS Health

Bioforce Canada Inc.

Biogen Idec Canada Inc

Biovail Pharmaceuticals Canada

Blistex Corporation

Boehringer Ingelheim Canada Ltd.

Boiron Canada Inc.

Bristol-Myers Squibb Pharmaceutical Group

Canada Safeway Ltd.

CanReg Inc.

Chattem (Canada) Inc.

Church & Dwight Canada

Cobalt Pharmaceuticals Inc.

Combe Incorporated

Contract Pharmaceuticals Limited Canada

Costco

Cytex Pharmaceutical Inc.

Dormer Laboratories Inc.

Dr. J.O. Lambert Ltd.

E-Z-EM Canada Inc.

Eli Lilly Canada Inc.

EMD-Serono Canada Inc.

Environmental Advisory Group

Enzymatic Therapy

Ferring Inc.

Gaia Garden Herbals Inc.

Galderma Canada

General Nutrition Centres Canada

GlaxoSmithKline Consumer Healthcare Inc.

GlaxoSmithKline Inc.

Graceway Pharmaceuticals

Helix BioPharma Corp.

Herbalife of Canada

Hospira Healthcare Corporation

HPI Health Products/Lakota

Hudson's Bay Company

Indigene Pharma Inc.

Institut Rosell-Lallemand

Jamieson Laboratories

Janssen Inc.

Johnson & Johnson Inc.

Katz Group Canada Ltd

King Pharmaceuticals

Kripps Pharmacy

Laboratoire Atlas Inc.

Laboratoires Riva

Leo Pharma Inc.

Loblaw Companies Ltd

London Drugs Limited

Lorus Therapeutics Inc.

Lundbeck Canada Inc.

MDS Inc.

Mead Johnson Nutrition (Canada) Co.

Mentholatum Company of Canada Limited

Merck Canada Inc.

Mint Pharmaceuticals Inc

Mylan Canada

Natural Factors Nutritional Products Ltd.

Nature's Sunshine Products of Canada Ltd.

Nature's Way Canada Ltd

Northwest Natural Products

Novartis Consumer Health Canada Inc.

Novartis Pharma Canada Inc.

Novo Nordisk

Nu-Pharm Inc

Nucro-Technics

Nycomed Canada Inc.

Odan Laboratories Ltd.

Omega Alpha Pharmaceuticals

Omega Laboratories Ltd.

Organika Health Products Inc.

Overwaitea Food Group Ltd Partnership

Paladin Labs Inc.

Patheon Inc.

Peoples Drug Mart (B.C.) Ltd

Pfizer Canada Inc

Pfizer Consumer Healthcare, Division of Pfizer

Canada Inc.


25

Pharmasave Drugs (National) Ltd.

Pharmascience Inc.

PharmEng Technology, a division of PE Pharma

Platinum Naturals

Procter & Gamble Inc.

ProMedics Nutraceutical Ltd

Purdue Pharma

Ranbaxy Pharmaceuticals Canada Inc.

Ratiopharm

Reckitt Benckiser (Canada) Inc.

Roche Limited

Ropack Inc.

Sandoz Canada

Sanis Health Inc.

Sanofi-Aventis

Schering-Plough Canada Inc.

Seaford Pharmaceuticals Inc.

Sepracor Pharmaceuticals Inc.

Servier Canada Inc.

SFBC New Drug Services Canada

Shaklee Canada Inc.

Shire Canada Inc.

Shoppers Drug Mart, Pharmaprix

SISU Inc.

Solvay Pharma Inc.

Stiefel Canada Inc., a GSK Company

Swiss Herbal Remedies Ltd.

Taro Pharmaceuticals Inc.

Teva Canada / Novopharm

Theramed Corporation

Theratechnologies Inc.

Tianshi Health Products

Triton Pharma Inc.

Trophic Canada

UniPHARM Wholesale Drugs

USANA Canada Co.

Valeant Canada Limited

Vita Health Products Inc.

Wal-Mart Pharmacy

Warner Chilcott Canada Co.

WellSpring Pharmaceutical Canada Corp.

Westcoast Naturals

WN Pharmaceuticals Ltd.

Wyeth Canada

Appendix 4 Population Survey

26

POPULATION SURVEY

This summary provides an overview of a survey undertaken with 509 adult British

Columbians in September 2010.

Ninety percent of British Columbians report that they have health products in their home,

including 30% who have unused or expired health products.

Without prompting, almost one-half of British Columbians (48%) are able to identify

pharmacies as a place where consumers may dispose of unwanted health products. This is

up significantly from 31% in 2007.

Asked directly whether health products may be returned to a pharmacy, 60% of British

Columbians say they may. About one half (51%) of British Columbians claim they were

aware of this before completing the survey.

Thirty-three percent of British Columbians say they have disposed of health products in

the last six months. This marks a 10% decrease since 2007.

Since 2007, there has been a remarkable increase in the percentage of British Columbians

who returned their unwanted health products to pharmacies. This percentage has more than

doubled, from 21% to 51%. There has also been a large corresponding decline in the use of

garbage to dispose of health products.

Three-quarters of all British Columbians who claim to be aware that pharmacy disposal is

an option actually used this option the last time they had unwanted health products. Thus,

awareness is a very powerful driver of behavior in British Columbia.

Among those British Columbians who disposed of health products at a pharmacy, the

experience was both convenient (93% agree) and satisfactory (94% agree).

Unprompted, 43% of British Columbians say they would return health products to a

pharmacy in the future (up 19 points since 2007), while 51% would use either the regular

garbage or a household drain (down 17 points since 2007).

When prompted, the overwhelming majority of British Columbians (86%) say they would

be likely to use pharmacy disposal if it were available. Specifically, 70% say they are very

likely to use a pharmacy and 16% say they are somewhat likely.

There are no major barriers in the minds of consumers to using pharmacies to dispose of

unwanted health products. More than two-thirds of consumers (69%) say they can see no

reason why they would not use a pharmacy for this purpose. For most others, the potential

barriers are convenience, distance, laziness or forgetfulness.

Appendix 5 Stakeholder consultation summary

27

From a demographic perspective, women are generally more aware and more active in the

proper disposal of health products. Older consumers are also more aware and more

proactive.

Appendix 5Stakeholder consultation summary

28

CONSULTATION SUMMARY

LIST OF ATTENDEES AT PUBLIC CONSULTATION MEETINGS NAME POSITION COMPANY OR ORGANIZATION

NEW WESTMINSTER MEETING

Andrew Doi. Environmental Planner Metro Vancouver Ann Johnston. Director Mayne Island Recycling Society Bill Reid Executive Director Cloverdale District Chamber of Commerce Brigitte Pronovost. .Supervisor, Solid Waste City of Port Moody Buddy Boyd/Barb Hetherington. Owners Gibsons Recycling Depot Cassandra Caunce. Section Head, EM, Business & Standards. Ministry of Environment Chris Falloon Principal Stonehouse Management Services David Ellwood Sales..... Newalta Don Blythe Chair Tire Stewardship BC Donna Bucsis. Operations Assistant. City of Port Moody Ela Lukowska Waste Diversion Supervisor. City of Surrey Emy Lai..... City of Richmond Greg Tyson... Analyst... BC Ministry of Environment Jack Liu. Senior Business/Financial Development Officer. Mansonville Plastics Jason Lee..... Project Engineer... Metro Vancouver Jennifer Lukianchuk.... Environmental Coordinator City of New Westminster Jim Favaro. Vice-President PCPSA Ken Falconer General Manager Operations.. ToxFree Energy Canada Kim Day. Executive Director Ridge Meadows Recycling Society Kim Harris Mayne Island Recycling society Leanne Koelin.. Ridge Meadows Recycling Society Lisa Sullivan Manager Abbotsford Community Services Recycling Mark Den Harder Account Manager.. Stericycle Martin Oconnon Sale. Newalta Maury MCIntosh.. Administrator. London Drugs Mike Marocchi.. Director, Scientific & Technical Affairs SISU Inc. Monica Kosmak Zero Waste Planning Program Manager City of Vancouver Neil Hastie CEO Encorp Pacific Richard Aikema Manager Abbotsford Community Services Rod Lotzkar Regional Recycling Scott Temreck. Business Development. Action Environmental Tauseef Waraich.. General Manager.. TRI - Technology Resource Inc. Tom Madigan. Superintendent Street Cleaning City of Vancouver

PRINCE GEORGE MEETING

Dave Fuller... Owner.... Ave Maria Specialties Helen Sherrard President Canadian Health Food Association Janine Dougall Director of Environmental Services.... Regional District of Bulkley-Nechako Kevin Grose.. Owner/Manager.... OK Tire Auto Service Lyn Smirl Environmental Management Analyst. Ministry of Environment Mike Hennessy. Executive Director Tire Stewardship BC Petra Wildaur Regional District of Fraser-Fort George Rachael Ryder Waste Diversion Program Leader Regional District of Fraser-Fort George Rachel Simpson Business Manager Selen Anita Securities Inc. (Canadian Tire) Terri McClymont Executive Director REAPS Recycling & Envi. Action Planning Society) Vic Caron President Victor Surplus Equipment Ltd.


29

PRINCE GEORGE MEETING

Casey Mitchell.. Co-owner Island Natural Markets Cathy Kenny. Solid Waste Management Coordinator Sunshine Coast Regional District Dave Ross..... Operations Manager, North Island...... Enterra Environmental David Brown. Former MoE Ed Walsh...... V.P. Operations BC. Enterra Environmental Gary Franssen.. Manager of Sanitation and Recycling. City of Nanaimo Henry Lee..... Supervisor, Outreach and Partnerships. C apital Regional District Jennifer Crabbe.. Operations Manager.. Cowichan Valley Bottle Depot Kathleen Milward Environmental Technologist. Cowichan Valley Regional District Kristi MacMillan.. Environmental Management Analyst. Ministry of Environment Lyn Smirl...... Environmental Management Analyst. BC Ministry of Environment Michael Schellinck. Executive Director Nanaimo Recycling Exchange Michael Schellinck.... Nanaimo Recycling Exchange Michele Patterson.. Manager, Environment & Sustainability. Vancouver Island University Mike Johnson Harbourview Volkswagen Rob Williams Environmental Technologist. CVRD Sharon Horsburgh. Senior Zero Waste Coordinator.. RDN Sophy Roberge. Public Relations.... Cowichan Valley Bottle Depot Steve McKerrell.. Executive Chairman Swiss Natural Tom Watkins. Capital Regional District Wendy Dunn.. Capital Regional District Will Burrows Executive Director Coast Waste Management Association

KELOWNA MEETING

Paul Marois President Planet Earth Recycling Ltd. Alan Stanley. Director of Environmental Services..... Regional District of Kootenay Boundary Allan Miedema. Owner/Operator..... KP Tirecraft (1977) Ltd. Ben Van Nostrand Waste Management Coordinator. Columbia Shuswap Regional District Bert Monesmith Senior Market Director.. EBA, A Tetra Tech Company Don Hamilton. Solid Waste Facilities Coordinator. Regionl District of Okanagan-Similkameen Jay Aarsen Interior Freight & Bottle Depot Jongjin Lee Owner. J&C Bottle Depot Karen Oh Boucherie Bottle Depot Ken .Westbank Bottle Depot Ken Muller City of Kelowna Kristi MacMillan Environmental Management Analyst... Ministry of Environment Lyn Smirl Analyst Ministry of Environment Nicole Kohnert Manager Regional Engineering Services Regional District of North Okanagan Peter Rotheisler Regional District of Central Okanagan Rick Monahan. Natures Fare Markets Shaun Daniels. Corporate General Manager Nature’s Fare Markets Wendy Bennett. Solid Waste Facilities Assistant. Regional District of Okanagan Similkameen


30

We have distilled four hours of discussion and eight written comments into the following

table.Terminology

Comment/Questions

Answer

Term medication is misleading as natural health

products are not considered medications.

The expression health product is frequently

accompanied by additional clarification such

as: including prescription drugs,

nonprescription drugs and natural health

products.

This program was established before Health

Canada created (in the nineties) a separate

regulatory framework for natural health

products.

„Consumer health product‟ should be replaced, or

natural health product should be explicitly stated.

Term “consumer health products” not clearly

understood to consumers

Based on consultation, we will add in the

glossary:

Consumer health products: health products

sold to consumers.

Health products: prescription drugs,

nonprescription drugs and natural health

products.

Natural health products:

Vitamins and minerals

Herbal remedies

Homeopathic medicines

Traditional Chinese medicines

Probiotics

Other products like amino acids and

essential fatty acids

What is the risk associated with misuse of

supplements?

This Recycling Regulation appliesproducts

under NHP‟s definition, not specific to natural

supplements. Program is designed to meet the

requirements of the Recycling Regulation

which stipulates that all types of

pharmaceuticals be included in the program

The Recycling Regulation, B.C. 449/2004 refers to the

Pharmaceutical product category and not to

medications. Unclear if the regulations require that

Natural Health Products be included in this program.

The purpose of the program plan is to be a

bridge between the language in the regulation

and more explicit working language. NHP‟s

are clearly included in the definition of

products captured by the program.

Does the program include sharps?

Does program include Epi-Pens?

Program does not include sharps. Different

product category that is yet to be regulated.

Should not e in our containers as medications

are shipped as non-bio hazard waste.

Will there be something on website of how to get rid

of other materials (sharps)? Put a link.

We direct people to BCPhA. But we could put

link on the website.

Appendix 6 Participating Pharmacies

31

Expand range of products to include hospitals,

doctor‟s office, institutions, farms and veterinary

products.

B.C. regulations exempts those sectors

Packaging/containers Vials and packaging are excluded from the

program plan. This program was established

to provide a safe disposal options for

medications through pharmacies; Public is

encouraged to bring in medications in original

container and place medications in our

containers. The original regulatory obligation

referred to the product and not the packaging.

Recommend to pharmacies and the public to

recycle the containers.

Can the stewards in the natural health industry meet

the requirements of the regulation by only providing

education to the public about safe disposal options?

Public education is only one component. Also

need a collection system that follows the 5 Rs.

A public education program, on its own,

would not meet the requirements of the

regulation.

Will there be a program in place for packaging?

Yes, they will be included in the new

packaging and printed materials program that

was just announced this week.

Board of Directors

Comment/Questions

Answer

Explicit representation from the natural health product

and small business sector should be stipulated in the

bylaws and be made publicly available.

PCPSA is a member (health products

industries) based association; election and

appointment of all directors are held during

AGM. Equal representation of sectors (brand

name, generic and consumer health industries)

is in the by-laws.

CHFA represents 1000 members that are fully

engaged in the natural health product sector with our

members ranging from suppliers to independent

health food store retailers.

Despite this fact, we were only afforded 4 days notice

prior to this consultation session.

Following our attendance at the consultation session,

CHFA does not feel that our concerns with the

program and the inclusion of natural health products

have been addressed appropriately by either PCPSA

or the BC Ministry of the Environment.

Notice to PCPSA‟s members was circulated,

in our newsletters (January/April) and through

direct e-mail announcement in April.

The majority of industries affected by this

regulation are currently registered and

participating in the program.

Suppliers and retailers, unless they own a

brand and private label are not targeted by this

regulation.

Questions on the product definition should be

addressed to the Ministry and not through

public consultation; these sessions are to

evaluate program plans.

Believe that the fee base is unfair for NHP‟s. Fee base

should be proportional to environmental risk.

Fess is not based on risks but on quantity

generated/sales. Fee structure is reviewed by

Board of Directors If membership disagrees;

they can propose a change in the funding

model through elected directors on the board.

Members can vote on a proposed revised

revenue model.

Collection Answer


32

Comment/Questions

What assurance can be provided or checks and

balances are in place to ensure that pre-consumer

damaged products, whose disposal is paid for as part

of a commercial transaction between the vendor and

the retailer, are not disposed of through the post-

consumer mechanism and hence double paid for by

suppliers of natural health products.

We do verify containers to ensure compliance

both with product definition

(cosmetics)/consumer returns vs pharmacy

waste (stale dated product).

Suppliers are not funding the program, only

brand owners.

CHFA strongly recommends that the option to act as

a collection location for natural health products be

expanded beyond pharmacies to include all locations

for where natural health products are sold.

PCPSA advocates community pharmacies for

the public to return unused or expired health

products. Nonetheless, we have expanded our

collection sites to other locations such as

clinics, health center and, hospitals when

applicable. New locations are assessed based

on completing an application form available

on our website at www.medicationsreturn.ca .

There is no need to involve a pharmacist for

unscheduled natural health products

That is correct; however the program covers a

wide range of products in addition to NHP‟s.

80% of products returned are prescription

drugs.

Add clarity that damaged pre-consumer goods as a

result of normal retail and distribution practices are

not accepted into the return program described in this

document

Clarification on acceptable products is found

in the protocol and agreement, provided upon

registration. Appendix 1

Independent Health food Stores should also be

specifically listed

All registered collection sites are listed,

regardless of type of business.

Unused or expired drugs from hospitals and

institutions are excluded from the program

B.C. Regulation exempts these sectors.

Is there a diversion rate target?

No. Only consumer access, consumer

awareness, and % of people that have used the

program. Report on quantity collected by

regional district.

Numbers that are returned that are natural health

products versus prescription drugs?

Survey indicated 80% prescription drugs

versus 20% consumer health products,

including natural health products.

Do weights in per-capita figures include weights of

containers?

Yes, a small percentage of packaging with

liquids, gels, powder etc ,

Is there a financial incentive for pharmacies to

participate?

No, there is no financial incentive.

Participation is fully voluntary.

I have never been told when I purchase drugs that the

unused medications can be returned.

Drugs are generally prescribed for a specific

treatment period and should be used

completely. Education and outreach inform

the public of medications return programs.

How does the BC collected numbers compare to other

provinces?

The other comparable programs in Canada are

Alberta and Manitoba. Other international

programs collect different products. BC

collection is currently in line with Alberta but

we will have to wait until 2012 to compare

with Manitoba.

If 10-15% of medication is unused, how much of that All numbers are estimates only. Therefore this

http://www.medicationsreturn.ca/


33

is the program collecting? calculation is difficult to perform.

Want a performance measure that allows current

collection rate to compare to what is available for

collection.

Can‟t compare what is sold (in units) to what

is returned (in kg).

Waste audit in CO showed diversion rate of about

4%. Lowest of all EPR programs. Doesn‟t even show

stuff that was put down the drain. Need way more

communications. Maybe door to door would be

required.

I would have to look at the methodology used

to identify health products to comment.

However, when comparing BC results with

other programs such as Alberta, Ontario,

Australia, Spain, UK, our recovery per capita

at .0134 kg is lower but within a 20 % range.

What was the change in relation to the containers in

2009?

Changed containers from single use to re-

usable. The public encouraged to bring in

health products in original container, place it

in container and encourage pharmacy to

recycle the container. Regulatory obligation

refers to the medication, not the packaging.

Disposal/Incineration

Comment/Questions

Answer

There is no research that shows that it is necessary to

incinerate natural health products vs. composting

We do not separate returns; all dry

medications are placed in our containers

regardless of type and chemicals ingredients.

Not all NHP‟s are suitable for composting,

similar to not all health products present a

danger to the environment.

There is no literature or research that suggests that

NHPs are dangerous to the environment. NHPs can be

recycled in other manners (composted as an example)

or can be given to friends/family unlike prescription

pharmaceuticals (since they don‟t require a

prescription).

This program is for safe disposal of health

products and has no specific recommendation

for recycling or reuse of any products.

We have no information suggesting that

composting/recycling is a viable option.

A separate assessment of NHPs entering the

environment should also be conducted/reviewed prior

to the inclusion of these products in this program.

Substance division for new substance

notification regulation applies to NHP‟s.

What science suggests it is harmful to handle natural

health products, or that they are harmful to the

environment?

The program is intended to assist the public

with responsible disposal of all health

products, including products that have been

deemed safe for human health and the

environment. This program was not designed

to educate the public on product safety but to

offer an alternative to flushing or throwing in

the garbage.

All product stewardship programs should include

disposal hierarchy on the material collected.

The pollution prevention hierarchy (recycle,

recover, residual disposal requirements

outlined in the Recycling Regulation is not

feasible without affecting pharmaceutical

product safety, efficacy, and quality. There are

very few licensed facilities (3) capable of

handling health products. All products are


34

disposed through incineration In 2012; we

will be sending our products to Brampton

Ontario. There is no energy recovery available

from approved sites in Canada. Our products

recovered represent less than 1 % of the total

load destroyed yearly.

Fee

Comment/Questions

Answer

This document should clearly articulate a fee and

category for NHPs so as to not mislead consumers.

An across the board minimum fee unfairly penalizes

small businesses and the thousands of multi-level

marketing companies or direct sellers who import into

the province and sell small quantities of natural health

products. We recommend that no fee be payable for

those companies whose sales of captured products are

less than $1 million (a person who sells $5,000 worth

of product vs. $1 million worth of product and both

pay $200 is unfair).

There is no fee to the consumer.

Companies that are doing business in Canada

under their own private label with products

captured under the definition are rarely under

the $1 million threshold. Retailers/ suppliers

unless they own their private label, are not

charged a fee.

Fees are reviewed by the board (elected by the

members); members can request changes to

the revenue model.

We support the funding ;mechanism for the program,

with direct fees to brandowners and no eco-fee to

consumers

Maintaining funding formula

Educational Materials and Strategies

Comment/Questions

Answer

Should also include naturopathic doctors. All request for printed material are assessed;

including doctor‟s office

Outline the events that have been considered that

include natural health products.

Events are listed in the annual report available

on our website at www.medicationsreturn.ca

Adopt Results based goal Changes were made as recommended

Clarify the target Changes were made as recommended public

awareness to 60% and usage of the program to

61%.

Pharmacies are often the weak link, and don‟t know

about the program. Do you anticipate a program to

educate front line staff?

A newsletter to individual pharmacies to

remind them of what is included is now part

the program plan. New brochures for

pharmacy will be available in2012.

Actively engage pharmacists as ambassadors of the

program

PCPSA is working with the BC Pharmacists

Association and a marketing firm in

promoting the program to pharmacists. Yearly

campaigns to engage the pharmacist‟s

community and clear messages on the benefit

of the program have been develop. Additional

financial resources have been allocated to

further engage pharmacists.


35

A key role identified for pharmacists was to

understand why residents chose not to consume all the

medications.

This is outside the scope of this program and

might be part of the pharmacist‟s mandate.

One of our objectives is to ensure pharmacists

do understand the scope of the program,

however, following therapy is not one of our

responsibilities.

Training material for pharmacy staff Already available with pharmacy with

protocol and agreement. Appendix 2

Consider training pharmacists on the environmental

health hazard associated with improperly disposing of

medications down the toilet or in the garbage

This is part of the ongoing joint effort with the

BCPhA and the BC college of Pharmacists.

Expand the range of communications tools. Product monographs (patient information

sheet) have been changing to include

instruction for disposal.

Do not flush medications down the drain or

pour them into a drain unless instructed to do

so. Properly discards this product when it is

expired or no longer needed. Consult your

pharmacists or local waste disposal company

for more details about how to safely discard

your product.

Social media contest for short video on health

products safety was initiated in 2011. Video

on our website at medicationsreturn.ca.

Since material is so easy to throw away and put down

the drain, perhaps it needs door to door service.

Survey shows that people still throw away, despite no

barriers.

People‟s behavior changes over time. The

2010 survey results shows progress in both

awareness and usage. We will continue to

reach out with promotion and educational

material.

Product Recovery Target

Comment/Questions

Answer

Work with local government to develop a target

related to the amount of medications disposed of

through solid waste and sewerage systems.

Conduct regular waste audit

PCPSA along with the BC Stewards, the

Ministry and some RD‟s representatives are

working on municipal solid waste

characterisation project to facilitate reliable

municipal solid waste characterisation studies

through use of a standardised tool.

If sale triple is the tonnage still appropriate target. Recovery rate with consumable products such

as health products is not necessarily related to

sales. The rate of increase of prescriptions

dispensed in Canada have decrease from 7.4%

in 2007 to 4.5% in 2010.

Source: IMS Brogan, CompuScript.

www.imsbrogan.com

http://www.imsbrogan.com/


36

Program is very low profile. Don‟t see posters,

communications etc.

Program is low volume when compared with

other programs. Percent of people who have

reported using it is high.

Is there a diversion rate target?

Need to be able to evaluate what you are missing.

We are reporting on consumer access and

consumer awareness, and % of people that

have used the program in the past 6 months

with full report on quantity collected by

regional districts.

Consumer awareness

Comment/Questions

Answer

Is consumer awareness determined through prompted

or unprompted questions

September Ipso Reid survey questions were:

A) Can you name any specific places or

facilities where consumers can dispose of

their unwanted or expired medications?

(Unprompted) 48% pharmacies

B) As far as you know, can unwanted and

expired medications can be returned to a

pharmacy near you for safe disposal? 60%

reported yes

Promotion

Comment/Questions

Answer

Concerns the options for promotion rely solely on

regional districts and municipalities to convey

message.

Increase public promotion; social marketing

Strategies to reach beyond those markets will

be address by contracting out marketing and

promotion to suitable agency.

Signage at entrance of pharmacy Display signage on the MRP will be available

to registered sites.

Stickers.

Information advising of return options with packaging

Products Monogram, are starting to indicate

safe disposal options (appendix 7 )

Visible signage in Dr offices, clinics, care facilities

etc.

Added to the plan under Promotion:

Connect with other health professionals such

as nurses and home care personnel

Well promoted events should be done for this

program.

We have used BCPhA promotion during

Pharmacists Awareness Week in March to

promote the program for the past 3 years.

Misc.

Comment/Questions

Answer

How do you ensure privacy of information on labels

etc ?

Program instructs public to remove personal

information. Pharmacy code of conduct

requires them to remove or overwrite

information (like with a black marker) before

they can be discarded.

Any outreach to trade schools and universities to talk

with those being trained in the profession

Yes, we advertise in the pharmacists

association newsletter and licensing


37

authorities


38

PARTICIPATING PHARMACIES

PharmacyName Aaroson's Pharmacy Abbott (renuka)Pharmacy Ltd. Ackroyd Pharmacy Alberto Pharmacy #1 Alberto Pharmacy No.2 Aldergrove Community Pharmacy Alert Bay Drug Store All Care Pharmacy Alouette Pharmacy Anderson's Pharmacy #1 Andreen's Lakeview Pharmacy Anita's Pharmacy Apple Pharmacy Apple Prescriptions Centre Armstrong Pharmacy and Wellness Centre Barriere IDA Pharmacy Barry's Drugs Black's Pharmacy Blueridge Pharmacy Bond Street Pharmacy Bonsor Pharmacy Boundary Pharmacy Broadway Pharmacy Ltd. Buckshon Pharmacy Burke Mountain Pharmacy Cadboro Bay Peoples Pharmacy Calea Pharmacy Cambell River Health & Drug Store Campus Medicine Centre Pharmacy Candrug Canpharm Drugs Care In Motion Pharmacy Carepoint Pharmacy Cates Medicine Centre Cedar Park Pharmacy Central Drug Central Drug Store Central drug Store Central Drugs Central Drugs-Beban Plaza Central Park Pharmacy Central Pharmacy City Centre Pharmacy Clearbrook Pharmacy Clinic Drugstore Columbia Prescription Xpress Columbia Street Pharmacy Community Care Pharmacy and Ostomy Supplies Consumers Drug Mart Continental Pharmacy Coolaid Dispensary

Cooper's Foods Pharmacy #160 Corning Drugs Ltd. #1 Corning Pharmacy #2 Costco Pharmacy #051 Costco Pharmacy #054 Costco Pharmacy #055 Costco Pharmacy #059 Costco Pharmacy #1092 Costco Pharmacy #155 Costco Pharmacy #158 Costco Pharmacy #161 Costco Pharmacy #163 Costco Pharmacy #255 Costco Pharmacy #256 Costco Pharmacy #259 Costco Pharmacy #548 Costco Pharmacy #552 Crystal Pharmacy & Medical Supplies Davies Prescriptions-St. Georges Deep Cove Pharmacy Delta Natural Health Centre & Pharmacy Delta Prescription Clinic Donex Pharmacy Downtown Clinic Pharmacy Drugstore Pharmacy #1517 Drugstore Pharmacy #1518 Drugstore Pharmacy #1519 Drugstore Pharmacy #1521 Drugstore Pharmacy #1524 Drugstore Pharmacy #1526 Drugstore Pharmacy #1527 Drugstore Pharmacy #1531 Drugstore Pharmacy #1553 Drugstore Pharmacy #1554 Drugstore Pharmacy #1555 Drugstore Pharmacy #1556 Drugstore Pharmacy #1557 Drugstore Pharmacy #1558 Drugstore Pharmacy #1559 Drugstore Pharmacy #1560 Drugstore Pharmacy #1562 Drugstore Pharmacy #1563 Drugstore Pharmacy #6708 Drugstore Pharmacy #6726 Drugstore Pharmacy #6729 Drugstore Pharmacy #6732 Drugstore Pharmacy #6733 Drugstore Pharmacy #6734 Drugstore Pharmacy #8552 Drugstore Pharmacy #8563 Drugstore Pharmacy #8565 Drugstore Pharmacy #8566 Drugstore Pharmacy #8572


39

Drugstore Pharmacy #8573 Drugstore Pharmacy #8574 Drugstore Pharmacy #8576 Drugstore Pharmacy #8578 Drugstore Pharmacy #8579 Drugstore Pharmacy #8580 Drugstore Pharmacy #8581 Drugstore Pharmacy #8582 Drugstore Pharmacy #8583 Drugstore Pharmacy #8585 Drugstore Pharmacy #9047 Dyck's Medicine Centre-Gordon Dyck's Medicine Centre-Springfield Dyck's Medicine Centre-St. Pauls-#299 Dycks Pharmacists Eagle Ridge Drugs Eagle Valley I.D.A. Pharmacy Ltd. East End Pharmacy Eastside Pharmacy Ltd. Edmonds Pharmadrugs Elements Compounding Pharmacy Enderby Pharmacy and Wellness Centre Estevan Pharmacy Limited Fairway Drug Mart Family Care Pharmacy Ferraro Foods Festubert Pharmacy Finlandia Pharmacy Forbes IDA Pharmacy #001 Forbes IDA Pharmacy #2 Fort Nelson IDA Pharmacy Fort St. John Pharmacy and Wellness Centre Fraser Heights Pharmacy Ltd. Fraser Lake Medicine Centre Fraser Pharmacy Fraserview Pharmacy Ltd. Front Street Pharmacy Frontier Street Pharmacy-IDA Fruitvale Pharmacy (2003) Ltd. Gain Pharmacy Gant's Pharmacy #2 Garden Park Pharmacy Garlane Pharmacy #1 Garlane Pharmacy #2 Gateway Pharmacy Glen Pharmacy Glover Medicine Centre Pharmacy Glover's Medicine Centre Pharmacy Golden Life Pharmacy Gonzales Pharmacy Good Health Pharmacy Gourlay's Golden Pharmacy Haney Pharmacy Hart Drug Mart Harvard Pharmacy Harvest Drive Pharmacy

Hastings Pharmacy HealthPlus Pharmacy Healthside Pharmacy High Gate pharmacy Ltd. Hogarth's Clinic Pharmacy Ltd Hollyburn Medicine Centre Pharmacy Howe Sound Pharmacy Ltd Howe Street Pharmacy I.G.S. Value Drug Mart IDA Plaza Pharmacy Ideal Drug Mart Ltd. Imperial Pharmacy Ingram Clinic Pharmacy Isand Pharmacy #06 Island Crisis Care Society Island Pharmacy Island Pharmacy #08 Jay's Pharmacy Ltd. Jeff's I.D.A. Pharmacy Jericho Pharmacy & Health Food Store Kaslo drugs (1980) Ltd. Kenneth Street Pharmacy Kerrisdale Pharmacy King George Medic Pharmacy Kipp-Mallery Pharmacy Knights Medicine Centre Knowlton's Drugstore Kootenay Boundary Regional Hospital Pharmacy Kornak & Hamm's Pharmacy Koscan Pharmacy Kroll's Surrey Pharmacy Ltd. La Vie Remedy's Pharmacy Lake Cowichan Drug Store Lakeside Medicine Centre Lakeside pharmacy Lallicare Pharmacy #1 Lallicare Pharmacy #2 Lambert-Kipp Pharmacy Ltd. Lancaster Medical Suppl. & Presc. #1 Lancaster Medical Suppl. & Presc. #4 Lancaster Prescriptions #2 Langley Pharmacy Laurel Prescriptions Lillooet I.D.A. Pharmacy Linda Pharmacy Living Room Pharmacy Loblaw Pharmacy #1520 Loblaw Pharmacy #1522 Loblaw Pharmacy #1523 Loblaw Pharmacy #1528 Loblaw Pharmacy #1552 Loblaw Pharmacy #1561 Loblaw Pharmacy #1564 Loblaw Pharmacy #4368 Loblaw Pharmacy #4979


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Lock's Prescription Pharmacy Ltd. Logan Lake I.D.A. Drugmart London Drugs London Drugs #02 London Drugs #03 London Drugs #04 London Drugs #05 London Drugs #06 London Drugs #07 London Drugs #08 London Drugs #09 London Drugs #10 London Drugs #11 London Drugs #12 London Drugs #14 London Drugs #15 London Drugs #16 - Clearbrook London Drugs #17 London Drugs #18 London Drugs #19 London Drugs #25 London Drugs #28 London Drugs #29 London Drugs #35 London Drugs #36 London Drugs #37 London Drugs #39 London Drugs #41 London Drugs #42 London Drugs #44 London Drugs #46 London Drugs #47 London Drugs #50 London Drugs #51 London Drugs #52 London Drugs #53 London Drugs #54 London Drugs #55 London Drugs #56 London Drugs #61 London Drugs #67 London Drugs #70 London Drugs #71-Marine & Byrne London Drugs #72 London Drugs #73 London Drugs #74 London Drugs #75 London Drugs #76 London Drugs #77 London Drugs #78 London Drugs #80 London Drugs #81 Loomis Express - Maureen Adams - F.S.C. Dept. Low Cost Western pharmacy Low Cost Western Pharmacy #2

Lumby Pharmacy Lynnvalley Pharmacy MacDonald's Prescriptions #3 MacDonald's Prescriptions #4 Macdonald's Prescriptions #5 MacDonald's Prescriptions Ltd Maggie's Pharmacy Main Prescriptions Main Station Pharmacy Main Street Remedy's RX Mann's Prescription Pharmacy Maple Pharmacy Marigold Natural Pharmacy Marina Pharmacy Mark's Marine Pharmacy Mark's Pharmacy Mark's Pharmacy #4 Marshall Pharmacy Ltd. McCallum Pharmacy McCue Drugs McKesson Specialty Prescription Services Meadows Pharmacy Medesis Pharmacy Medical Centre Pharmacy Medical Centre Prescriptions Medical Pharmacy Medical Tower Drugs Ltd. Medicare Pharmacy Medicine Centre #4 Medicine Shoppe #116 Medicine Shoppe #142 (The) Medicine Shoppe #148 Medicine Shoppe #149 Medicine Shoppe #156 Medicine Shoppe #163 Medicine Shoppe #168 Medicine Shoppe #175 (The) Medicine Shoppe #195 Medicine Shoppe #221 Medicine Shoppe #231 (The) Medicine Shoppe #239 Medicine Shoppe #253 Medicine Shoppe #254 Medicine Shoppe #255 Medicine Shoppe #259 Medicine Shoppe #268 Medicine Shoppe #281 Medicine Shoppe #285 Medicine Shoppe #292 Medicine Shoppe #312 Medicine Shoppe #321 Medicine Shoppe Pharmacy #166 Medicine Shoppe Pharmacy #169 Medicine Shoppe Pharmacy #272 Mediglen Pharmacy Medisave Pharmacy #1


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Medisave Pharmacy #2 Medisave Pharmacy #3 Medisave Pharmacy #4 Medisave Pharmacy #7 Memorial Compounding Medical Center Metrocare Pharmacy Minoru Pharmacy MJ'S Natural Pharmacy MJ''s Natural Pharmacy no. 2 Morgan Creek Medicine Centre Mount IDA Pharmacy Munro's Sorrento Pharmacy Murrayville Healthcentre Pharmacy Murrayville Pharmacy #2 Nanaimo Pharmacy Nanoose Medicine Centre Naz's Prescription Plus Pharmacy Naz''s Prescription Plus Pharmacy #2 Nesters Pharmacy Nesters Pharmacy SFU New West Drugs Nolan's Clinic Pharmacy Nolan's Pharmasave drugs #222 North Fraser Drugs North West Pharmacy Northburn Prescriptions Ltd. Northmount Pharmacy Ltd. Oakridge South Tower Pharmacy Ocean Walk Pharmacy Oh Pharmacy Okanagan Resident Plus Pharmacy Otter Co-op Pharmacy Out Reach Pharmacy Overwaitea Foods & Drugs #70 Overwaitea Pharmacy #21 Fort Nelson Overwaitea Pharmacy #219 Overwaitea Pharmacy #24 Overwaitea Pharmacy #34 Owl Drugs P & A Pharmacy Ltd Pacific Compounding Pharmacy Pacific Compounding Pharmacy #2 Pacific Pharmacy & Medical Supplies #2 Pacific Prescriptions & Medical Supplies Pandora Pharmacy Paragon Central Fill Pharmacy Paragon Centuria Pharmacy Paragon Columbia Pharmacy Paragon Crestview Pharmacy Paragon GlenPark Pharmacy Paragon Lake Country Pharmacy Paragon Mission Centre Pharmacy Paragon Pharmacy #1 Paragon Pharmacy #2 Park Pacific Pharmacy Parkridge Pharmacy & Health Centre

PDC Pharmacy Peachland Pharmacy Pender Island Pharmacy Peoples Drug Mart #027 Peoples Drug Mart #029 Peoples Drug Mart #038 Peoples Drug Mart #043 Peoples Drug Mart #067 Peoples Drug Mart #072 Peoples Drug Mart #076 Peoples Drug Mart #077 Peoples Drug Mart #093 Peoples Drug Mart #110 Peoples Drug Mart #119 Peoples Drug Mart #122 Peoples Drug Mart #123 Peoples Drug Mart #128 Peoples Drug Mart #135 Peoples Drug Mart #137 Peoples Drug Mart #139 Peoples Drug mart #146 Peoples Drug Mart #147 Peoples Drug Mart #168 Peoples Drug Mart #175 Peoples Drug Mart #180 Peoples Drug Mart #188 Peoples Drug Mart #193 Peoples Drug Mart #317 Peoples Drug Mart #334 Peoples Drug Mart #347 Peoples Drug Mart #372 Peoples Pharmacy #057 Peoples Pharmacy #239 Peoples Pharmacy #301 Peoples Pharmacy #303 Peoples Pharmacy #316 Peoples Pharmacy #321 Peoples Pharmacy #344 People's Pharmacy #356 Peoples Pharmacy #357 Peoples Pharmacy #358 Peoples Pharmacy #360 Peoples Pharmacy #367 Peoples Pharmacy #372 Peoples Pharmacy #374 Peoples Pharmacy #379 People's Pharmacy #380 Peoples Pharmacy #388 Pharmacity Drugstore Pharmacity Drugstore #2 Pharmasave #006 Pharmasave #008 - Diamond Drugs Pharmasave #022 - D Pharmasave #022 - H Pharmasave #022-M Pharmasave #028


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Pharmasave #031 Pharmasave #032 Pharmasave #034 Pharmasave #036 Pharmasave #037 (Cambie) Pharmasave #040 Pharmasave #042 Pharmasave #043 Pharmasave #045 - Newport Village Pharmasave #057 Pharmasave #059 Pharmasave #060 Pharmasave #065 Pharmasave #066 Pharmasave #068 Pharmasave #070 Pharmasave #071 Pharmasave #072 Pharmasave #077 Pharmasave #088 Pharmasave #099 Pharmasave #102 Pharmasave #105 Pharmasave #107 Pharmasave #108 Pharmasave #115 Pharmasave #129 Pharmasave #131 Pharmasave #139 Pharmasave #148 Pharmasave #151 Pharmasave #154 Pharmasave #158 Pharmasave #162 Pharmasave #173 Pharmasave #178 Pharmasave #179 Pharmasave #182 Pharmasave #183 Pharmasave #190 Pharmasave #198 Pharmasave #202 Pharmasave #203 Pharmasave #205 Pharmasave #206 Pharmasave #211 Pharmasave #213 Pharmasave #214 Pharmasave #221 Pharmasave #229 Pharmasave #231 Pharmasave #232 Pharmasave #234 Pharmasave #241 Pharmasave #242 Pharmasave #244

Pharmasave #246 Pharmasave #248 Pharmasave #249 Pharmasave #250 Pharmasave #252 Pharmasave #253 Pharmasave #255 Pharmasave #256 Pharmasave #257 Pharmasave #259 Pharmasave #260 Pharmasave #263 Pharmasave #264 Pharmasave #265 Pharmasave #266 Pharmasave #267 Pharmasave #270 Pharmasave #275 Pharmasave #277 Pharmasave #278 Pharmasave #282 Pharmasave #284 Pharmasave #286 Pharmasave #288 Pharmasave #290 Pharmasave #291 Pharmasave #299 Pharmasave & Food #142 Pharmasave Ganges #120 Pharmasave Health Centre #001 Pharmasave Health Centre #002 Pharmasave Health Centre #003 Pharmasave Health Centre #007 Pharmasave Health Centre #009 Pharmasave Health Centre #010 Pharmasave Health Centre #011 Pharmasave Health Centre #015 Pharmasave Health Centre #016 Pharmasave Health Centre #020 Pharmasave Health Centre #021 Pharmasave Health Centre #022 Pharmasave Health Centre #024 Pharmasave Health Centre #026 Pharmasave Health Centre #027 Pharmasave Health Centre #029 Pharmasave Health Centre #030 Pharmasave Health Centre #033 Pharmasave Health Centre #038 Pharmasave Health Centre #050 Pharmasave Health Centre #051 Pharmasave Health Centre #052 Pharmasave Health Centre #053 Pharmasave Health Centre #054 Pharmasave Health Centre #058 Pharmasave Health Centre #061 Pharmasave Health Centre #062


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Pharmasave Health Centre #064 Pharmasave Health Centre #080 Pharmasave Health Centre #207 Pharmasave James Bay #130 Pharmasave Oak Bay #152 Pharmasave Scott Town #167 Pharmatrust Pharmacy Pharmawest Pharmacy Pharmax Health Phoenix Dispensary Ltd. Point Grey Pharmacy Pratt's Compounding Pharmacy Inc. Prerscription Depot Pricesmart Foods Pharmacy #2207-King George Pricesmart Foods Pharmacy #2208 Pricesmart Foods Pharmacy #2213 Pricesmart Foods Pharmacy #2215 Pricesmart Foods Pharmacy #2221 Pricesmart Foods Pharmacy #2228 Pricesmart Foods Pharmacy #2235 - White Rock Pricesmart Foods Pharmacy #2242 PriceSmart Foods Pharmacy #2249 PriceSmart Foods Pharmacy #2256 Pricesmart Foods Pharmacy #2263-Fraser HWY Pricesmart Foods Pharmacy #2274 Prostate Centre Public Trustees Office Pure Pharmacy Pure Pharmacy - Cordova Bay Pure Pharmacy at Meinhardt Pure Pharmacy Health Centre #01 Quadra Maple Pharmacy Qualicum Medicine Centre Queen Charlotte Islands Pharmacy Queensborough Community Pharmacy R.E.A.C.H. Centre Regency #6 Medicine Centre Regency Medicine Centre Regency Prescriptions #1 Regency Prescriptions #3 Reid's Prescriptions Remedy's Custom Compounding Remedy's Health Co-Operative Pharmacy Resident Plus Pharmacy Rexall #7154 Rexall Drug Store #7104 Rexall Drug Store #7106 Rexall Drug Store #7114 Rexall Drug Store #7158 Rexall Drug Store #7160 Rexall Drug Store #7181 Rexall Drug Store #7182 Rexall Drug Store #7185

Rexall Drug Store #7191 Rexall Drugstore # 7121 Rexall Drugstore # 7125 Rexall Drugstore # 7177 Rexall Drugstore #7102 Rexall Drugstore #7103 Rexall Drugstore #7107 Rexall Drugstore #7111 Rexall Drugstore #7113 Rexall Drugstore #7116 Rexall Drugstore #7123 Rexall Drugstore #7129 Rexall Drugstore #7133 Rexall Drugstore #7139 (Sooke Rd.) Rexall Drugstore #7150 - Meditrust Rexall Drugstore #7152 Rexall Drugstore #7180 Rexall Drugstore #7187 Rexall Drugstore (Royal Centre) Richmond Pharmacy #25058 Richport Pharmacy Ridgeway I.D.A. Pharmacy Robin's Pharmacy Robson Valley Pharmacy Roots Pharmacy Royal City Drugs Royal Oak Drugs Ltd RX R US Pharmacy RX Ram Pharmacy Specialists Safeway Food & Drug Pharmacy #1 Safeway Food & Drug -Pharmacy #110 Safeway Food & Drug -Pharmacy #123 Safeway Food & Drug- Pharmacy #14 Safeway Food & Drug -Pharmacy #144 Safeway Food & Drug- Pharmacy #182 Safeway Food & Drug -Pharmacy #196 Safeway Food & Drug -Pharmacy #28 Safeway Food & Drug -Pharmacy #38 Safeway Food & Drug -Pharmacy #39 Safeway Food & Drug -Pharmacy #48 Safeway Food & Drug -Pharmacy #53 Safeway Food & Drug- Pharmacy #69 Safeway Food & Drug -Pharmacy #70 Safeway Food & Drug -Pharmacy #819 Safeway Food & Drug-Pharmacy # 62 Safeway Food & Drug-Pharmacy #109 Safeway Food & Drug-Pharmacy #114 Safeway Food & Drug-Pharmacy #115 Safeway Food & Drug-Pharmacy #118 Safeway Food & Drug-Pharmacy #121 Safeway Food & Drug-Pharmacy #122 Safeway Food & Drug-Pharmacy #126 Safeway Food & Drug-Pharmacy #127 Safeway Food & Drug-Pharmacy #133 Safeway Food & Drug-Pharmacy #138 Safeway Food & Drug-Pharmacy #140


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Safeway Food & Drug-Pharmacy #148 Safeway Food & Drug-Pharmacy #159 Safeway Food & Drug-Pharmacy #161 Safeway Food & Drug-Pharmacy #162 Safeway Food & Drug-Pharmacy #165 Safeway Food & Drug-Pharmacy #170 Safeway Food & Drug-Pharmacy #171 Safeway Food & Drug-Pharmacy #184 Safeway Food & Drug-Pharmacy #191 Safeway Food & Drug-Pharmacy #193 Safeway Food & Drug-Pharmacy #195 Safeway Food & Drug-Pharmacy #198 Safeway Food & Drug-Pharmacy #2 Safeway Food & Drug-Pharmacy #20 Safeway Food & Drug-Pharmacy #2271 Safeway Food & Drug-Pharmacy #23 Safeway Food & Drug-Pharmacy #24 Safeway Food & Drug-Pharmacy #33 Safeway Food & Drug-Pharmacy #42 Safeway Food & Drug-Pharmacy #43 Safeway Food & Drug-Pharmacy #44 Safeway Food & Drug-Pharmacy #45 Safeway Food & Drug-Pharmacy #53 Safeway Food & Drug-Pharmacy #59 Safeway Food & Drug-Pharmacy #61 Safeway Food & Drug-Pharmacy #66 Safeway Food & Drug-Pharmacy #67 Safeway Food & Drug-Pharmacy #71 Safeway Food & Drug-Pharmacy #76 Safeway Food & Drug-Pharmacy #78 Safeway Food & Drug-Pharmacy #80 Safeway Food & Drug-Pharmacy #820 Safeway Food & Drug-Pharmacy #84 Safeway Food & Drug-Pharmacy #88 Safeway Food & Drug-Pharmacy #89 Safeway Food & Drug-Pharmacy #90 Safeway Food & Drug-Pharmacy #92 Safeway Food & Drug-Pharmacy #93 Safeway Food & Drug-Pharmacy #98 Safeway Food & Drug-Pharmacy #99 Safeway Food & Drug-Pharmacy#142 Safeway Food & Drug-Pharmacy#185 Safeway Food & Drug-Pharmcay #47 Saigon Pharmacy Salmon Arm Prescription Centre Sam's Pharmacy Sandell I.D.A. Pharmacy Satnam Pharmacy Save On Foods Pharmacy Save-On Drugs (Indep.) Save-On Food & Drugs #97 Save-On Food & Drugs #972 Save-On Foods & Drugs #973 Save-On Foods & Drugs #984-Walnut Grove Save-On Foods and Drugs #935-E. Save-On Foods Pharmacy #952

Save-On Foods Pharmacy #956 Save-On Foods Pharmacy #959-French Creek Save-On Foods Pharmacy #975 Save-On Foods Pharmacy #981 Save-On Foods Pharmacy #989 Lynn Valley Save-On-Foods Pharmacy #902 Save-On-Foods Pharmacy #903 Save-On-Foods Pharmacy #904 Save-On-Foods Pharmacy #907 Save-On-Foods Pharmacy #910 Save-On-Foods Pharmacy #912 Save-On-Foods Pharmacy #915 Save-On-Foods Pharmacy #918 Save-On-Foods Pharmacy #920 Save-On-Foods Pharmacy #928-W. Save-On-Foods Pharmacy #929 Save-On-Foods Pharmacy #931-Shahali Save-On-foods Pharmacy #932-Lakeshore Save-On-Foods Pharmacy #936 Save-On-Foods Pharmacy #937 Save-On-Foods Pharmacy #946 Save-On-Foods Pharmacy #948-Woodgrove Save-On-Foods Pharmacy #951-Country Club Save-On-Foods Pharmacy #955 Save-On-Foods Pharmacy #957 Save-On-Foods Pharmacy #962 Save-On-Foods Pharmacy #963 Save-On-Foods Pharmacy #965 - College Heights Save-On-Foods Pharmacy #966 Save-On-Foods Pharmacy #967-Spruceland Save-On-Foods Pharmacy #968-Hart Highway Save-On-foods Pharmacy #969-Ironwood Mall Save-On-Foods Pharmacy #977-Saanich Save-On-Foods Pharmacy #979 Save-On-Foods Pharmacy #980 Save-On-Foods Pharmacy #983 Save-On-Foods Pharmacy #987 Save-On-Foods Pharmacy #988 Save-On-Foods Pharmacy #990 Save-On-Foods Pharmacy #992 Save-On-Foods Pharmacy #993 Save-On-Foods Pharmacy #996 Save-On-Foods Pharmacy #999 Sav-On-foods Pharmacy #939-Nordel Sav-On-Foods Pharmacy #998 Sav-On-Foods Pharmacy#949-Terminal Park Script Care Pharmacy Service Drugs Service Plus #3 Seymour Peoples Drug Mart #174 Shawnigan Lake Peoples Pharmacy #304 Shiraz Pharmacy Shoppers Drug Mart #201 Shoppers Drug Mart #202 Shoppers Drug Mart #203


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Shoppers Drug Mart #204 Shoppers Drug Mart #205 Shoppers Drug Mart #208 Shoppers Drug Mart #209 Shoppers Drug Mart #210 Shoppers Drug Mart #2102 Shoppers Drug Mart #2107 Shoppers Drug Mart #211 Shoppers Drug Mart #212 Shoppers Drug Mart #2122 Shoppers Drug Mart #2123 Shoppers Drug Mart #2124 Shoppers Drug Mart #2125 Shoppers Drug Mart #2126 Shoppers Drug Mart #213 Shoppers Drug Mart #2133 Shoppers Drug Mart #214 Shoppers Drug Mart #2141 Shoppers Drug Mart #216 Shoppers Drug Mart #217 Shoppers Drug Mart #218 Shoppers Drug Mart #219 Shoppers Drug Mart #2200 Shoppers Drug Mart #2201 Shoppers Drug Mart #2203 Shoppers Drug Mart #2204 Shoppers Drug Mart #2205 Shoppers Drug Mart #2207 Shoppers Drug Mart #2208 Shoppers Drug Mart #2209 Shoppers Drug Mart #221 Shoppers Drug Mart #2211 Shoppers Drug Mart #2212 Shoppers Drug Mart #2213 Shoppers Drug Mart #2214 Shoppers Drug Mart #2215 Shoppers Drug Mart #2216 Shoppers Drug Mart #2217 Shoppers Drug Mart #2218 Shoppers Drug Mart #222 Shoppers Drug Mart #2220 Shoppers Drug Mart #2221 Shoppers Drug Mart #2222 Shoppers Drug Mart #2223 Shoppers Drug Mart #2224 Shoppers Drug Mart #2225 Shoppers Drug Mart #2226 Shoppers Drug Mart #223 Shoppers Drug Mart #2231 Shoppers Drug Mart #2232 Shoppers Drug Mart #2234 Shoppers Drug Mart #2235 Shoppers Drug Mart #2236 Shoppers Drug Mart #2237 Shoppers Drug Mart #2238 Shoppers Drug Mart #2239

Shoppers Drug Mart #2244 Shoppers Drug Mart #2246 Shoppers Drug Mart #2248 Shoppers Drug Mart #2249 Shoppers Drug Mart #225 Shoppers Drug Mart #2250 Shoppers Drug Mart #2251 Shoppers Drug Mart #2255 Shopper's Drug Mart #2256 Shoppers Drug Mart #2257 Shoppers Drug Mart #2259 Shoppers Drug Mart #226 Shoppers Drug Mart #2260 Shoppers Drug Mart #2266 Shoppers Drug Mart #227 Shoppers Drug Mart #2270 Shoppers Drug Mart #2271 Shoppers Drug Mart #2273 Shoppers Drug Mart #2275 Shoppers Drug Mart #2277 Shoppers Drug Mart #2279 Shoppers Drug Mart #228 Shoppers Drug Mart #2282 Shoppers Drug Mart #2283 Shoppers Drug Mart #2284 Shoppers Drug Mart #2285 Shoppers Drug Mart #2288 Shoppers Drug Mart #2290 Shoppers Drug Mart #2291 Shoppers Drug Mart #2292 Shoppers Drug Mart #2295 Shoppers Drug Mart #2299 Shoppers Drug Mart #230 Shoppers Drug Mart #231 Shoppers Drug Mart #232 Shoppers Drug Mart #233 Shoppers Drug Mart #234 Shoppers Drug Mart #236 Shoppers Drug Mart #237 Shoppers Drug Mart #238 Shoppers Drug Mart #239 Shoppers Drug Mart #241 Shoppers Drug Mart #242 Shoppers Drug Mart #243 Shoppers Drug Mart #244 Shoppers Drug Mart #246 Shoppers Drug Mart #248 Shoppers Drug Mart #251 Shoppers Drug Mart #252 Shoppers Drug Mart #253 Shoppers Drug Mart #254 Shoppers Drug Mart #255 Shoppers Drug Mart #257 Shoppers Drug Mart #258 Shoppers Drug Mart #260 Shoppers Drug Mart #261


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Shoppers Drug Mart #262 Shoppers Drug Mart #263 Shoppers Drug Mart #265 Shoppers Drug Mart #266 Shoppers Drug Mart #267 Shoppers Drug Mart #268 Shoppers Drug Mart #269 Shoppers Drug Mart #271 Shoppers Drug Mart #272 Shoppers Drug Mart #273 Shoppers Drug Mart #274 Shoppers Drug Mart #275 Shoppers Drug Mart #276 Shoppers Drug Mart #277 Shoppers Drug Mart #278 Shoppers Drug Mart #279 Shoppers Drug Mart #280 Shoppers Drug Mart #281 Shoppers Drug Mart #283 Shoppers Drug Mart #285 Shoppers Drug Mart #286 Shoppers Drug Mart #287 Shoppers Drug Mart #288 Shoppers Drug Mart #290 Shoppers Drug Mart #291 Shoppers Drug Mart #3005 Shopper's Drug Mart #3007 Sidney Pharmacy ll Silvermere Pharmacy Similkameen Pharmacy Skaha Pharmacy Somerset Pharmacy Services St. Anthony's Clinic Pharmacy St. Paul''s Hospital Steveston Pharmacy Sukh's Phamacy Sukh's Pharmacy #2 Summerland Pharmacy Sunnyside Evergreen Pharmacy Sunset Pharmacy Limited Super Grocer & Pharmacy Surlang Med.Centre The Antidote Pharmacy #001 The Bay Pharmacy The Bay Pharmacy The Bay Pharmacy #1101 The Chemist #1 The Chemist #2 The Chemist #4 The Chemist #6 Third Avenue Evergreen Pharmacy Thrifty Foods and Pharmacy #06 Thrifty Foods and Pharmacy #10 Thrifty Foods and Pharmacy #13 Thrifty Foods And Pharmacy #16 Thrifty Foods and Pharmacy #19

Thrifty Foods and Pharmacy #20 Thrifty Foods and Pharmacy #23 Thrifty Foods and Pharmacy #24 Thrifty Foods and Pharmacy #25 Thrifty Foods and Pharmacy #27 Thrifty Foods and Pharmacy #28 Tofino Phamacy Town Centre Pharmacy Toy's Pharmacy Tsawwassen Pharmacy Tux Pharmacy #1 Unicare Pharmacy Universal Pharmacy University Pharmacy (1987) Ltd. Urban Fare Pharmacy #7615 Urban Fare Pharmacy #914-Yaletown Valemont IDA Pharmacy Valley Evergreen Pharmacy Value Drug Mart-Grand Forks Victoria Compounding Pharmacy Victoria Health Unit Clinical Pharmacist View Pharmacy Village Pharmacy Village Pharmacy (The) Vita Vie Pharmacy Inc. Viva Med Pharmacy Viva Med Pharmacy #02 Wal-Mart Pharmacy #1011 Wal-Mart Pharmacy #1015 Wal-Mart Pharmacy #1018 Wal-Mart Pharmacy #1036 Wal-Mart Pharmacy #1077 Wal-Mart Pharmacy #1104 Wal-Mart Pharmacy #1112 Wal-Mart Pharmacy #3025 Wal-Mart Pharmacy #3040 Wal-Mart Pharmacy #3057 Wal-Mart Pharmacy #3059 Wal-Mart Pharmacy #3060 Wal-Mart Pharmacy #3070 Wal-Mart Pharmacy #3072 Wal-Mart Pharmacy #3109 Wal-Mart Pharmacy #3169 Wal-Mart Pharmacy #3183 Wal-Mart Pharmacy #3188 Wal-Mart Pharmacy #5776 Wal-Mart Pharmacy #5777 Wal-Mart Pharmacy #5834 Wescana Pharmacy #03 Wescana Pharmacy #04 Wescana Pharmacy #05 Wescana Pharmacy #06 Wescana Pharmacy #07 Wescana Pharmacy #08 Wescana Pharmacy #11 West 10th Medical Pharmacy


47

West Coast Central Fill West End Medicine Centre Westview Pharmacy Whalley Pharmacy Whistler IDA Pharmacy White Clinic Pharmacy Wilson Pharmacy Winfield IDA Pharmacy Yale Central Pharmacy Yale Pharmacy Yyoung Medicine Mart Yyoung Medicint Mart Zellers Pharmacy #022 Zellers Pharmacy #025 Zellers Pharmacy #029 Zellers Pharmacy #105 Zellers Pharmacy #122 Zellers Pharmacy #145 Zellers Pharmacy #171 Zellers Pharmacy #191

Zellers Pharmacy #244 Zellers Pharmacy #246 Zellers Pharmacy #248 Zellers Pharmacy #264 Zellers Pharmacy #355 Zellers Pharmacy #360 Zellers Pharmacy #361 Zellers Pharmacy #412 Zellers Pharmacy #430 Zellers Pharmacy #432 Zellers Pharmacy #440 Zellers Pharmacy #442 Zellers Pharmacy #443 Zellers Pharmacy #444 Zellers Pharmacy #459 Zellers Pharmacy #465 Zellers Pharmacy #466 Zellers Pharmacy #470 Zellers Pharmacy #486

Appendix 7 Patient Monograms

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