Drug Banks for poor patient

Sucessful Drug banks will be a boon to poor patients

You tell your doctor that you are ill. And what does he do besides writing a bill, Of which you need not read one  letter, The worst the scrawl, the dose the better. For if you knew but what you take, Though you recover, he must break.
- Mathew Prior, English poet and diplomat (1664-1721).

With increasing pressure from drug companies, through their ubiquitous medical representatives, doctors are quick and generous in prescribing long lists of medicines. Many drugs come in packages of ten and its multiples and patients end up buying more than what is required. In some cases, patients recover fast and give up the prescribed medical course. For such and other similar reasons, patients are saddled with a stock of unused drugs – many of them very expensive. On the other hand, there are patients who cannot afford expensive drugs and yet forced to buy them sacrificing some of their domestic essentials, including food. One way out of this dilemma is to source unused drugs to the needy through the drug bank.Blood donation through the blood bank involves unfounded fears and some discomfort. Eye donation through the eye bank involves documentation in advance of death. But drug donation through the drug bank does not require much except shedding of inertia. There isn’t even a sacrifice; for what is given away is what cannot be used, for once the illness is cured to hoard drugs in anticipation of another similar illness is against one’s interests  unless one wants to invite illness so that unused, accumulated drug can be used! Meanwhile drugs age and their validity period expire. It is a waste of national resource which could help a poor patient gain health.
According to statistics, India’s per capita consumption of drugs is one of the lowest in the world. Consumed drugs too have urban bias and within the urban setting itself the consumption is concentrated among high income groups on part or full basis. The poor generally cannot afford drugs. On the other hand, those who buy drugs are often saddled with unused drugs. If unused drugs are collected systematically, there is potential to develop this on the lines of blood banks or eye banks.  The success of drug bank is surely going to create awareness among primary drug buyers about collecting unused drugs within a time limit and handing them over to a drug bank. A drug bank, operated by persons on a voluntary basis, can have one or more collection boxes in the building, on the floor or establishment in which the persons work/live.
A place of worship like church or temple or mass transit points like railway station  platforms or state transport stations can host collection boxes. I had visualized and had fabricated for a corporate company (L&T) as part of its public service outreach. There are four models of  collection boxes – mass transit model, floor model, reception table model and wall model. The mass transit model is suitable for railway station platforms and ground floor lift landings of high-rise buildings. Since these points are visited by the same people repeatedly, these boxes will serve as reminders.  The floor model is suitable for lift-landing on each floor of high-rises where many offices are located. The reception model is suitable for placing on thereception counter of large offices. The wall model, like the public phones fixed on the wall, is suitable for placing near the entrance of buildings and offices in them.All the models are designed to receive strips and non-liquid capsules and tablets in containers. Bottled liquids call for careful handling and may be handed over to the drug bank volunteers. The larger models have a compartment at the rear where bottle gently slide into place. The unused drugs should be deposited in the collection boxes as soon as discontinuation of the drug use and preferably within a week. Drug strips should be put in an envelope which should carry the following information: Name of the drug, date and place of purchase and expiry date. In case of drugs in containers, the information should be written on a slip of paper and pasted on the container in such a way that the manufacturer’s information is not obliterated.Each drug bank will make arrangement with a deserving and convenient free clinic to receive the drugs and dispense them free to its patients. The drug boxes should be cleared at least once a week. The drug bank should write to the receiving free clinic that the unused drugs are given in good faith and no responsibility would be assumed for any adverse effect after their use. A similar notice can be displayed at the free clinic.
A drug bank operates on good faith. However, there is need for vigilance against misuse by the banks and the clinics receiving the drugs for free. With increasing pressure from drug companies, through their ubiquitous medical representatives, doctors are quick and generous in prescribing long lists of medicines. Many drugs come in packages of ten and its multiples and patients end up buying more than what is required. In some cases, patients recover fast and give up the prescribed medical course. For such and other similar reasons, patients are saddled with a stock of unused drugs – many of them very expensive. On the other hand, there are patients who cannot afford expensive drugs and yet forced to buy them sacrificing some of their domestic essentials, including food. One way out of this dilemma is to source unused drugs to the needy through the drug bank.Blood donation through the blood bank involves unfounded fears and some discomfort. Eye donation through the eye bank involves documentation in advance of death. But drug donation through the drug bank does not require much except shedding of inertia. There isn’t even a sacrifice; for what is given away is what cannot be used, for once the illness is cured to hoard drugs in anticipation of another similar illness is against one’s interests unless one wants to invite illness so that unused, accumulated drug can be used! Meanwhile drugs age and their validity period expire. It is a waste of national resource which could help a poor patient gain health.

 According to statistics, India’s per capita consumption of drugs is one of the lowest in the world. Consumed drugs too have urban bias and within the urban setting itself the consumption is concentrated among high income groups on part or full basis. The poor generally cannot afford drugs. On the other hand, those who buy drugs are often saddled with unused drugs. If unused drugs are collected systematically, there is potential to develop this on the lines of blood banks or eye banks. The success of drug bank is surely going to create awareness among primary drug buyers about collecting unused drugs within a time limit and handing them over to a drug bank. A drug bank, operated by persons on a voluntary basis, can have one or more collection boxes in the building, on the floor or establishment in which the persons work/live.

A place of worship like church or temple or mass transit points like railway station platforms or state transport stations can host collection boxes. I had visualized and had fabricated for a corporate company (L&T) as part of its public service outreach. There are four models of collection boxes – mass transit model, floor model, reception table model and wall model. The mass transit model is suitable for railway station platforms and ground floor lift landings of high-rise buildings. Since these points are visited by the same people repeatedly, these boxes will serve as reminders. The floor model is suitable for lift-landing on each floor of high-rises where many offices are located. The reception model is suitable for placing on thereception counter of large offices. The wall model, like the public phones fixed on the wall, is suitable for placing near the entrance of buildings and offices in them.All the models are designed to receive strips and non-liquid capsules and tablets in containers. Bottled liquids call for careful handling and may be handed over to the drug bank volunteers. The larger models have a compartment at the rear where bottle gently slide into place. The unused drugs should be deposited in the collection boxes as soon as discontinuation of the drug use and preferably within a week. Drug strips should be put in an envelope which should carry the following information: Name of the drug, date and place of purchase and expiry date. In case of drugs in containers, the information should be written on a slip of paper and pasted on the container in such a way that the manufacturer’s information is not obliterated.Each drug bank will make arrangement with a deserving and convenient free clinic to receive the drugs and dispense them free to its patients. The drug boxes should be cleared at least once a week. The drug bank should write to the receiving free clinic that the unused drugs are given in good faith and no responsibility would be assumed for any adverse effect after their use. A similar notice can be displayed at the free clinic. A drug bank operates on good faith. However, there is need for vigilance against misuse by the banks and the clinics receiving the drugs for free.

The proposals outlined above are preliminary and meant to be a starting point. One can modify and adapt the scheme according to experience and local circumstances. It is ideal for Rotary and Lion organizations to start and run drug banks. Since the drug collection boxes involve cost, sponsors may be allowed to inscribe their logos or names suitably.  Finally, Thomas Macaulay, English historian (1800-1859) had said that everybody’s business is nobody’s business. Don’t wait for everybody or nobody. Go ahead and do it yourself and bask in it success. Good luck!