Annual Report on the Ontario Medications Return Program and the Ontario Sharps Collection Program for the period of January 1, 2020 – December 31, 2020 Submitted to: Charles O'Hara Resource Recovery Policy Branch Environmental Policy Division Ministry of the Environment Conservation and Parks Prepared by: Terri Drover HPSA Director General March 31, 2021 1 Contents Definitions ..................................................................................................................................................... 3 Executive Summary ....................................................................................................................................... 5 I. 2020 HPSA Members ............................................................................................................................ 6 II. 2020 Collection Locations ..................................................................................................................... 6 III. Overview of the Collection and Disposal Process ............................................................................. 7 IV. 2020 Collections ................................................................................................................................ 8 A. Pharmaceuticals ................................................................................................................................ 8 Table 1 - Program Performance – Report on Collection of Pharmaceuticals by Quarter ..................... 9 B. Medical Sharps .................................................................................................................................. 9 Table 2 - Program Performance – Report on Collection of Medical Sharps by Quarter ..................... 10 V. Public Education Materials and Campaigns ........................................................................................ 11 A. Collection Locations ........................................................................................................................ 11 B. Website and Social Media ............................................................................................................... 11 C. Municipal Outreach in Ontario ....................................................................................................... 13 D. National Campaigns ........................................................................................................................ 14 1) Institute for Safe Medication Practices Canada .......................................................................... 14 2) Drug Free Kids Canada ................................................................................................................ 15 VI. Auditor’s Report .............................................................................................................................. 16 Appendix 1 - HPSA Members – OMRP .................................................................................................... 17 Appendix 2 - HPSA Members – OSCP ...................................................................................................... 19 Appendix 3 - Auditor’s Report (Opinion from a Licensed Public Accountant) ........................................ 20 Appendix 4 - Samples of HPSA Materials ................................................................................................ 23 Appendix 4 (continued)- Samples of HPSA Materials ........................................................................... 23 Appendix 5 - Producer Member Websites .............................................................................................. 25 Appendix 6 - List of Registered Pharmacies with OMRP & OSCP ........................................................... 30 2 Definitions The following terminology is used throughout this document: Collection Sites Community pharmacies registered in the HPSA programs to collect unused and/or expired Pharmaceuticals and used Medical Sharps returned from the public. Pharmaceuticals Products sold directly to consumer and include: • Prescription drugs • Non-prescription drugs • Natural health products Member Brand-owner/steward/producer who is a member of the Health Products Stewardship Association (HPSA). Medical Sharps Ont. Reg. 298/12 - "A needle, safety engineered needle, lancet or other similar instrument that is designed to puncture the skin of individuals or companion animals for medical purposes and that is sold to consumers in Ontario, whether it is sold by the producer of the sharp or by any another person, and includes anything affixed to the sharp, including a syringe" For the purpose of the Ontario Sharps Collection Program (OSCP) Plan, a medical sharp shall be generally defined as a. Infusion sets with needles attached. b. Lancets, including safety lancets. c. Needle tips. d. Needles, including safety needles. e. Pen only with needle attached. f. Pen needles. g. Prefilled cartridges only with needles attached. h. Pre-filled syringes only with needles attached. i. Safety pens only with needles attached. j. Syringes only with needles attached. Natural Health Under the Natural Health Products Regulations, natural health Products products (NHPs) are defined as: • Vitamins and minerals • Herbal remedies • Homeopathic medicines • Traditional medicines such as traditional Chinese medicines • Probiotics • Other products like amino acids and essential fatty acids NHPs must be safe to use as over-the-counter products and do not need a prescription to be sold. 3 Non-prescription Drugs Non-prescription drugs do not require a prescription of a practitioner under Section C.01.040.03 of the Food and Drugs Regulations in order to be sold and are not listed in the Prescription Drug List established under Section 29.1 of the Food and Drugs Act. Examples include: 1) A drug available from a pharmacist but does not require a prescription. These are the drugs located in the area of the pharmacy "behind the counter", where there is no public access and no opportunity for patient self-selection or 2) A drug which does not require a prescription and is available for self-selection from the area of the pharmacy under the direct supervision of the pharmacist or 3) A drug that may be purchased from any retail outlet (such as a grocery store) OMRP Ontario Medications Return Program OSCP Ontario Sharps Collection Program Prescription Drugs A drug requiring a prescription for sale in Canada Regulation Collection of Pharmaceuticals and Sharps – Responsibilities of Producers – 298/12 – Environmental Protection Act Producer Means a brand owner or first importer under HPSA membership criteria 4 Executive Summary Since 2013, the Health Products Stewardship Association (HPSA) has been administering the Ontario Medications Return Program (OMRP) for Pharmaceuticals (prescriptions drugs, non- prescription drugs and natural health products) as well as the Ontario Sharps Collection Program (OSCP) for Medical Sharps that are sold in the province of Ontario through the "consumer/residential" waste stream. These programs are operated under the principles defined by Ontario Regulation 298/12 Collection of Pharmaceuticals and Sharps – Responsibilities of Producers, which is Ontario's first and only Extended Producer Responsibility regulation created under the Environmental Protection Act (EPA). The OMRP and OSCP are designed to ensure that collection sites are available to all municipalities of the province so that any unused and/or expired Pharmaceuticals and used Medical Sharps returned by the public can be properly collected, packaged, handled, transported and disposed of in a safe, compliant and environmentally responsible manner. 2020 has been a difficult year due to the pandemic. Although collected weights have decreased from 2019 (-7% for Pharmaceuticals and -10% for Medical Sharps), the collection network remained strong: In 2020, a total of 4,146 Ontario retail pharmacies or 91.2% of total accredited pharmacies in Ontario were registered as HPSA collection sites. HPSA would like to express its gratitude to the pharmacy community for supporting both of these collection return programs during these challenging times. 5 I. 2020 HPSA Members Section 9 (2) 1 – The name of each producer on whose behalf the report is prepared. • The list of producers/members for Pharmaceuticals is attached in Appendix 1. • The list of producers/members for Medical Sharps is attached in Appendix 2. • Under Regulation 298/12, producers are required to have a link on their website that takes consumers to the HPSA website where information on the OSCP and OMRP can be found. A list of HPSA producer/member website links can be found in Appendix 5. II. 2020 Collection Locations Section 9 (2) 2 - The number of collection locations and the location of each of the collection locations at which collection of the designated material of the producers was provided for by all of the producers and a description of any changes that occurred with respect to the number and location of collection locations from the previous calendar year. • The collection sites for both the OMRP and the OSCP are community pharmacies (listed in Appendix 6). • Each HPSA collection site has signed a Collection Location Agreement or CLA detailing procedure for collection, handling and storage of Pharmaceutical and Medical Sharps received from the public. • In accordance with Section 4 of the Regulation, HPSA ensured that the number of collection locations is at minimum