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I am a patient advocate who assists in healthcare navigation – and communication – and in these biweekly segments, I like to take my followers on some sort of thought-provoking journey. It may be about the emotions of caregiving or the evolution of healthcare and how it is delivered… It might be about the hidden costs of healthcare. Might be about healthcare and how it is marketed to us… or about aging and the “ism,” or how to best age as a Solo Ager.
Today I am bringing a bit of “Did You Know” -information about something I will venture can be found in nearly everyone’s home: plastic prescription pill bottles.
In our daily lives, you and I encounter a common item that seems harmless but holds significant environmental consequences. These small amber containers, widely used in the healthcare industry, contribute to the staggering amount of plastic waste generated globally. Thus they -and we- contribute to the “carbon footprint” (to use an increasingly familiar term).
A carbon footprint is the total greenhouse gas (GHG) emissions caused directly and indirectly by an individual, organization, event, or product. Prescription pill bottles carry a footprint, and so do we. Our own footprints might be emissions from driving a car, or that Briggs and Straton engine on your lawnmower, or grilling a steak as that charcoal emits gasses also. Plastic carries a lot of emissions potential, and as you begin to think about it, that is why the plastics and recycling industries want us to become more mindful of this.
Did you know that the average person produces about four tons of carbon dioxide each year? That is the very stuff that is a greenhouse gas and causes our climate to warm.
The healthcare industry is a very carbon-intensive service sector, representing 4-5% of global emissions. With 8 billion plastic pill bottles used in the United States every year, this will be one of the easiest ways for any healthcare provider to lower their carbon footprint”.
The plastics industry is all over this. There is a monitoring of emissions afoot, industrially, and companies or industries who go over certain emissions limits will be fined, so everyone is looking at emissions reduction.
This whole segment began when I was staring at my little amber prescription bottle. They have such a familiarity as a household item that I thought I would “dispense” some information today. I hope it’s not too much to swallow.
The history of our amber plastic bottles is rather interesting.
Earlier in our history, the druggist bottles were glass. Thousands of bottles were used, and no labeling was required. Folks went to their druggist, who might be compounding these remedies. Everything from “bitters” to “cures” to “purifiers” were sold. Finally, there were embossed bottles that contained poisons and were in the ‘Household’ (non-food related) category, although some were still OK for external human use, like witch hazel or denatured alcohol.
Labeling began in 1706 with a law: The Pure Food and Drugs Act, and was soon bolstered by the Sherley Amendment that prohibited false claims. Now you will get a kick out of this: all that had to be done to the bottles was remove the word “cure” and sell it as a “remedy”. Please note that I am not throwing our pharmaceutical industry under the bus, mind you. We do need our innovation and medication, no doubt. But the patient advocate and marketer in me finds it interesting that there were marketing and labeling initiatives that were alive and well back in the 1700s that required packaging and marketing to be within the law.
Also known back in the 1700s was that colored containers prevented reaction with light from altering the substance, and so we saw blue and amber glass come into play. Picture in your mind now the little multi-colored bottles we’ve seen in our history readings: red, blue, black, green, amber. Red was the best, but amber was the least expensive to produce.
Bottles would often include cotton to cushion powdery, breakable pills that carried over between glass and plastic bottles. In modern times, pills are coated, and thus the inclusion of a cotton ball is no longer necessary. They probably attracted and held moisture anyway.
From glass to plastic
Plastics began to really enter our lives in the 1950s, after WWII. Over time, plastic has replaced many glass items, such as milk containers, baby bottles, and even druggist’s bottles.
Innovative solutions are emerging to address our usage and reliance on plastics — and thus the emissions issue and to pave the way for a more sustainable healthcare future.
The issues with plastics, especially in healthcare, make it a prime place to introduce change.
The healthcare industry is a very carbon-intensive sector, representing 4-5% of global emissions. (Think of the last time you or a loved one was inpatient; can you recall all the plastic being used?). With 8 billion plastic pill bottles used in the United States every year, this will be one of the easiest ways for any healthcare provider to lower their carbon footprint.
Our healthcare industry, particularly the pharmaceutical sector, is a major contributor to global carbon emissions, with the ubiquitous single-use pill bottles being a significant part of the problem. Each year, those 8 billion plastic pill bottles that are used in the United States alone contribute to pollution and environmental degradation. The bottles, typically made of non-biodegradable polypropylene plastic, end up in landfills, releasing harmful microparticles and toxins into the environment.
Prescription pill bottles in the US are typically made of polypropylene and recyclable polyethylene plastic. But because of their small size, 90% of them are never recycled. The problem lies in the metal sorting device used at neighborhood recycling stations. Smaller items the size of pill bottles slip through the holes in the devices; they are rejected and then sent to dumps.
Innovations and Solutions:
Target flipped the medicine bottle design on its head in 2005 when it introduced a red container with an opening on the bottom. That allowed the label to wrap around the top so it could be seen from above. It included a flat surface that customers found easier to read than the curve of a typical pill bottle, and it came with color-coded rings for the neck to help family members quickly tell their medicines apart. The cap was on the bottom.
Many customers reported that the red Target bottles were easier to locate. Some reported that the red bottles were easier to open. Problems arose when patients began to pour their meds from the traditional amber bottles with the instructions on the side into old Target bottles to find them more easily. The result there, as you can guess, was mistakes in taking medication.
There’s change ahead for us, and our amber bottles. Industry leaders involved in innovation all seem to agree that we are entering “a massive environmental challenge” and an opportunity to persuade customers to switch to more sustainable usage and packaging.
Here is one projection and the innovation developed as solution:
From 2016 to 2021, 35% more Americans received their medicines by mail, and the mail-order drug market is expected to grow at a rate of 18.7% each year between 2022 and 2030.
Enter a startup company called Cabinet Health, whose founders believe that the healthcare industry can’t ignore a waste stream that’s literally endangering humans’ well-being. As consumers increasingly switch to mail-order drug services, the company sees an opportunity to make that transition sustainable and eliminate single-use plastics. It has launched the first refillable and compostable prescription service, whereby it will send medicines in bio-based pill pouches that can naturally decompose in the backyard.
Once empty, the pouches can be composted in “your classic worm bin,” the company says. For city residents, they should be compostable in municipal programs. They have partnered with Lomi, a smart composting machine brand designed for the kitchen. In a Lomi, a pouch can be turned into usable soil within a few days.
Currently, Cabinet has 150 prescription drugs on offer, which it says is about 80% of the most commonly dispensed oral medications. By mid-2024, it aims to expand that to 800 drugs, including liquid medications and birth control, both of which will need different formulations of the pouch.
How About Paper?
Another solution comes in the form of a paper pill bottle. This alternative is 100% compostable and biodegradable, meeting FDA regulations for durability, water resistance, and child resistance. The open-source design (meaning anyone can order the design) allows any pharmacy to fill prescription tablets and capsules in these eco-friendly containers. Finding a coating that would be water-resistant in the bathroom was a big challenge, and an environmentally friendly solution was found in beeswax.
But paper needs folding and some sort of way to seal. And what about child-proofing concerns?
Tikkun Olam Makers designed a paper pill bottle that’s 100% compostable, biodegradable, and meets FDA regulations for water, light, and child resistance! When the bottle is empty, it can be composted to add more value to the soil without leaving behind any harmful waste. It’s available to any pharmacy for filling prescription tablets and capsules. Once used and then emptied, the paper bottle can be tossed into any compostable bin with its Rx label to decompose and be reused as fertilizer to safely replenish the soil in fields, gardens, and landscapes.
If you are an engineer in packaging, plastics or the environment, the intersection of plastics and healthcare should allow for an exciting career.
Will new packaging be a bitter pill to swallow?
Will America take to it? Knowing what we know about colored plastic preventing damage of products from light America at first resisted colored milk cartons. One distributor introduced some light blue ones, saw a drop in sales, and returned to the translucent jugs customers seem to prefer. We see some yellow ones these days but most remain the lighter, more clear ones. America was not wild about the 2005 Target red bottles with the cap on the bottom. Will we conform to the new for ourselves, our carbon footprint, and the environment? It will be interesting to see how this rolls out.
You and I will be here to watch and embrace it all. The entire packaging industry will likely follow suit, either because it is the right thing to do, it better protects the product and travels, it saves space, it is more easily used by the consumer, or it is to avoid fines for exceeding a carbon footprint allowance.
What We Can Do – Doing Our Part
Back now to us consumers, the little guy, if you will. What can we do right now?
There is repurposing. Have you ever used these containers for other purposes? Of course, Reuse comes before Recycle and there’s always a way to reuse a prescription bottle! It is a great spot to hold pins (straight, bobby, safety, push), beads, cotton swabs, nails, tacks, buttons, and more. You can make a portable sewing kit. They may be perfect for serving as your own travel shampoo, lotion, or conditioner. I bet you can find hundreds of ideas on Pinterest to repurpose our amber friends.
More about recycling:
Four billion prescriptions are filled by Americans each year … and then there are the over-the-counter medications for everything from a headache to creaky joints to your daily vitamins.
Your prescription bottle, that small amber bottle doled out to just about every American at some point in their lives, is made of polypropylene, or #5 plastic. Haulers that accept plastics #1-7 will accept your prescription bottles in your curbside bin.
Tips and To Do’s: First and foremost, remove all personal information. In general, these labels are easily peeled off the bottle. Rinse the bottle with warm, soapy water and allow it to dry. Put the cap back on and place it in your recycling bin.
Some pharmacies actively promote programs for the return of bottles for recycling. Publix has it on their website. In fact, Publix recycles all their stock bottles, the ones you see on the shelves behind the counter when you visit the pharmacy. Your city or municipality may have information and instructions specifically about recycling, so look at their websites. I called my own pharmacy, and they do not have such a program, so this is my way of furthering the conversation for the sake of making a dent in our carbon footprint.
There are charitable organizations that get involved with repurposing and recycling. You may also send prescription bottles with lids to Matthew 25 Ministries out of Ohio and other ministries who will sanitize and send them to places where medical supplies are needed, or they will shred and recycle.
It is another conversation, however if you have unused medication, do NOT flush it down the toilet or throw it in your trash. Check with your local police department to see if they have a drug take-back program. Speak with your local pharmacy to see if they have a disposal system in place.
I have read that some Walgreens stores have safe medication disposal kiosks to provide a safe and convenient way to dispose of unwanted, unused, or expired medication at no cost, year-round. I believe CVS may have a similar program in select stores
As consumers, there are steps we can take to contribute to a more sustainable healthcare system. Recycling prescription bottles is a start – removing personal information, rinsing the bottle, and placing it in the recycling bin.
By supporting such sustainable options, we can collectively reduce the environmental impact of the pharmaceutical industry and, thus, the healthcare industry.
It’s time to dispense with the old and welcome the new.
(I really am trying to keep the puns to a minimum here, y’all).
The redesign of the humble pill bottle signifies a crucial step towards a more sustainable and eco-friendly healthcare industry. As consumers, we hold the power to drive change by supporting innovations that prioritize the planet’s well-being. Whether through recycling, reusing, or embracing new, sustainable alternatives, each action contributes to a healthier future for both individuals and the environment.
It’s time to dispense with the old and welcome a new era of responsible healthcare packaging. My prescription for you and for me is to notice. Think. Call this issue to the fore. Talk (I know you have an RX bottle, most households will). Support innovation in adapting to the change, even proponing it to others. I always try to leave you with good table talk!
Nancy’s marketing headscratchers
Because I find humor or horror or because I recognize the strategy (good and bad) used in healthcare marketing, I will add this section:
Will consumers take to the change? We are a finicky bunch.
Will we need thousands of new pharmacy printers able to generate dosage instructions and warnings? Can we reconfigure existing ones, or will they now go to the landfill? (Hey, I worry).
In my research for this segment, I read an article entitled “Women-founded Medication Packaging Startup Pilots Sustainable Prescription.” (Hello, women invent things every day). Focusing the title on the article as women introducing something spectacular and not so much the spectacular thing introduced, to me, screams objectification of women’s abilities. My strong hunch is that a man did not write that headline.
The market for change I’ve been talking about can be extended further in healthcare: We can roll out what I’ve covered today to existing markets, which will be huge! Then, we can expand it to include more sustainable packaging offerings for prescriptions and other medications—such as injectable packaging and liquid packaging. Then, on to shippers and secondary packaging, etc., within pharmacy operations. (Ever witness those big plastic totes arrive at a pharmacy from its distribution center, from vans loaded with totes? There could be space and cost savings here too. Less vans on the road).
Mirroring the plastic prescription bottle scenario, there is also a need for non-plastic sustainable packaging in the OTC and vitamin space. (Envision any drugstore you enter, and specifically the 2+ aisles of “wellness” products, all in plastic. It’s concerning, but there is an opportunity here for great change, wouldn’t you agree?
Don’t you enjoy having options and feeling more in the know? The next time you have one of our little amber friends in your hand, think about this conversation today, and join in the innovation, as they say: “For all the right reasons!”
To Your Good Health and that of our planet!
Nancy Ruffner is a Patient Advocate, consultant, speaker, and coach who guides folks in healthcare navigation, communication, and successful aging. Want to work with Nancy and see if we’re a fit? Schedule a Complimentary Consultation today. nancyruffner.com