It is unclear whether a 2004 Missouri law that allows some health care facilities and pharmaceutical companies to redirect surplus, unused prescription drugs to other facilities has had any effect on the state's drug costs, the AP/St. Louis Post-Dispatch reports. The law allows a dispenser of drugs, such as a hospital, wholesale drug distributor or individual, to donate medication as long as the drugs have not been dispensed for personal use. State Sen. Charlie Shields (R) in 2004 estimated that the law would save the state millions of dollars annually in drug costs.

However, pharmaceutical companies, hospitals and nursing homes say the law is not working as intended, the AP/Post-Dispatch reports. The state knows of just one organization that offers to collect drugs and distribute them to facilities that have trouble affording medications, and a phone number listed on the program's Web site is disconnected, according to the AP/Post-Dispatch. The state Department of Health and Senior Services has no means of tracking savings or overseeing the program, and groups are not required to report their participation.

Jon Dolan, executive director of the Missouri Health Care Association, said nursing homes largely are unable to make use of the law because they typically purchase only what they need and rarely have extra drugs to donate. Under the law, nursing homes must donate unused drugs to an outside clinic, pharmacy or hospital and cannot use a resident's unused medications for another resident in the same facility. Missouri Association of Homes for the Aging CEO Denise Clemonds said, "We're throwing away thousands and thousands of dollars [worth of unused drugs] everyday." Clemonds added, "We all were hoping we would have a very user friendly program where those could be basically utilized instead of being thrown away. We're not there at all."

Thirty-three states have passed laws creating similar programs, but fewer than half have been implemented, and it is difficult to assess whether the programs have been successful in reducing drug costs, according to the National Conference of State Legislatures (Wiese, AP/St. Louis Post-Dispatch, 8/6).