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Pharmaceuticals in Wastewater Streams: Behavior, Preferences, and Willingness-to-Pay for a Disposal Program James Kallaos, Matthew Kotchen, Kaleena Wheeler, Crispin Wong, and Margaret Zahller Presented by: James Kallaos and Margaret Zahller Overview • Surveyed 1,005 randomly selected households on the central coast of California • Survey questions inquired about: – general awareness of pharmaceutical pollution – disposal practices – willingness to participate in a disposal program – willingness-to-pay (WTP) to establish a pharmaceutical disposal program Data collection • Data collected as part of the Central Coast Survey (CCS), an annual telephone survey conducted by the Social Science Survey Center at the University of California, Santa Barbara • Covers Santa Barbara and Ventura counties • Interviews conducted in English and Spanish Data collection • 1,657 households were contacted and 1,005 interviews were completed • Compared to national averages, the results show our sample to be older, with greater income, and more highly educated Awareness • “Are you aware that medical compounds have been found in treated wastewater and surface water?” 43% of respondents are aware Disposal habits “How do you typically get rid of unwanted or expired prescription or over-the-counter medications in your household?” Other 4% Store at Home 12% Hazardous Waste Center 5% Trash 45% Pharmacy 6% Toilet/Sink 28% Age and disposal habits • Older respondents are more likely to choose disposal through the toilet/sink • Older respondents more than twice as likely to return unused medications to the pharmacy • Both age groups more likely to choose trash as the most common disposal method Disposal program: contingent valuation • “The presence of medicines in surface waters is a growing environmental concern. To address this concern, there is currently a proposal to add a surcharge to prescription medication to fund a national disposal program.” • “To implement this program, would you be willing to pay $_____ per prescription you purchase?” YES/NO • Bid Amounts: $0.05, $0.10, $0.25, $0.50, $1.00, $1.50, $2.00, $2.50 Model coefficients and effects Pr[YES] = f [bid, gender, age, awareness, political party, race] Variable Bid ($) Gender (female) Age Awareness Political party (Dem) Statistical significant effects – + – – + Mean willingness-to-pay • Logit model: Pr(Yesi)=a+b1(Bidi)+ei • E(WTP) = a/b Mean WTP $1.53 90-percent confidence interval $1.14 $2.63 95-percent confidence interval $1.09 $2.97 Hanemann, W. M. (1984) Welfare evaluations in contingent valuation experiments with discrete responses. American Journal of Agricultural Economics, 66(3), 332-341. Willingness to participate “If a disposal program was implemented at local pharmacies, how likely would you be to return unwanted or expired medicines to your pharmacy for disposal?” 80% 70% 60% 50% 40% 30% 20% 10% 0% Very unlikely Somewhat unlikely Neutral Somewhat likely Very likely Prescriptions and out-of-pocket expenditures for 2004 Prescriptions per year Age cohort 0 to 17 Mean 2.28 Median 0.0 18 to 24 25 to 44 45 to 64 65 and older 2.71 5.45 16.33 29.82 0.0 1.0 6.0 21.0 Out-of-pocket expenditures Mean $31.69 $63.26 $134.91 $397.88 $929.90 Overall 9.22 1.0 $239.61 Source: Medical Expenditure Panel Survey (2004) Annual benefits of establishing a pharmaceutical disposal program • Multiplying the mean WTP of $1.53 by the average number of prescriptions per year of 9.22 yields a benefit of $14.11 per person per year • Summed over population >18 years of age • An annual benefit of nearly $12.6 million per year in Santa Barbara and Ventura counties Caution with interpreting annual benefits • “Yeah-saying” • Extrapolation to other parts of the country would be biased because WTP may differ regionally • Respondents may not account for how many prescriptions they actually fill per year Annual benefits • Conservative calculation: – assume that the estimated mean WTP of $1.53 applies for only one prescription per individual per year • Estimates an aggregate benefit of $1.36 million per year for Santa Barbara and Ventura counties and $320 million for the nation • This estimate would affect the population more equitably Comparison of benefits and costs • Substantial benefits that outweigh what would be the costs of establishing disposal programs • Special collection events – Collection events held by the Northeast Recycling Council ranged from $1,576 to $4,190 – The Bay Area Pollution Prevention Group event cost $3,645 for disposal of the collected pharmaceuticals, $86,360 for advertising, and 1,980 in staff hours Rubinstein, L. (2006). Operating unwanted medication collections - A legal and safe approach. Brattleboro, VT: Northeast Recycling Council, Inc. Available: http://www.nerc.org/adobe/setting.up.draftFINAL.pdf [2007, June 11] BAPPG. Bay Area Pollution Prevention Group. (2006). Report on the San Francisco Bay Area's Safe Medicine Disposal Days. Available: http://www.baywise.info/disposaldays/ SFBAY_SafeMeds_Report_August2006.pdf [2007, April 20]. Comparison of benefits and costs • Washington State pilot program has required funding of $251,000 to cover all costs, including one-time planning and infrastructure costs, plus labor equivalent to one to two full-time employees in its first two years • The San Mateo County program, with drop off boxes at police stations, has cost $1,900 in six months of collection • The state of Maine recently allocated one-time funding of $150,000 for the Maine Drug Enforcement Agency to establish a mail-back program Gordon, R. (2007). Innovative clean-water plan a hit: Medicine disposal program elicits inquires from all over. The Mercury News [2007, February 20]. Other issues • A requisite component of all the aforementioned disposal programs is a marketing or advertising campaign • Disposal programs will also encourage people to dispose of their unwanted medications instead of keeping them around the house, where there is an increasing risk of misuse • DEA regulations pose challenge Conclusion • People dispose of pharmaceuticals using methods that may harm the environment • Comparison of benefits and costs suggest ample scope for establishing pharmaceutical disposal programs that would yield positive net social benefits • Respondents are also likely to participate in a disposal program if one were established Acknowledgements • Dr. Matthew Kotchen • Community Environmental Council – Jenny Phillips – National Marine Sanctuaries Foundation • County of Santa Barbara (Resource Recovery and Waste Management Dept.) – Leslie Robinson • Santa Barbara Channelkeeper – Kira Schmidt • Dr. Trish Holden • William Lee • Paolo Gardinali, SSSC associate director