James Kallaos, Matthew Kotchen, Kaleena Wheeler, Crispin Wong, and Margaret Zahller

1. 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

2. 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

3. 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

4. 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

5. Awareness • “Are you aware that medical compounds have been found in treated wastewater and surface water?” • 43% of respondents are aware

6. Disposal habits “How do you typically get rid of unwanted or expired prescription or over-the-counter medications in your household?”

7. 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

8. 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

9. Model coefficients and effects Pr[YES] = f [bid, gender, age, awareness, political party, race]

10. Mean willingness-to-pay • Logit model: Pr(Yesi)=a+b1(Bidi)+ei • E(WTP) = / Hanemann, W. M. (1984) Welfare evaluations in contingent valuation experiments with discrete responses. American Journal of Agricultural Economics,66(3), 332-341.

11. 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?”

12. Prescriptions and out-of-pocket expenditures for 2004

13. 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

14. 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

15. 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

16. 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].

17. 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].

18. 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

19. 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

20. 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