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MIT Alum Founds Nonprofit to Reuse Prescriptions

By Jeffrey Krasner

As a child growing up on a farm in Israel, Moshe Alamaro SM ’01 would feed grass clippings to the chickens. The green food made the birds robust, and they produced eggs with stronger shells. It was an early manifestation of Alamaro’s strong aversion to any kind of waste.

He still feels a compulsion to turn waste into opportunity. Now, he has taken aim at what he says is one of the most obvious and valuable streams of waste in America: the pile of unused pills that sit in almost everyone’s medicine chest.

The drugs pile up when people change treatments or get better before their prescription has run out or when they die and leave vials of pills behind. It all goes into the trash can, and that infuriates Alamaro as rising drug costs contribute to ever-increasing healthcare insurance premiums.

“My estimate is 15 to 20 percent of drugs dispensed by pharmacies eventually are wasted,” said Alamaro, 58, a research associate at MIT who was trained in atmospheric sciences and mechanical engineering. “There’s easily more than $10 billion in prescription drugs that can be recovered each year in the US.”

He’s working to build a nonprofit organization that could collect unwanted prescription drugs and distribute them to needy patients who can’t afford to buy them. He calls it drug recycling. But even Alamaro admits that his plan could cross legal lines.

“When a friend’s father died, he left behind $40,000 worth of drugs,” he said. “When I changed my prescription, I was left with a bottle worth $200, and there was nothing I could do with it.”

Alamaro envisions community pharmacies that collect these drugs, certify and repackage them, and then dole them out to those who can use them.

The concept is starting to work, at least on a very small scale. As a result of an article in AARP’s magazine and other publicity, Alamaro has begun to receive donations of drugs from Americans who share his reluctance to throw valuable drugs away. For now, he sends many of those medications to Action for Post-Soviet Jewry, a Waltham nonprofit that sends many of the prescriptions to Ukraine. There, they are distributed to seniors with chronic diseases like diabetes and asthma who don’t have health insurance.

“The pensioners are the most needy,” said Judy Patkin, executive director of the group. “What they need more than anything is access to decent medicine.”

But even such a small-scale experiment highlights the challenges to Alamaro’s quest. How can you ensure that drugs in opened vials are safe? Do some medications get stale and need to be discarded? What do regulators think of shipping drugs to people who may not have a doctor’s prescription?

Alamaro has been tinkering with the first problem. He is planning new packaging systems for drugs that would segregate smaller quantities of pills. For example, instead of getting a vial of 30 capsules for a month, a container might hold six smaller containers, each safety-sealed and holding five capsules. He is also working on a new type of packaging that could show whether drugs were exposed to excessive heat.

The legal challenges are more daunting. Prescription drugs are controlled substances in Massachusetts, and state law prohibits anyone other than a doctor or pharmacist from distributing them to patients.

Those laws give pause to Dr. Scott Morris, founder and executive director of the Church Health Center of Memphis, a nonprofit clinic that serves residents who don’t have health insurance. He said he is intrigued by Alamaro’s plan but afraid of possible legal penalties.

“I have an army of volunteers that could put the drugs into safe packaging for redistribution,” Morris said.

Morris said he wants his clinic’s pharmacy to gather recycled drugs from Alamaro, as well as free samples and other donations from pharmaceutical companies, and make them available to anyone in the community who lacks health insurance.

“I’m totally enamored with the possibility,” Morris said. “I’m ready to take Moshe’s drugs. Everything he says makes sense. We’re going to start as soon as we get totally comfortable with the legal issues.”

Alamaro scoffs at laws prohibiting the redistribution of drugs, adding that he’s willing to go to jail for his activities. It’s typical of Alamaro, who calls himself an inventor and has a skill for conjuring big ideas, but a less successful record of turning them into reality.

As a graduate student at MIT, he designed a system that could steer hurricanes away from vulnerable shorelines. He has also championed a method of producing nitrogen plant fertilizer using only air, water, and electricity. Deregulation of the market for electricity killed that plan, he said. Now, he’s working on another scheme to build greenhouses adjacent to electric power plants, enabling vegetables to benefit from the high concentrations of carbon dioxide and the waste heat in winter.

“He’s a very creative guy,” said Dr. Robert S. Langer, the famed bioengineer at MIT whose research has spawned numerous commercial ventures.

Alamaro said that the first step is to build up a recycling plan in a nonprofit like the church clinic. After that, he’s sees a chance for a commercial venture.

“It would be supervised by a licensed pharmacist,” he said, “and the company would get some percentage of the retail value of the drugs.”