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Stanford undergrad works to redistribute unused medications and reduce health-care costs

1Sanchay Gupta arrived at Stanford with a strong interest in income inequality. In 2013, he spent two weeks of his summer vacation in Guatemala exploring issues of global chronic underdevelopment as part of an intensive field research internship sponsored by the Freeman Spogli Institute for International Studies. While on the trip, he shadowed Stanford doctors in ad-hoc rural clinics serving the indigenous communities and got a firsthand look at the country's rural health-care system. He also interviewed patients about how their health status affected their family's welfare while conducting field research.

Among the patients he interviewed was a father of nine children who made his living carrying firewood. One day the man injured himself carrying a particularly heavy load and was declared unfit for work. Seemingly overnight, the family income drastically fell below $3 a day and the father could no longer afford to see a doctor for treatment. But until he received proper medical care, there was no way that he could recover from his injury and resume supporting his family.

"It was during my time in these community settings that I witnessed how disparities in access to medical care can perpetuate inequality," said Gupta, who was recently named one of the "15 incredibly impressive students at Stanford" by Business Insider. "As a result, I became really interested in how solving issues of inequality could break the cyclical theme of poverty."

At the same time, Gupta was  fostering a vested interest in the fate of America's health-care system. He had taken a few courses on U.S. health policy and strategies for health-care delivery innovation, and the experiences sparked a desire to get involved in efforts to eliminate costly inefficiencies within the health-care sector.

In looking for opportunities to get involved in helping reduce inefficiencies in health care, he learned about Supporting Initiatives to Redistribute Unused Medicine (SIRUM), a non-profit launched by Stanford students that engages with health-facility donors, converting their regulated medicine destruction process into medicine donation.

Nearly one-third of patients don't fill first-time prescriptions and many say concerns about costs are a key reason for their non-compliance. At the same time, an estimated $5 billion of unused and unexpired prescriptions drugs are destroyed in the United States annually. To address these problems, SIRUM has developed an online platform that allows medical facilities, manufacturers, wholesalers and pharmacies to donate unused drugs instead of destroying them.

"The consistent turnover of medicine at these facilities provides an ongoing supply of medicine donations, rather than one-off donations," explains Gupta. "And unlike traditional donation models, facilities are both financially and personally motivated. From a business perspective, donating reduces the time and cost associated with otherwise disposing of unused medicine, a process that typically takes several nursing staff hours and costs up to $3 per pound. Personally, health-care workers are eager to make a larger impact on their local communities."

Through the Haas Center for Public Service, Gupta applied for financial support from the Donald A. Strauss Foundation and was awarded a scholarship to lead SIRUM's expansion into the assisted-living industry.

With approximately 300 existing donors, the non-profit has been eager to increase its presence in and beyond the state of California. However, the technology to donate is ahead of current government processes and procedures in terms of accessibility of public records. Key records and third-party evaluations of health and care facilities are not always available online. This makes it difficult for potential pharmacies that receive donations to vet organizations that they would receive medication from.

"It so happens that assisted-living communities constitute a significant proportion of the facilities that lack online records," Gupta said. "Based on this information, we decided that the project would involve digitizing key records and third-party evaluations of health and care facilities in California, allowing for the creation of California's largest database of assisted-living community and residential care facilities for the elderly."

Last summer, Gupta completed the database and now SIRUM is using it to identify and help receiving pharmacies vet potential partners from thousands of eligible facilities. He has also assisted in developing a virtual-training model for facilities interested in donating using computer tablets.

The preliminary results from the virtual-training model look promising, and SIRUM has high hopes that the program will allow it to continue adding new partners while decreasing recruitment costs. As for Gupta, he's looking forward to graduating in spring 2015 and continuing to address income inequality and reduce inefficiencies and waste in the health-care system as a physician.

Previously: Is disposing of unused drugs in household trash the most environmental option?
Photo, of Sanchay Gupta (in pink) and others in Guatemala, courtesy of Gupta

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