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Every day in this country,

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families are forced to make
impossible choices

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when it comes to their health care.

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Like Kimberly, who said,

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"There was times I had to choose
between my food and my pills.

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It wasn't luxury stuff,
because I didn't make that much.

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It was like, 'Can I get
shampoo or conditioner?'

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Things you take for granted."

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And Debbie, who said,

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"You put your medicine in one hand,

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your living costs in the other.

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OK. Well, what am I going to do?

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Am I going to get my medicine

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or am I going to pay my bills?

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Well, I can't live without my medicine,

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but I can't live if I don't pay my bills."

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Ten thousand people die
every month in this country,

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because they don't take
the medicine that they need.

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More people die
from not taking medications

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than opioid overdoses
and car accidents combined.

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But you can't take medicine
if you can't afford it.

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Today, the average household
spends 3,000 dollars a year

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on medications.

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About a third of folks who are uninsured

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said that they stopped
taking medicine as prescribed

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because of cost.

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Even folks with insurance,

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if they make under 35,000 dollars a year,

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half of them report
skipping the medications

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if their insurance doesn't cover it.

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So there are 10 million adults
like Kimberly and like Debbie

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who are forced to make
impossible choices every day.

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We all know that prescription
drug prices are too high.

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And our health care system,

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that makes some folks uninsured
and other folks underinsured,

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doesn't prioritize
people who need access now

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and need medications now.

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Ten million -- it's a big number,

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but it's also a solvable number,

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because there's also 10 billion dollars

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of perfectly good, unused medication

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that goes to waste.

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So this is an injustice on two sides:

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people not getting the medicine
that they need to survive and to thrive,

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and that very same medication
being sent to a medical waste incinerator

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to be destroyed.

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This waste is unconscionable,
but it also offers an opportunity.

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I started SIRUM,

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a not-for-profit technology company,
with my cofounders Adam and George,

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to turn discarded medications
into a lifeline,

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just like the medications
in this warehouse.

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We may not be able to fix

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all the ways in which
our health care system is failing us,

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but we can fix this one.

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Medications come from manufacturers
and wholesalers who have safety stock,

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and when it's short-dated,
they destroy it.

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It also comes from health care facilities

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like hospitals, pharmacies
and nursing homes,

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who end up with surplus
when a patient stops taking medication

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or when they pass away.

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We can use this untapped
source of medications

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to supply all 10 million people
who need medications.

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And we can do this today.

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SIRUM gets surplus medications

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by putting recycling bins into
these hundreds of facilities

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that have surplus.

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They fill the bin,
and when the box is full,

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SIRUM initiates a courier pickup
to pick up that medication,

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and we handle the shipping, the tracking,
the manifests and the tax receipt.

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Medicine donors want to donate
because it's actually cheaper and easier

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than the highly regulated
medicine destruction process.

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And there are strong tax incentives
to actually donate.

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We then deliver those donated medications
to people who need it.

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A new prescription comes in,

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and our platform matches that patient need
with the inventory that's available.

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Our platform then generates
a warehouse pick list,

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the medications are picked
and the prescriptions filled.

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We are building the 21st-century
pharmacy experience

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that low-income families deserve.

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Patients can register
in under five minutes

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and have access to
over 500 different medications,

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a stable list of medications
for everything from heart disease

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to mental health conditions,

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actually representing over 75 percent
of all prescriptions prescribed

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in the United States today.

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We also partner with a network of doctors,
nurses and case managers

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at community health centers
and free clinics

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that refer patients to the service.

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We make it as easy
for these health care providers

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to have a prescription filled
with donated medications

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as it is to send a prescription
to a local pharmacy.

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And patients can pick up medications
on-site at one of our partners

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or have medications delivered
directly to their home.

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By circumventing
the traditional supply chain,

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we're able to offer flat,
transparent pricing --

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about two dollars for a month's supply
of most medications.

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And that allows a predictable,
affordable price

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that folks can actually budget for.

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We've already supplied enough medication
for 150,000 people.

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But we can do more.

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Our goal is to reach one million people

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with approaching a billion dollars
of unused medicine

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in the next five years,

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scaling our program to 12 states.

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At this scale, we can actually cover
communities that are home

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to 40 percent of the 10 million people

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who lack consistent, affordable access.

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Our direct service to one million people

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will drive price competition
for so many more.

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Walmart launched one of the only
price innovations in pharmacy

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in 2006,

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by offering a limited list of medications

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for a flat fee of four dollars.

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This sparked incredible change.

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It sparked competitors
to offer other lists

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and price match guarantees.

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By targeting transparent,
affordable medications

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into these new states,

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we can actually drive
regional price competition

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that drives down the prices
for entire low-income communities.

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Our health care system is complex.

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It is daunting.

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It feels impossible to make headway.

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But we can completely
reimagine medicine access.

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By using surplus medications
as a beachhead to force change

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into this multibillion dollar industry,

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we can create radical access
to medications

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based on a fundamental belief

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that people who live in one of
the wealthiest nations in the world

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can and should have access
to medicine that they need

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to survive and to thrive.

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I do not pretend to have
all of the answers

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to fix all of the problems
in our health care system.

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But getting medications
to the millions of people

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who need it to live a healthy life,

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saving medicine to save lives --

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that is something we can do today.

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Thank you.