You shouldn't have to choose between filling your prescriptions and paying bills

As prescription drug costs skyrocket in the US, thousands of people are forced to forgo lifesaving medications -- all while manufacturers and health care facilities systematically destroy perfectly good, surplus pills. Kiah Williams shares how SIRUM -- a nonprofit that delivers unused medications to families who need them most -- plans to drive down prescription prices by recycling almost a billion dollars' worth of medications in the next five years. (This ambitious plan is a part of the Audacious Project, TED's initiative to inspire and fund global change.)

Every day in this country,

families are forced to make
impossible choices

when it comes to their health care.

Like Kimberly, who said,

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

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

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

Things you take for granted."

And Debbie, who said,

"You put your medicine in one hand,

your living costs in the other.

OK. Well, what am I going to do?

Am I going to get my medicine

or am I going to pay my bills?

Well, I can't live without my medicine,

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

Ten thousand people die
every month in this country,

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

More people die
from not taking medications

than opioid overdoses
and car accidents combined.

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

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

on medications.

About a third of folks who are uninsured

said that they stopped
taking medicine as prescribed

because of cost.

Even folks with insurance,

if they make under 35,000 dollars a year,

half of them report
skipping the medications

if their insurance doesn't cover it.

So there are 10 million adults
like Kimberly and like Debbie

who are forced to make
impossible choices every day.

We all know that prescription
drug prices are too high.

And our health care system,

that makes some folks uninsured
and other folks underinsured,

doesn't prioritize
people who need access now

and need medications now.

Ten million -- it's a big number,

but it's also a solvable number,

because there's also 10 billion dollars

of perfectly good, unused medication

that goes to waste.

So this is an injustice on two sides:

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

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

to be destroyed.

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

I started SIRUM,

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

to turn discarded medications
into a lifeline,

just like the medications
in this warehouse.

We may not be able to fix

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

but we can fix this one.

Medications come from manufacturers
and wholesalers who have safety stock,

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

It also comes from health care facilities

like hospitals, pharmacies
and nursing homes,

who end up with surplus
when a patient stops taking medication

or when they pass away.

We can use this untapped
source of medications

to supply all 10 million people
who need medications.

And we can do this today.

SIRUM gets surplus medications

by putting recycling bins into
these hundreds of facilities

that have surplus.

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

SIRUM initiates a courier pickup
to pick up that medication,

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

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

than the highly regulated
medicine destruction process.

And there are strong tax incentives
to actually donate.

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

A new prescription comes in,

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

Our platform then generates
a warehouse pick list,

the medications are picked
and the prescriptions filled.

We are building the 21st-century
pharmacy experience

that low-income families deserve.

Patients can register
in under five minutes

and have access to
over 500 different medications,

a stable list of medications
for everything from heart disease

to mental health conditions,

actually representing over 75 percent
of all prescriptions prescribed

in the United States today.

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

at community health centers
and free clinics

that refer patients to the service.

We make it as easy
for these health care providers

to have a prescription filled
with donated medications

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

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

or have medications delivered
directly to their home.

By circumventing
the traditional supply chain,

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

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

And that allows a predictable,
affordable price

that folks can actually budget for.

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

But we can do more.

Our goal is to reach one million people

with approaching a billion dollars
of unused medicine

in the next five years,

scaling our program to 12 states.

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

to 40 percent of the 10 million people

who lack consistent, affordable access.

Our direct service to one million people

will drive price competition
for so many more.

Walmart launched one of the only
price innovations in pharmacy

in 2006,

by offering a limited list of medications

for a flat fee of four dollars.

This sparked incredible change.

It sparked competitors
to offer other lists

and price match guarantees.

By targeting transparent,
affordable medications

into these new states,

we can actually drive
regional price competition

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

Our health care system is complex.

It is daunting.

It feels impossible to make headway.

But we can completely
reimagine medicine access.

By using surplus medications
as a beachhead to force change

into this multibillion dollar industry,

we can create radical access
to medications

based on a fundamental belief

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

can and should have access
to medicine that they need

to survive and to thrive.

I do not pretend to have
all of the answers

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

But getting medications
to the millions of people

who need it to live a healthy life,

saving medicine to save lives --

that is something we can do today.

Thank you.