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Warren County Fire & Rescue readies in-house medication exchange after hospital program ends
Summary
After hospitals said a Virginia drug box exchange will end Nov. 27, Warren County Fire & Rescue plans to lease a Pyxis MedBank Tower, begin staff training and seek Board of Pharmacy inspection and DEA registration; staff said monthly lease fees would come from cost‑recovery funds while medication purchase costs remain under analysis.
Assistant Chief Mayatico told the Warren County Board of Supervisors that the Virginia hospital‑based drug box exchange program will end "as soon as 11/27/2024," citing federal regulatory changes tied to the Drug Supply Chain Security Act and related FDA enforcement.
Mayatico said the county plans to install a Pyxis MedBank Tower at Front Royal Station 1 and has selected a 60‑month lease. "The vendor package breaks down to $642 a month, or $7,704 a year," he said, and staff said they expect to fund the monthly fee from the department's cost‑recovery account. The department carries 47 medications in its response system and about 100 units per drug kit, Mayatico said.
In questions from the board, Mayatico said individual drug doses range widely in price: "There is a cost to those, we get them, it's anywhere from $2 a dose up to $200 a dose," and replacing roughly 100 units in a drug bag was estimated "somewhere around $3,000." He cautioned staff is still pricing vendors and evaluating regional procurement to reduce cost and waste from expirations.
Mayatico described workflow changes: after a medic picks up medication from the hospital, crews would access the exchange cabinet at Station 1 to transfer used drugs and return to their home station. Staff are drafting policies to limit out‑of‑service time when units restock. He said the county is awaiting a final inspection from the Virginia Board of Pharmacy; once that is complete the department will apply for a DEA registration to order controlled substances directly.
Board members and staff noted some inconsistencies in the meeting's cost references. Mayatico initially stated the Pyxis package at $642 per month ($7,704 per year); later in the discussion another figure — "77,000" — was mentioned by a board member as an earlier quoted number but the transcript does not record staff confirming that higher figure. The county said it will present detailed, line‑item cost projections and vendor comparisons to the finance and procurement teams during the budget process.
Next steps: staff said vendor system build would begin the following week, internal staff training is planned, and an internal go‑live target of Nov. 1 was set to allow a cushion before the hospital program's Nov. 27 end date. The board did not take a formal vote on funding during the meeting.
