Saying “Yes” to Filling Gaps in Cancer Drug Access

By: Markie Heideman, Content Marketing Manager

Each year, billions of dollars worth of unused cancer drugs are thrown out across the United States after patients no longer need them. At the same time, thousands of cancer patients across the country are desperately waiting for drug treatments – due to drug shortages or simply because they cannot afford them. So, what if those unused drugs went to those in need, instead of harming our water supply and environment? That’s where Emily Mackler, PharmD, and her business partner, Siobhan Norman step in.

In 2023, Mackler and Norman founded YesRx, a charitable service organization. YesRx supports clinicians and practices in the utilization of the Michigan Cancer Drug Repository (CDR) Program. This program allows patients to donate unused cancer drugs which are then repurposed by pharmacists for patients with cancer who are often uninsured or underinsured and in need of that medication.

“When Emily came to me with this vision, it was such an opportunity to reach patients directly with an important resource. The problem was clear, and we knew the resource could be free (for clinicians and practices) if we found the right funding mechanisms,” Norman explained.

The organization works with oncology practices across Michigan to connect them with all the resources they need to accept patient donations and provide CDR medications for those in need. At its launch, the YesRx Network, a statewide CDR collective, worked with three community practices who had their own CDR programs. Today, YesRx works with more than 60 and intends to keep growing to ensure its reach is wide and can help as many patients as possible. In the first year of operations, the YesRx Network helped more than 700 patients in 75% of Michigan counties. $7.1 million dollars in cancer medication was provided to patients in Michigan for free. The medication donated by patients, families, and caregivers reached more than $13.3 million worth of unused cancer medicine (that’s more than 30,000 pills) that would have been thrown away. Mackler credits the partnerships with clinics for helping YesRx become a success.

“We really rely on our YesRx Network partners and oncology practices to identify patients in need,” Mackler explained. “Oftentimes, the amount of medication donated isn’t enough to cover someone for their entire course of therapy, so the clinic remains active in identifying a sustainable method of medication access. Sometimes that’s another resource, sometimes it’s a second fill through our network of repositories. That communication and partnership is key in making this happen.”

As far as the name “YesRx,” it originated from the ability to allow these donations to happen.

“For a long time, patients have had the earnestness to want to donate their medications,” Norman explained. “For years, they were told no, that facilities couldn’t take them. Now, because of this program, it’s a yes. Yes, we can take your medications, and yes, they will be used for other patients in need.”

Forever Maize and Blue

Arriving in Ann Arbor in 2002, Mackler spent more than a decade as an Adjunct Associate Professor at the University of Michigan College of Pharmacy teaching an array of therapeutics courses. She went on to start the Oncology Residency Program a year later in 2003, at Michigan Medicine. With a passion for educating students while also being a mentor and preceptor, she is driven to advance oncology pharmacy practice.

“My interest in oncology really came from my time in school,” explained Mackler. “I fell in love with oncology and ended up doing my residency at the same site that my college preceptor had done hers because I thought she was amazing and the work she did was impactful.”

Now, Mackler gets to be that same supportive figure as she continues to serve as a preceptor for students in the College of Pharmacy. Preceptors play an important role in shaping a PharmD student’s experience by exposing them to real-world pharmacy work during rotations and supporting the development of soft and professional skills.

Outside of her time as a preceptor, Mackler also gives back to her students by volunteering at the Safe Medication and Sharps Disposal event that takes place on campus each year, giving community members a chance to safely dispose of unused medications, and now to donate to YesRx.

It isn’t just Mackler who has maize and blue in her blood, but also Norman. A 1998 graduate of the University of Michigan’s Sports Management and Communications programs, Norman has remained close and committed to serving the Ann Arbor community.

United in Friendship

It’s that love for the local community that helped Norman’s world collide with Mackler’s. They met 13 years ago when Mackler served as a consultant at a tech startup company Norman was working at – and they have been leaning on each other’s friendship and expertise ever since.

They both say their friendship has gotten them through the tougher days on the job.

“We know that we can show up fully ourselves every single day and know that we’re going to be supported no matter what part of our self is showing up that day,” said Norman. “We’re all complex human beings, and we get scared and nervous and worry often, especially in a nonprofit space, but to know you can show up and really be who you are makes the way we work together so much more effective.”

“I think the biggest thing is how aligned we are on what we want to see happen, and how committed we both are to the mission,” said Mackler. “We care so deeply about the members and the patients they serve each day, and I can’t imagine doing this with someone who doesn’t have that same drive to make their lives better.”

Forever Leading

Right now, most states do not have a similar cancer drug repository resource, but Mackler and Norman hope to change that.

“What we’re doing has never been done before, YesRx is the first of its kind in the U.S.,” said Norman. “Our focus is to do it very well in Michigan, and then take those outcomes forward to leverage best practices and continue to reach the most vulnerable and underserved patients and communities..”

Mackler and Norman’s passion for medication access is an example of the life-changing work that can be done in the field of pharmacy. Mackler’s journey took her through a path from academia to entrepreneur – because, with a PharmD and a passion to make a difference, you can explore diverse pathways.

Mackler’s continued involvement in supporting students at the U-M College of Pharmacy is a testament to the networking and learning opportunities our students have access to during their time here, and another example of our commitment to endlessly lead.