Cancer researchers have found that $3 billion a year in cancer medicines is wasted because drug manufacturers package single dose vials that contain more medicine than needed. The leftover medication is discarded. The New York Times reports:
The expensive drugs are usually injected by nurses working in doctors’ offices and hospitals who carefully measure the amount needed for a particular patient and then, because of safety concerns, discard the rest.
If drug makers distributed vials containing smaller quantities, nurses could pick the right volume for a patient and minimize waste. Instead, many drug makers exclusively sell one-size-fits-all vials, ensuring that many smaller patients pay thousands of dollars for medicine they are never given, according to researchers at Memorial Sloan Kettering Cancer Center, who published a study on Tuesday in BMJ, formerly known as the British Medical Journal.
Reviewing the waste generated by the top 20 selling cancer drugs, the researchers found that insurers ended up paying drug makers $1.8 billion each year on discarded medications plus another $1 billion on price markups to doctors and hospitals. This is because most cancer drugs are injected by needle, and the amount is carefully measured out based on a particular patient profile.
For example, a patient may need 150 mg of drug X, which comes packaged only in 100 mg vials. The patient would of course have to open two such packages, and the remaining 50 mg in the second package would have to be discarded after opening. Doctors and hospitals typically add a mark-up onto drugs when they administer them, even for those quantities of a drug that are trashed. Congress sets the mark-up for Federal Medicare patients at 6%, but for private insurers (which cover most Americans) the mark-up tacked on by doctors and hospitals can be much higher—closer to 22% and 142% respectively, say study authors.
