STAT | PHARMALOT
Keith Srakocic/Associated Press/File 2012
A group of lawmakers in Washington, D.C., want to reduce the amount of medicine wasted each year because many drugs are distributed in so-called single-use vials that contain more than most patients need.
They’ve introduced a bill, the Reducing Drug Waste Act of 2017, that would require the Food and Drug Administration to coordinate with the Centers for Medicare and Medicaid Services to develop a plan to reduce waste and better manage costs, as well as submit a report to Congress with legislative recommendations.
The move follows various reports that large quantities of medicines — from expensive cancer treatments to pricey eyedrops — are wasted each year because of packaging.
An analysis published last year, for instance, estimated that $2.8 billion is wasted each year by government and private insurers on cancer meds, which are typically injected or infused in doctor’s offices and hospitals, based on the patient’s weight. But the drugs are packaged in uniform-sized vials, which often generates leftover medicine that must be discarded due to safety standards.
“This is a colossal and completely preventable waste of taxpayer dollars, and it means American patients and hard-working families are paying for medication that gets tossed in the trash,” said Senator Dick Durbin, an Illinois Democrat who is cosponsoring the bipartisan legislation. “Instead of allowing the pharmaceutical industry to profit at our expense, it’s time we put an end to this wasteful spending.”
The lawmakers pointed to a report from the Office of Inspector General of the Department of Health and Human Services that analyzed 20 drugs in single-use vials with the highest amounts of identifiable Medicare Part B reimbursement for discarded medicines during 2013 and 2014. The watchdog office found that $195 million was reimbursed for discarded drugs.
The authors of an analysis published last year in BMJ argued that leftover medicine makes it possible for drug makers to “artificially increase” the amount of medicine they sell. The companies can accomplish this by increasing the amount of each single-dose vial relative to the required dose. The leftover can vary anywhere from 1 percent to 33 percent of the amount of drug that patients actually need.
The authors recommended that the FDA require drug makers to provide different vial sizes to ensure the amount of wasted medicine is low. They suggested a goal of no more than 3 percent waste and urged the different government agencies to get on the same page when it comes to vial sharing. They contend the amount of money spent on discarded medicines would drop to $400 million from $1.8 billion.
Their analysis prompted nearly a dozen lawmakers to ask the FDA and the CMS to investigate the impact of large one-size-fits-all vials on the federal health care system and public health.
More recently, eyedrops — from pricey glaucoma treatments to ordinary salves for dry eye — have been a focus. Some drug makers produce the drops in oversize doses, sometimes more than twice what the eye can hold, resulting in medicine running down the patient’s face. As a result, some patients run out of medicine before they can refill prescriptions, according to a recent story by ProPublica.
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