March 28, 2016
The U.S. medical system throws out around $2.8 billion worth of cancer drugs each year because they come in large vials that contain more medication than the typical patient needs, according to a new report from the Memorial Sloan Kettering Cancer Center in New York City.
As Medscape reported, researchers at Sloan Kettering examined 20 cancer drugs where the dose depends on the patient's body size. Leftover medication cannot be reused unless two patients have chemotherapy at the same time, which is very difficult to schedule. So instead, expensive and lifesaving cancer drugs are usually thrown out.
One of the biggest money-wasters on the list is Avastin, a drug for colorectal cancer made by Genentech. It comes in 100- and 400-milligram vials, but the typical patient needs 350 milligrams. That means half a vial gets thrown out, costing patients and insurers $284.5 million per year.
The drug companies that make these medications make 10 percent of their revenue on these drugs, or $1.8 billion, just from what gets discarded.
Take, for example, Keytruda, which is used for melanoma patients. It comes in 100-milligram vials, but a typical patient needs 140 milligrams. That means that hospitals have to use two vials but throw most of one out, at a cost of $197.9 million per year.
Keytruda did once come in smaller vials, but that size option was discontinued in the U.S. However, Merck is still selling the 50-milligram vials in Europe.
"Merck withdrew the 50-milligram vial and replaced it with a 100-milligram vial," lead author Dr. Peter Bach said to Medscape. "The increase in revenue from this switch is substantial and we estimate it will add about $1 billion in revenue over the next 5 years."
Not every drug on the list was singled out for wastefulness. For example, the leukemia drug Treanda, made by Cephalon, comes in four different size options, ranging from 25 to 180 milligrams. As a result, hospitals only have to discard 1 percent of the drug each year, although that still costs $7.4 million.
Bach says that insurers and the government have to find a way to incentivize drug companies to offer drugs in smaller doses.
“The waste is driving up the cost of their care and it is money that they are spending that provides them no benefit,” Bach told Reuters.
The study's authors created an interactive graphic to show how much money is wasted on each drug per year. Find it here.
