Jan 6, 2020

The medications that are thrown away

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Data: Centers for Medicare & Medicaid Services; Table: Axios Visuals

Last year, Medicare paid for $725 million worth of expensive medications administered in outpatient clinics — things like chemotherapy drugs — that ended up being discarded, according to new data released by the federal government.

Why it matters: Although that amount is just 2% of what Medicare paid for those types of infusion drugs, that's still a "very astonishing amount of waste," said Rena Conti, a health economist at Boston University who has studied the issue.

By the numbers: 10 highly discarded drugs accounted for 63% of Medicare's wasted dollars.

  • More than 26% of what Medicare paid for blood cancer drug Velcade, or $123 million, was flushed down the drain — the highest amount of any drug.
  • Medicare paid $226 million for the blood platelet injection NPlate, or more than half of the drug's U.S. sales, yet 22% of that drug ($78 million) was thrown away.
  • Takeda, which makes Velcade, and Amgen, which makes NPlate, did not immediately respond to interview requests.

Between the lines: Drugs that are given intravenously and are based on someone's weight are more difficult to administer than pills, and some cannot be reused after the vials are opened — thus making them prone to some inevitable waste.

  • But some pharmaceutical companies package drugs in oversized single-use vials, knowing a lot will get thrown out but will lead to more reorders and sales.

The big picture: Requiring companies to make more appropriate vial sizes may not reduce wasted medications or save money. Researchers say drug companies could easily adapt because, as monopolists, they would still be able to charge whatever they want regardless of the vial or dose size.

  • "It's not necessarily true that if we got smaller vials, we would be paying less money," said Stacie Dusetzina, a pharmacoepidemiologist at Vanderbilt.

Hospitals and doctors play important roles, too, because they control the purchasing and use of these infused drugs.

  • However, "the system does not reward hospitals to be good stewards of resources," Conti said.

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