
New Study Examines Overspending on Oversized Cancer Drug Vials
The researchers examine the top 20 cancer drugs dosed by body size in the US, and estimate that drug companies will earn $1.8 billion in 2016 in revenue from leftover cancer drugs.
A new study published in BMJ argues that the cost of oversized single dose vials of cancer drugs may be causing patients to overpay for unused medicine.
The study, titled “
According to researchers, many cancer drugs sold in single-use vials are dosed by the body size or weight of the patient. As a result of this, the researchers suggest, pharmaceutical companies may be able to artificially increase the amount of drug sold per patient. Drug companies may do this by “increasing the amount in each single-dose vial relative to the typically required dose.”
According to the study, when hospitals or doctors are forced to purchase oversized vials that do not easily fit typical dosing requirements for a drug, they may end up discarding the remaining contents in the vial. Safety standards set by the US Pharmacopeial Convention “permit sharing only if leftover drug is used within six hours, and only in specialized pharmacies.” This leaves a limited window for a drug to be used for multiple patients.
In one example, the researchers cite pembrolizumab, which is
Pamela L. Eisele, a spokeswoman for Merck,
The researchers claim the increase in vial sizes can be expensive for patients and insurance companies, which are billed for the entire single-use dose, even if the entire dosage is not used. These bills also include “percentage-based markups,” which, the study says, “can equate to large amounts of money given that many of the drugs cost thousands of dollars per vial.”
The researchers say discarding expensive drugs is “antithetical to efforts to reduce spending on healthcare services that provide no value.” They say FDA has been “inconsistent” in guidances on vial sharing.
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