$3 billion will be wasted on unused portion of cancer drugs, study says

TRENTON, N.J. – High prices for cancer medicines aren’t the only reason they cost so much.

Waste pads the bill, a study finds, because infused cancer drugs are distributed in the U.S. in vials that usually contain more medicine than most patients need. Most of the time that excess is thrown out, even though it’s good – and worth thousands of dollars.

Researchers at Memorial Sloan Kettering Cancer Center in New York estimate that wasted cancer medicine in the U.S. this year will add up to nearly $3 billion in excess costs.

Their finding comes as the federal government and much of the health care system try to reduce waste and overall medical spending, which accounts for about one-sixth of U.S. gross domestic product. Meanwhile, cancer medicines are one of the highest-priced, fastest-growing drug categories.

“Hopefully, our regulators will take this as a problem worth addressing,” the study’s lead author, Dr. Peter B. Bach, said in an interview.

The study, published Tuesday in BMJ (formerly the British Medical Journal), focuses on the top 20 drugs for multiple cancer types packaged in single-dose vials and for which the dose depends on the patient’s weight, finding that 1 percent to 33 percent of those 20 cancer drugs, on average, remains in vials after each dose is administered.

Based on the available vial sizes in the U.S., the researchers estimated that makers of those 20 drugs this year will receive an extra $1.84 billion from charges for unused medicine, or about 10 percent of their expected U.S. sale.

Insurers and cancer patients will pay at least another $1 billion on unused medicine in 2016, based on the markups hospitals and doctors charge every time they infuse patients with those drugs, the researchers concluded.

Among the examples in the study is Amgen Inc.’s myeloma drug Kyprolis, for which one-third of a vial’s contents on average is unneeded. With estimated 2016 sales of $677 million, the wasted portion comes to $231 million.

The researchers say regulators could require manufacturers to supply multiple vial-size options, and the FDA and other federal health agencies need to reconcile their disparate guidelines on vial size and when leftover medicine from one vial can be given to another patient. Currently, sharing generally is only allowed within six hours of when the vial is opened to ensure the medicine’s sterility.