Cancer drugs are a major advance in medicine — they are life-saving, expensive and, according to a recent study, wasted.
This year alone, a projected $3 billion will be wasted on leftover cancer drugs that are simply being thrown away, a new study by Memorial Sloan Kettering Cancer Center concluded.
American patients are paying the price for these unused drugs, Dr. Peter B. Bach, director of the Center for Health Policy and Outcomes at the Memorial Sloan Kettering Cancer Center tells NBC News.
“I don’t think most patients are aware of this and I really hope patients with cancer can focus on things much more important than how companies are packaging their drugs,” says Bach. “But, the truth is, patients are paying for it and we need to worry about it. We have to address this problem.”
Drug companies in the U.S. distribute intravenous cancer drugs in single vials that contain more medicine than many patients will need. The leftover drug is often thrown away, creating a multi-billion dollar waste.
The U.S. government plays no role in regulating drug prices or how doctors and hospitals can profit, according to the study. In Europe, doctors and hospitals are allowed to match a patient’s required dose in smaller vials.
“I don’t think most patients are aware of this and I really hope patients with cancer can focus on things much more important than how companies are packaging their drugs"
Researchers investigated the top 20 cancer drugs that are packaged in single dose vials and administered based on body size. Together the medications account for 93 percent of cancer drug sales. To determine leftover doses, the report used projected data from federal Medicare claims and from the National Health and Nutrition Examination Survey.
In 2016, insurers are expected to pay drug makers an extra $1.8 billion for cancer drugs which are discarded. Another $1 billion will go to hospitals and doctors due to price markups of the drug, the MSK researchers found.
Safety standards allow sharing only if the leftover drug is used within 6 hours and only in specialized pharmacies. However, there are not always patients available to use the leftover medication within that restriction.
Based on the data, only six to 36 percent of the leftover vials of the top 20 cancer drugs were shared.
"We have to address this problem"
Drug companies should offer more varied packaging, Bach says. “The solution to the problem is having the company sell them in sizes where there is no leftover.”
In a statement to NBC News, biotech company Genentech said:
"All of our medicines are packaged to meet FDA regulations. The FDA calls on companies to balance vial contents so that leftover drug is minimized yet also provide enough drug so that more than one vial is rarely needed for a single dose."
In addition, the pharmaceutical industry trade group PHRMA responded to NBC News in a statement: "The drug development and manufacturing process for biologics, including oncology medicines, is extremely complex. Decisions regarding vial size are tied to a product’s initially approved dosage and labeled use, taking into account that different patients will have different needs. Vial fill size must be approved by FDA as part of the sponsor’s drug application and any excess volume must meet FDA standards outlined in regulations."
For the full statements from Genentech and the pharmaceutical industry trade group PHRMA, go here
TOP 2O INTRAVENOUS CANCER DRUGS
PROJECTED 2016 REVENUE FROM LEFTOVER DRUGS (SINGLE DOSE VIALS)
Source: Bach et al, BMJ, 1 March 2016
- BREAST CANCER
Abraxane (Paclitaxel protein bound): $76.72 million
Halaven (Eribulin): $21.85 million
Kadcyla (Ado-trastuzumab emtansine): $23.66 million
- CHRONIC LYMPHOCYTIC LEUKEMIA
Treanda (Bendamustine): $7.38 million
Avastin (Bevacizumab): $284.49 million
Vectibix (Panitumumab): $18.72 million
Cryamza (Ramucirumab): $28.78 million
Erbitux (Cetuximab): $29.18 million
Adcetris (Brentuximab vedotin): $29.15 million
Keytruda (Pembrolizumab): $197.94 million
Opdivo (Nivolumab): $68.93 million
Yervoy (Ipilimumab): $46.47 million
Alimta (Pemetrexed): $54.64 million
Kyprolis (Carfilzomib): $231.45 million
Velcade (Bortezomib): $308.74 million
Neupogen (Filgrastim): $106.01 million
- NON-HODGKIN'S LYMPHOMA
Rituxan (Rituximab): $253.85 million
Onivyde (Irinotecan liposome):$7.13 million
Jevtana (Cabazitaxel): $26.89 million
- ALL TYPES OF CANCER
Erwinaze (Asparaginase Erwinia chrysanthemi): $14.13 million