Waste due to oversized single-dose infused cancer drug vials results in overspending of approximately $1.8 billion annually in the United States, according to an analysis. Percentage-based price markups to hospitals and clinicians account for an additional $1 billion in unnecessary spending.1

Researchers analyzed the cost of 20 cancer drugs that are dosed based on body size but packaged in single-dose vials.  These drugs are marketed only in vials that are much larger than the average required dose. Manufacturers do not provide smaller vials that could be used to dose more precisely based on body size to minimize waste.

“It is inconceivable that the drug companies are unaware of the impact of their packaging decisions on waste,” Peter Bach, MD, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering in New York, NY, told Cancer Therapy Advisor.

“They are intimately familiar with the profile of the patients being treated with their drugs. They have detailed knowledge of the average dose based on clinical trials and requirements for FDA approvals. In fact, the drug companies publish recommended dosing. There can be little doubt that they are aware of the waste package sizes tend to generate.”

In the analysis, the researchers pointed out examples where the same drugs are available in smaller vials in Europe but not in the United States.

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For example, Bach and his colleagues noted that while bortezomib, a multiple myeloma drug, is available only in 3.5 mg vials in the United States, it is sold in 1 mg vials in the United Kingdom. They calculated that the average bortezomib dose is 2.5 mg, and estimated that waste of this drug alone accounted for $309 million in unnecessary spending.