Drug companies will earn $1.8 billion this year from cancer drugs that patients never take

These are expensive cancer drugs that can cost upward of $13,000 per month. A new study suggests that the way drug companies package these intravenous drugs — in single-use vials that contain way more medication than an average patient needs — ends up wasting a lot of money.

“What manufacturers are doing is they’re not right-sizing the vials to the dosages patients actually need,” says study author Peter Bach, who is a physician at Memorial Sloan Kettering Cancer Center.

Cancer drugs are different from most other medications because they are delivered intravenously. Unlike pills that get dispensed out of a bottle, these are liquids or powders that will lose their potency if they sit on a shelf. Once opened, safety standards mandate that they must be used within six hours. After that, any leftovers have to go in the trash.

Bach and his co-authors argue in their new paper, published Monday in the British Medical Journal, that some drug companies sell too-large dosages that inevitably lead to waste. This creates income from medication that hospitals and patients will never actually use. That’s bad for the health care system but good for the drugmakers who net more revenue.

One of the most striking examples of this oversizing is a drug called Velcade that treats multiple myeloma, a bone marrow cancer.

Takeda Pharmaceutical, which makes Velcade, only sells the drug in 3.5 milligram vials in the United States (the company does manufacture 1 milligram vials abroad).

 The amount of medication that patients need turns out to be significantly smaller than the single dosage size. Using data on the weight distributions of cancer patients, Bach and his colleagues estimate that the average Velcade dose is 2.2 milligrams.

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