Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb 29:352:i788.
doi: 10.1136/bmj.i788.

Overspending driven by oversized single dose vials of cancer drugs

Peter B Bach  1 , Rena M Conti  2 , Raymond J Muller  3 , Geoffrey C Schnorr  4 , Leonard B Saltz  5
Affiliations

Overspending driven by oversized single dose vials of cancer drugs

Peter B Bach et al. BMJ. .

Abstract

Peter B Bach and colleagues call for an end to contradictory regulatory standards in the US that allow drug manufacturers to boost profits by producing single dose vials containing quantities that increase leftover drug

PubMed Disclaimer

Conflict of interest statement

Competing Interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: PBB reports personal fees from Association of Community Cancer Centers, America's Health Insurance Plans, AIM Specialty Health, American College of Chest Physicians, American Society of Clinical Oncology, Barclays, Defined Health, Express Scripts, Genentech, Goldman Sachs, McKinsey and Company, MPM Capital, National Comprehensive Cancer Network, Novartis, Biotechnology Industry Organization, American Journal of Managed Care, Boston Consulting Group, Foundation Medicine; LBS reports grants from Taiho Pharmaceuticals; RJM reports personal fees from Amgen, Hospira, Seattle Genetics, Sunesis, Amneal Biosciences, Magellan Medication Management System, and is an uncompensated member of the national clinical advisory committee for the Institute of Safe Medication Practices.

Figures

Fig 1
Fig 1
Study flowchart
Fig 2
Fig 2
Distribution of FDA approved dose (green histogram) in the US population of cancer patients, and available combinations of full vial contents (red lines) to achieve that dose for bortezomib (top) and bendamustine (bottom)
See this image and copyright information in PMC

Comment in

References

    1. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA 2012;307:1513-6. 10.1001/jama.2012.362. 22419800. - DOI - PubMed
    1. Lien K, Cheung MC, Chan KK. Adjusting for drug wastage in economic evaluations of new therapies for hematologic malignancies: a systematic review. J Oncol Pract 2015 . Sep 1 JOP.2015.005876. - PubMed
    1. Smith RS. A 2-year retrospective review of vial sharing options for the compounding of cytotoxics. Eur J Hosp Pharm 2015;22:161-4 10.1136/ejhpharm-2014-000547. . - DOI
    1. United States Pharmacopeia, ed. USP< 797> Guidebook to pharmaceutical compounding-sterile preparations.United States Pharmacopeial Convention, 2008.
    1. Fasola G, Aprile G, Marini L, Follador A, Mansutti M, Miscoria M. Drug waste minimization as an effective strategy of cost-containment in oncology. BMC Health Serv Res 2014;14:57. 10.1186/1472-6963-14-57. 24507545. - DOI - PMC - PubMed

Publication types