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If you've ever tried to use eye drops...you know it's hard to do without some of it rolling
down your cheek.
I used to think that was because I missed.
But turns out, I'm not actually so bad at this.
Well, most of the time anyway.
Eye drops run down our faces because the typical drop is larger than what the human eye can
physically contain.
Some are more than twice what the eye can hold.
That means using a single eye drop is like pouring water into a glass that's already
full.
Or like in those Clear Eyes commercials...
It's incredibly wasteful to make over-sized drops.
They cost a lot of money.
The waste from each one is like a tiny snowflake.
It's easy to overlook, until they've piled up into a billion dollar snowball.
It's wasted medicine, and all of us are paying for it.
The eye drops industry is huge.
They're sold by volume, and some can cost hundreds of dollars for a small bottle that
only lasts a month.
The financial cost is a particular problem for the millions of patients with chronic
conditions that require expensive drops every day.
Last year US drug companies brought in about $3.4 billion for dry eyes and glaucoma
drops alone.
Eye drops are far too big for our eyes.
That's Dr. Alan Robin, an ophthalmologist and glaucoma expert who teaches at Johns Hopkins Medicine.
It's very wasteful.
We see that patients are basically spending twice as much money as they need to on drops.
Everyone's body is different, but experts say almost every eye drop on the market is
larger than the eye can hold.
So the excess just washes out, and we end up paying for a lot more medication than we can use.
Wasted eye drops are part of a much bigger problem.
Experts estimate the U.S. health care system wastes $765 billion a year.
That's about a quarter of our overall spending.
And it's actually more than the entire budget of the Department of Defense.
ProPublica has been investigating the kind of wasted health care spending that exists
right in front of our eyes.
Literally.
Cancer drugs are also a big ticket waste item.
They can cost thousands of dollars per infusion but are frequently wasted just because of
the way they're packaged.
Most cancer drugs are infused based on body size, so patients need different amounts.
But most of them come in single-use vials that can be much too large for an individual patient.
So once a patient gets the needed dose, the rest of the expensive drug in the vial is thrown out.
Drug prices driving patients and their families into bankruptcy.
And on top of patients paying for expensive cancer drugs to help them, they're also paying
for in some cases a lot of extra cancer drug that's just going in the trash.
That's Dr. Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial
Sloan Kettering Cancer Center in New York.
Waste hurts people because it costs money.
If you waste half of a vial that costs $5,000, somebody is paying that money, $2500 back
to the drug company.
And the drug company benefits, because they count that as revenue or profit.
Take the case of Herceptin, a popular, and pricey drug that's mostly used to treat breast cancer.
The drug company used to make vials that patients could share, so little of the drug would be wasted.
But then it announced in May that the shareable vials would be replaced by single-use vials.
And the switch would mean throwing away any medication left over from an infusion, and
billing the patient for the waste.
Genentech, the company that makes Herceptin, told me that they had to make the change for
supply chain reasons, to go to a size that's more common worldwide.
Every milligram of Herceptin costs about $9, so a cancer patient's monthly infusion can
run more than $3,000.
One administrator at a California cancer treatment center calculated her average patient would
waste 110 milligrams per infusion with the single-use vials.
That's an average of almost $1,000 of wasted spending per infusion.
The waste associated with over-sized cancer drug vials is substantial.
A study led by Dr. Bach in 2016 calculated the waste associated with the top 20 cancer
drugs packaged in single-use vials.
It estimated that 10 percent of the medication gets wasted, costing $1.8 billion in a single year.
But here's the thing: this is a waste problem that's fixable.
For cancer drugs, manufacturing shareable vials, or vials in varying sizes, are proven
ways to reduce waste.
For eye drops, why not just make the drops smaller?
Dr. Robin knows it can be done - because he and a team of experts already did it in a
study about 20 years ago.
He consulted with global eye care leader, Alcon, when its researchers developed what
they called a microdrop for patients with glaucoma.
It was a 16 microliter drop -- one that was half to a third of the size of most drops
on the market today.
Then they studied the performance of the microdrop compared to regular size drops.
There was no significant difference between the smaller and larger eye drops.
Not only were the microdrops just as effective, they also reduced some the uncomfortable side effects.
And all the participants actually preferred the microdrop bottle.
But instead of being a breakthrough, the innovation
became a case study in how profits can come before patients.
I tried personally to get the microdrop accepted.
And they looked at me as though I was a pariah.
The pharmaceutical company would be losing half the money that they could be making.
Officials from Novartis, the drug company that now owns Alcon,
declined to discuss their microdrop study.
They said eye drops are designed with a "margin of safety" to help patients,
but they wouldn't go into specifics.
You'd think that regulators would care about all this wasted medicine.
But the FDA regulates the safety and effectiveness of a drug...not its price or the cost related to waste.
Patients paying billions of dollars for wasted medicine...is just one more reason
America has the highest health care costs in the world.
Hi guys, I'm Ranjani.
A video fellow working at Vox and ProPublica.
And this video is part of a new collaboration between our newsrooms.
For the full story at ProPublica, check out the link down below and
stay tuned for more stories coming this year.
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How drug companies make you buy more medicine than you need

104 タグ追加 保存
Evangeline 2018 年 4 月 24 日 に公開
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