Researchers have found that the federal Medicare programme and private health insurers waste nearly $3 billion every year buying cancer medicines that are thrown out because many drug makers distribute the drugs only in vials that hold too much for most patients. The expensive drugs are injected by nurses who measure the amount needed for a particular patient and then, because of safety concerns, discard the rest.

According to researchers at Memorial Sloan Kettering Cancer Center, who published a study in BMJ, if drug makers distributed vials containing smaller quantities, nurses could pick the right volume for a patient and minimise waste. Instead, many drug makers exclusively sell one-size-fits-all vials, ensuring that many smaller patients pay thousands of dollars for medicine they are never given.

Dr. Peter B Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering and a co-author of the study said that, “Drug companies are quietly making billions forcing little old ladies to buy enough medicine to treat football players, and regulators have completely missed it.

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The researchers analysed the waste generated by the top 20 selling cancer medicines and concluded that insurers paid drug makers $1.8 billion annually on discarded quantities and then spent about $1 billion on markups to doctors and hospitals.

In one example, the study said that in the US, Takeda Pharmaceuticals sells Velcade, a drug for the treatment of multiple myeloma and lymphoma, only in 3.5-milligram vials that sell for $1,034 and hold enough medicine to treat a person who is 6 feet 6 inches tall and weighs 250 pounds. Lena Haddad, 53, of Germantown, Md., who has been living with multiple myeloma for four years, now gets a weekly dose of 1.8 milligrams of Velcade. Her nurse takes a vial of Velcade, injects a syringeful of saline into it, withdraws half the contents and throws out the rest.

The researchers pointed out that Takeda stands to earn $309 million this year on supplies of Velcade that are discarded, which is 30% of the drug’s overall sales in the US. If Takeda provided a vial size of 0.25 milligram, waste would be cut by 84%, reducing Velcade’s sales in the US by $261 million annually.

Christopher Kelly, a spokesman for the FDA, said the agency objected to vial sizes only if it believed that an excessively large volume “could lead to medication errors or safety issues.”

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