The Drug Waste Problem: Cancer & Specialty Drugs

The pharmaceutical side of oncology and other specialty drugs is a multi-billion dollar business. This is one of the highest cost segments of pharmaceuticals to patients and insurance companies, and it is one of the highest profit areas for the pharmaceutical companies. In 2016, specialty drugs made up 40% of the $450 billion pharmaceutical market, which translates into $180 billion. This staggering amount of money is bad enough in itself, but what if I told you that some of those medications that make up that $180 billion was being wasted in hospitals and other healthcare centers every single day?

How Can Drugs Be Wasted?

In the specialty drug market, due to their ‘specialty’ status, meaning that they are not widely used due to the uniqueness of the condition/disease they treat, medications are largely single-dose formulations (up to 84%). A single-dose formulation will not work for every patient, due to differing weights and needs. Medications also cannot be saved to be used for another patient. The result is often an excess of medication left in the vial after the patient receives their dose. Additionally, specialty drugs are the highest priced drugs which exacerbates the issue. If drug waste could be reduce somehow, costs could decrease for patients and insurance companies.

Cancer Drugs Waste

One study by Bach et al., estimated that just within this class of drugs there was at least $3 billion in wastage each year. What does this mean and how does this happen? Cancer drugs are normally given via IV, which means they come in vials that must be measured out according to a patient’s weight and needs. The vials contain a dosage that is usually an even amount, such as 100mg or 400 mg, which does not fit every or most patients. One study narrowed down this issue further.

Total oncology drug costs over two weeks ranged from $50, 257 to $716,983 in three hospitals. They estimated that without mitigation strategies, the drug wastage in these three facilities would have been $11,232 to $149,131, which is approximately 16 to 18% of the total drug costs. With their mitigation strategies, however, the actual drug wastage ranged from $928 to $5,472, which was only 1 to 2% of the total drug costs. This is a huge difference. What did they do?


They looked at the medication vials that were available and looked for ways to waste less. For example, if a patient needed 200mg of a drug, but the drug came in a 400mg vial and a 100mg vial, they chose to use 2-100mg vials, which only wastes 20mg, versus 1-400mg vial, which would waste 200mg. This takes time and thought, but it can be done to save money

Other Specialty Drugs

The range of diseases and conditions that are treated by specialty drugs are numerous, but a few of them include psoriasis, hepatitis, hemophilia, chronic inflammation, growth conditions, and more. The medications that are given cost an average of $3000 per month and can be up to $300,000 a year. This is a huge amount of money that is being spent, which is why many insurance companies are working with pharmacists to try to find ways to decrease drug wastage.

For example, one popular medication given for adult psoriasis, Stelara, comes in 45-mg and 90-mg doses with a wholesale cost of $31,000 and $62,000 annually respectively. The 45-mg dose is given to patients under 220-pounds, while the 90-mg dose is for those who weight more. A pharmacist may call the physician if a patient is clearly under the 220-pound threshold and was prescribed the larger dose to see if the smaller dose is more in line with treatment recommendations. This could save an insurance company $31,000 a year.

Drug wastage is a huge issue. From oncology drugs where they are marketed in single dose vials to other specialty drugs where they come in different strengths, if the healthcare team of the physician, pharmacist, and insurance company will come together, it is possible that money could be saved for the patient and the insurance company, and thus, the employer. The Curus healthcare management team can help your company to save money on cancer and specialty drugs by staying in touch with healthcare providers to ensure that drug wastage is kept to a minimum for the good of your company and your bottom line, without sacrificing your employee’s health.