How much money do we waste when cancer patients change dose and throw out their pills?

Our new paper in JAMA Oncology

Just out in JAMA Oncology, our new paper (PDF attached below).

Led by oncology pharmacist Michael Lam, we calculate how much money is lost when patients throw out cancer pills from changing dose or stopping altogether. TL;DR - it is 4000 dollars ++ per patient, and for some drugs nearly 10%, which is an astonishing source of waste. How did we reach this figure?

First, consider that many patients taking cancer drugs have dose reductions or discontinuations.

Second, sometimes, often, the pills do not evenly break, and patients have to trade in 20 mg pills for 15 mg, for e.g.

Third, most trials track the dose reductions and the price of the pills is available.

Using these 3 facts, we did the analysis (with sensitivity analysis for higher rates of reduction. Here is what we find. The reduction in raw numbers.

And here it is as percent of total drug price. For some drugs it is near double digit.

Using our method, you can calculate it for any pill. Read from here on.

What’s the solution. The editorialists offer some, but for doctors, we should prescribe fewer pills initially (especially for drugs with lots of dose reductions), bc dose reduction often occurs early.

Second, Medicare has ability to demand refunds for unused medications

Third, it should not be illegal to give unused pills to another patient, if the patient acknowledges the tiny risk. This law was pushed for by the pharmaceutical industry.

Learn more; Read the paper

Jamaoncology Lam 2023 Oi 230031 1689198329

353KB ∙ PDF file

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