Blaming Style of Vials Takes Miles of Guile

Another day, another major health care problem addressed with blame-placing and finger-pointing.

A new study claims as much as $3 billion is wasted each year because cancer medications are sold in vials that often contain more medicine than is needed for each patient, and only limited amounts of the excess medication can be used, with the rest winding up as waste.

This is a problem, and it should be addressed.

Only it’s not. This study is from industry gadfly and medical shock jock Peter Bach, which means it will be a partisan attack on the pharmaceutical industry. He’s ready with a clever quote, too: “Drug companies are quietly making billions forcing little old ladies to buy enough medicine to treat football players.”

Quite a visual. But not quite the whole story.

The report says doctors and hospitals have skin in the game, too: “Increasing the amount of drug sold per treated patient also increases profits to doctors and hospitals in the United States. Under a system nicknamed ‘buy and bill,’ doctors and hospitals buy single dose vials of drugs and then bill insurers or patients when they are used. The bill includes a percentage based mark-up.”

While it is true that $3 billion is a staggering amount of money, it’s chump change compared to what is lost due to medical errors, fraud and abuse and defensive medicine by doctors who don’t want to be sued. According to some estimates, medical non-adherence by patients who don’t take their meds as prescribed (often because they cannot afford the insurance co-payments) costs the system more than $300 billion.

And then there’s the $315 billion in projected costs from America’s twisted and tangled insurance industry maze that was recently chronicled right here in these pages.

So what can be done? We agree with the study that there are contradictory regulatory guidelines about packaging size and residual re-use. We are eager to hear new suggestions from doctors, since they are the ones who determine optimal dosing for each individual patient based on their specific medical profiles. Working together on this issue that $3 billion can be reduced. But the key is working together.

Taking a medical problem and using it as an excuse to attack the pharmaceutical industry – or any industry – won’t help a single patient become happier or healthier or wealthier. The real waste comes from all the back-and-forth infighting. Let’s call that whole thing off.

Jonathan Wilcox is the Co-Founder and Policy Director of Patients Rising and Patients Rising NOW.  He is a fellow with the University of Southern California’s Unruh Institute of Politics and was a speechwriter for California Gov. Pete Wilson (R).

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