A study published this month in BMJ (previously known as the British Medical Journal) found that wasted cancer drugs will cost an estimated $3 billion this year. The study’s researchers say that wasted drugs are the result of improperly sized doses of cancer drugs.

Pharmaceutical Companies Dose for Profit, Not Patient Needs

The researchers, who are based out of the Memorial Sloan Kettering Cancer Center, found that drug companies package cancer drugs in doses designed to boost profits and encourage waste. The sizes chosen for a particular drug’s packaging may have little to do with how a drug is actually prescribed.

A good example of “encouraged waste” is the way Merck packages Keytruda, a drug used for melanoma and lung cancer. Keytruda comes in 100 mg vials – so if a person requires a 140 mg dose of Keytruda, two vials must be used. However, the 60 mg of Keytruda left over in the second vial will likely go unused. Although some large hospitals manage to utilize the leftover medication, the 60 mg of medicine left in the second vial is often thrown away.

Patients Often Still Pay For Wasted Cancer Drugs

Anywhere from 1% to 37% of cancer drugs go to waste in this manner, with the average being about 21%. In the Keytruda scenario described above, even though the patient only required 1.4 vials, it’s likely he or she will be charged for 2 vials because the hospital had already paid Merck for the medication.

Pharma Companies See No Reason to Change

Pharmaceutical companies are sticking to their guns, saying they’re acting in the best interests of all patients rather than catering to each unique case. Merck says it’s now testing 200 mg vials of Keytruda, which the company believes will “eliminate wastage.” However, Dr. Peter B. Bach, the lead author of the Memorial Sloan Kettering Cancer Center study, says that a move to 200 mg vials will only help patients who require very high doses of Keytruda and won’t eliminate the wasted drugs for other patients.

Refunds May Provide the Solution

According to Bach, one solution for addressing the overcharging/wasting problem is to require drug companies to refund the costs of leftover cancer drugs. The Food and Drug Administration (FDA) could enact such a regulation as a normal part of its oversight, without needing Congressional action. For now, though, most excess cancer drugs end up in the trash and patients still pay for them in full.