They make eye drops too big -- and make you pay for the waste

If you've ever tried to use eyedrops, you know what's hard to do without some of it rolling down your cheek. I used to think that was because I missed, but it turns out I'm not actually so bad at this well, most of the time, anyway, eye drops run down our faces. Because a typical drop is larger than what the human eye can physically contain, some are more than twice what the eye can hold. Oh, my gosh. That means using a single eyerop is like pouring water into a glass that's already full. Or it's like in those clear eyes commercials that an ingredient moisture provides up to 12 hours ofoothing comfort. It removes redness and has an ingrate. The moisture eyes wow, it's incredibly wasteful to make oversized drops. They cost a lot of money. The waste from each one is like a tiny snowflake. It's easy to overlook until they've piled up into a billion dollar snowball. It's wasted medicine and all of us are paying for it. 

Eye drops. They may all seem alike, but take another look. The eyedrops industry is huge, they're sold by volume, and some can cost 100 of dollars for a small bottle that only lasts a month. The financial cost is a particular problem for the millions of patients with chronic conditions that require expensive drops every day. Last year. US droid companies brought in about 3.4 billion dollars for dry eyes and glaucoma drops alone. Eye drops are far too big for our eyes. That's Dr. Allen Robin, an ophthalmologist and glaucoma expert who teaches it Johns Hopkins Medicine.

It's very wasteful. 

We see that patients are basically spending twice as much money as they need to undo. Everyone's body is different, but experts say almost every eyerop on the market is larger than the eye can hold, so the excess just washes out and we end up paying for a lot more medication than we can use. Wasted eye drops are part of a much bigger problem. Experts estimate that the US healthcare system wastes 700 and 65 billion dollars a year. That's about a quarter of our overall spending, and it's actually more than the entire budget of the Department of Defense. Propublica has been investigating the kind of wasted healthcare spending that exists right in front of our eyes. Literally. 

Cancer drugs are also a big- ticket waste item. They can cost thousands of dollars per infusion, but are frequently wasted just because of the way they're packaged. Most cancer drugs are infused based on body size, so patients need different amounts, but most of them come in single-use vials that can be much too large for an individual patient. So once the patient gets to need a dose, the rest of the expensive drug in the vile is thrown out. Drug prices driving patients and their families into bankruptcy. That on top of patients paying for expensive cancer drugs to help them, they're also paying for in some cases, a lot of extra cancer drug that's just going in the trash. That's Dr. Peter Back, the director of the Center for Health Policy and Outcomes at Memorial Sloan Keyer and Cancer Center in New York. Waste hurts people because it costs money if you waste half of a vial that costs 5 thousand dollars, somebody is paying that money 2500 dollars back to the drug company and it the drug company benefits because they count that as revenue or profit. 

Take the case of Herseptin, a popular and pricey drug that's mostly used to treat breast cancer. The drug company used to make vials that patients could share so little of the drug would be wasted. 

But then it announced in May that the shareable vials would be replaced by single-use vials and the switch would mean throwing away any medication left over from an infusion and billing the patient for the waste. 

Genentech, the company that makes receptptin told me that they had to make the change for supply chain reasons to go to a size that's more common worldwide. Every milligram of her septic costs about nine dollars, so a cancer patient's monthly infusion can run more than 3 thousand dollars. One administrator at a California cancer treatment center calculated her average patient would waste 100 and ten milligms per infusion with the single-use vials. That's an average of almost 1 thousand dollars of wasted spending per infusion. The waste associated with oversized cancer drug vials is substantial. A study led by Dr. Ba in 2016 calculated the waste with the top 20 cancer drugs packaged in single-use vials. It estimated that ten percent of the medication gets wasted, costing 1.8 billion dollars in a single year. 

But here's the thing. This is a waste problem that's fixable for cancer drugs, manufacturing shareable vials or vials, and varying sizes are proven ways to reduce waste for eyeros. Why not just make the drop smaller? Dr. Robin knows it can be done because he and a team of experts already did it. In a study about 20 years ago, he consulted with global ICAR leader Alcorn when its researchers developed what they called a microrop for patients with glaucoma. It was a 16 microliter drop, one that was half to a third of the size of most drops on the market today. Then they studied the performance of the Miro drop. Compared to regular size drops, there was no significant difference between the smaller and larger eyedrops. 

Not only were the microrops just as effective, they also reduce some of the uncomfortable side effects and all the participants actually preferred the Mirorop bottle. But instead of being a breakthrough, the innovation became a case study in how profits can come before patients. I try personally to get the micro accepted and they looked at me as though I was a pariah. The pharmaceutical company would be losing half the money that they could be making. Officials from Novartis, the drug company that now owns Alcorn, decline to discuss their micro study. They said eyedrops are designed with a margin of safety to help patients, but they wouldn't go into specifics. You'd think that regulators would care about all this wasted medicine. But the FDA regulates the safety and effectiveness of a drug, not its price or the cost related to waste. 

Patients paying billions of dollars for wasted medicine is just one more reason. America has the highest healthcare costs in the world. 
Hi Guys I'm Regen. A video fellow working at von propublica and this video is part of a new collaboration between our newsrooms. For the full story at propublica, check out the link down below and stay tuned for more stories coming this year. 

There Is A Better Way America