9 July 2021 - In 2016, my colleagues and I tabulated $2 billion in excess spending across the US health care system resulting from pharmaceutical companies packaging their cancer drugs in single-dose vials that were larger than they needed to be. Velcade, for instance, is only available in 3.5 mg vials in the United States—despite being sold in 1 mg vials in Europe—whereas the typical patient dose is only about 2.5 mg. 

Payers and patients have no choice but to buy full vials, which means that on average each dose involves an extra milligram of drug that generates $425 in revenue to the company per milligram even though it ends up being discarded.

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