(Washington, DC) - U.S. Senator Richard Blumenthal (D-Conn.), Ranking Member of the Senate Committee on Veterans’ Affairs, is calling on the U.S. Department of Veterans Affairs (VA) to stop wasteful spending on expensive, excessive medications. Companies producing cancer medications often exclusively sell one-size-fits-all vials. Many of these drugs cannot be used after a few hours so the unused portions are thrown away if they are not used immediately. In a letter today, Blumenthal called on VA to take immediate action to cut their share of the $3 billion reported annual cost to the U.S. health care system associated with wasting these expensive drugs.

“I urge you to decrease wasteful spending at the Department of Veterans Affairs (VA) from using oversized single-dose vials,” the senator wrote. “Researchers from Memorial Sloan Kettering Cancer Center estimated that oversized single-dose vials of cancer drugs lead to drug wastage costing the United States health care system around $3 billion annually. VA must take immediate action to cut costs associated with wasting of expensive drugs.”

The full text of the letter is available below:

Dear Secretary McDonald:

I urge you to decrease wasteful spending at the Department of Veterans Affairs (VA) from using oversized single-dose vials. Researchers from Memorial Sloan Kettering Cancer Center estimated that oversized single-dose vials of cancer drugs lead to drug wastage costing the United States health care system around $3 billion annually. VA must take immediate action to cut costs associated with wasting of expensive drugs.

In the United States, companies producing cancer medications often exclusively sell one-size-fits-all vials. Many of these drugs cannot be used after a few hours so the unused portions are being thrown away if they are not used immediately. This results in VA paying thousands of dollars for medicines that veterans do not need or receive. For example, Rituxan is available in the United States in 100mg and 500mg sizes, but an average patient dose is usually around 637.5 mg. Just 50mg in wastage per patient cost the healthcare system approximately $254 million in 2016. Since VA does not have a database to track the amount of drugs administered or the amount that is discarded, the cost impact of drug wastage on the VA health care system is unknown, but is without doubt sizeable since it is the nation’s largest healthcare provider.

I therefore ask that first, you fully utilize your authority under 40 U.S.C. 121(c) to require pharmaceutical companies to provide VA the best value on pharmaceutical products and consider multiple size single-dose packaging and for pharmaceutical companies to refund the cost of leftover medication within a single-dose vial. I encourage you to initially focus on the 50 most expensive injectable drugs purchased by VA since this is most likely to have the biggest impact.

Second, I ask that you establish a VA policy on vial sharing and repackaging of single-dose vials, when appropriate. Currently, there is no consensus among federal authorities at the Food and Drug Administration, Center for Medical Services, and Centers for Disease Control and Prevention on vial sharing and repackaging of single-dose drugs.  VA must set the standard by taking the lead on this issue.

Finally, in order to observe the effectiveness of these policies, VA must also establish a means to track the amount of injectable drugs administered and amount wasted to monitor the cost of wasted drugs to the VA health care system. I ask that this tracking of drug waste and associated cost be reported to Congress annually. I welcome any recommendations on how Congress and VA can work together to prevent drug wastage and reduce any costs to VA. I look forward to your response on these specific requests as part of our ongoing collaboration to ensure veterans get the health care and benefits they have earned.

Thank you for your immediate attention to this matter. 

Sincerely,

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