How drug companies make you buy more medicine than you need

If you’ve ever tried to use eye drops…you
know it’s hard to do without some of it rolling down your cheek. I used to think that was because I missed. But turns out, I’m not actually so bad at
this. Well, most of the time anyway. Eye drops run down our faces because the typical
drop is larger than what the human eye can physically contain. Some are more than twice what the eye can
hold. That means using a single eye drop is like
pouring water into a glass that’s already full. Or like in those Clear Eyes commercials… It’s incredibly wasteful to make over-sized
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. The eye drops industry is huge. They’re sold by volume, and some can cost
hundreds 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 drug companies brought in about
$3.4 billion for dry eyes and glaucoma drops alone. Eye drops are far too big for our eyes. That’s Dr. Alan Robin, an ophthalmologist
and glaucoma expert who teaches at Johns Hopkins Medicine. It’s very wasteful. We see that patients are basically spending
twice as much money as they need to on drops. Everyone’s body is different, but experts
say almost every eye drop 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 the U.S. health care system
wastes $765 billion 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 health care 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 a patient gets the needed dose, the
rest of the expensive drug in the vial is thrown out. Drug prices driving patients and their families
into bankruptcy. And 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 Bach, the director of the
Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York. Waste hurts people because it costs money. If you waste half of a vial that costs $5,000,
somebody is paying that money, $2500 back to the drug company. And the drug company benefits, because they
count that as revenue or profit. Take the case of Herceptin, 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 Herceptin,
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 Herceptin costs about $9,
so a cancer patient’s monthly infusion can run more than $3,000. One administrator at a California cancer treatment
center calculated her average patient would waste 110 milligrams per infusion with the
single-use vials. That’s an average of almost $1,000 of wasted
spending per infusion. The waste associated with over-sized cancer
drug vials is substantial. A study led by Dr. Bach in 2016 calculated
the waste associated with the top 20 cancer drugs packaged in single-use vials. It estimated that 10 percent of the medication
gets wasted, costing $1.8 billion 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 in varying sizes, are proven ways to reduce waste. For eye drops, why not just make the drops
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 eye care leader,
Alcon, when its researchers developed what they called a microdrop 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 microdrop
compared to regular size drops. There was no significant difference between
the smaller and larger eye drops. Not only were the microdrops just as effective,
they also reduced some the uncomfortable side effects. And all the participants actually preferred
the microdrop bottle. But instead of being a breakthrough, the innovation became a case study in how profits can come before patients. I tried personally to get the microdrop 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 Alcon, declined to discuss their microdrop study. They said eye drops 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 health care costs in the world. Hi guys, I’m Ranjani. A video fellow working at Vox and 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.


  1. Wrong! eyedrops only run down if you use them incorrectly. But if only part of the drop goes in the drop will still work. THAT IS A FACT!

  2. buy your eyedrops then transfer them into a different container that makes drops of the right size? problem solved

  3. it's like buying vegetables that are packaged in large sizes, if you can't eat them they will just go to waste

  4. Plus all this waste !all those plastic eye drop containers that will be in landfills for hundreds of years

  5. What about some of the bogus expiry dates on many medicines. People just throw a lot of them out because the label says they're not good anymore. But many medicine last like 5 to 6 years

  6. Well then. Why don’t people just get their own smaller eye dropper thingy and save money because honestly the people selling the stuff aren’t going to change

  7. 2:18 Makes me think of some video made by someone, about diagrams that are not to scale.
    Whom was it made by..?


  8. I’m pretty handy with an eye dropper. I can typically get about a half a drop into my eye, and have little to no runoff by applying it to the inside corner and letting it release by touching the drop near the tear duct rather than dropping a whole drop from a distance. Seems to work alright.

  9. Its the same thing done with toothpaste… If the hole is bigger, you put more on your toothbrush…and they sell more.

  10. There is so much wrong with America that it's sickening, hopefully the rest of the world learns from this.

  11. I’m gonna empty my eye drop bottle into a small glass bottle with a smaller dropper, and adopt this method where else necessary.

  12. Funny that I am just doing 4 kinds of eye drops for the 4th time today, after getting LASIK surgery. Every time there's wasted drops running down my cheeks.

  13. This video makes the mistake of forgetting R&D is a huge factor into drug costs. Throwing away half the drug isn't so bad if it's cheap to make. I'm not saying it is, but without knowing R&D and drug manufacturing cost, we won't know how expensive throwing away half a vial really is.

  14. The eye drops is a good example because you reuse the bottle. But the cancer treatment is a terrible one. The cost of the product does not come from its volume, almost all medicines are really cheap to produce. So half a bottle wasted is not equal to 2500€ wasted. It's 5000€ for a treatment, I guess it would not change much with different volumes.

  15. I have a testosterone deficiency, so I have to give myself an injection once a week. The prescription comes in 1ml bottles and it is literally impossible to get more than about 80% of the liquid in the bottle into the syringe (even the nurses in the doctor's office conceded as much). The doctor has a 50ml bottle. I asked if I could just have one of those every few months instead of getting a half dozen impractical micro bottles per month – you don't have to guess what the response was.

  16. and all this is happening because healthcare is seen as a business here rather than a basic human right

  17. Hey they "forgot" to mention death rate of the suckers/patients and the $$$ the cancer doctors make. How many months do they Have? Humm

  18. i mean it takes 7 years minimum of testing and manufacturing before u even have a chance to be approved by the FDA millions and millions of dollars for research so think about that

  19. Can't believe they're complaining about the size eye drops. Maybe because the size is larger than needed to make sure you get some in your eye. Alot of people aren't comfortable dropping something into their eye. Even if they made the drops smaller, I'm sure the cost would remain the same! You're not just paying for the physical product, but the research, testing, patents, employees, etc.

  20. U guys r doing it wrong. Not once have i missed a single eye drop ever since my doctor showed me the correct way back in 2012

  21. With vials there's a conondrum.
    Lets say you need 3ml. But only 5ml vials are available.
    So you waste 3ml.
    What if only 4 ml vials were availble? Then you waste 2ml too.
    What if they came in 3ml vials? Awesome, you dont waste!
    But when if you needes 4ml and vials held 3?
    Same stuff.
    Doesnt matter what size the packaging is, you will ALWAYS waste

  22. In another angle, medications are really specific to every person and I believe it is not possible to mass produce units of medicine that could cater everyone. It is a problem but it is not just about greed.

  23. Here's the tip genius, instead of pull your upper eye lid, pull the below one then give it one or two drops and close your eye. Not so hard isn't it?

  24. For people arguing about drug prices, let me put it the way another physician explained it to me. How many new drugs have come out of Russia or China in the past 100 or so years? How many of have come out of USA? Take away the money and you take away the only incentive for companies to pour millions down a drain for research and trial for an new drug that may or may not hit the market. It’s not a perfect system by any means but it’s the only sure way to ensure that we keep coming up with new drugs all the time and pharmacological field doesn’t go stagnant.

  25. But i think if i was the company that make eye drop, i would just leave it so, so the company could earn more money, people will buy more of our medicine because it run out faster so that the customer will buy more of our product. Which i think its logical, well this is the case if I were the owner of a company. But since im not I still think they should change the design, now that im thinking of getting the company to change it design I think it would cost million to change designs for eye drop or those container, like just changing name could cost millions of dollar.

  26. Have you noticed how much food get wasted from the farm because it's not perfect looking to the supermarkets for trivial reasons to stores to our homes?

  27. I honestly don't understand why Americans take so many drugs. I don't think I've taken any in months, probably since the last time I had hayfever two years ago. Recently I've been playing squash regularly and eating a plant-based diet, and I don't remember the last time I was seriously sick or in pain. Americans seem to have a lot of pathologies which might be better prevented than cured.

  28. Such a chilling revelation this one, my heart goes out to those innocent americans who spend a major chunk of their livelihood on wastage like this. So much for being a superpower, if you are treating your people in such miserable way then what's the point? This abomination has to stop, hoping it will.

  29. Technically, the commercials aren't lying… 😂🤣😂🤣 You are going to waste some of the mls anyways…

  30. Probably half your friends, and or family will, or have been killed by pharmaceutical companies, via their products, and advertising. And lobbying, your doctor is probably thier agent.

  31. I have not taken one pharmaceutical pill in three years, not one flu shot, I haven't gotten the flu, haven't gotten a cold, and I guess the Idea I was ever mentally ill, and would need medication forever, was a sick joke🤣

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