Articles, Blog

How drug companies make you buy more medicine than you need

February 2, 2020


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.

100 Comments

  • Reply Petter Houting April 13, 2019 at 12:54 pm

    Well, taxes are too high so they heve to do it for profit

  • Reply Marie Katherine April 13, 2019 at 4:52 pm

    Get a syringe. Put in the right amount for you. I NEVER buy eye drops otc. There's lots of diy natural solutions you can make yourself.

  • Reply that ford guy April 14, 2019 at 3:30 am

    I never understand the medical industry/field. I've always known it to be wasteful but you cant really do anything about it cause you need to treatment or medicine. I dont see how people can claim they love helping people be healthy but then charge so much money to help them. Medical field us a big scam

  • Reply Spookay T'is Me April 16, 2019 at 12:28 am

    I'm glad I live somewhere that I don't have to think about this at all

  • Reply Core Blaster April 17, 2019 at 5:27 pm

    It's almost like we shouldn't commercialize medicine.. hmmmmm……

  • Reply Graf Zeppelin April 17, 2019 at 11:28 pm

    I can make eyedrops go in pretty easy

  • Reply Jude Lind April 18, 2019 at 6:57 pm

    As a Brit, the US is so mad! From what I hear, the US is the most third-world first-world country I've ever seen. I don't care if the US has the highest GDP or largest military; I think countries should put less effort into trying to be an empire and just make the citizens of your country be healthier, feel better and live comfortable.

    I'm sot saying the UK is perfect, but we have:
    – Universal free healthcare
    – No gun(s) allowed
    – No gerrymandering
    – No (biased) supreme court

  • Reply ike eki April 19, 2019 at 7:10 am

    this is evil

  • Reply MG 666 April 26, 2019 at 8:25 pm

    Well the only way to solve the problem of eye drops is to pour it side ways in the corner of the eye. I always do that. Never goes waste. Basically when you do that it will eventually spread in the eyes. Since it's a liquid

  • Reply MEELO April 28, 2019 at 9:11 pm

    EXPOSe tHeSE HoEs

  • Reply Arved Ludwig May 8, 2019 at 9:57 pm

    Here in Germany I can buy eyedrops that come in a dispenser. Press the dispenser together and a small drop will be released. The drop is not oversized because I've never had a tear running down after using it.

  • Reply Butter Games May 14, 2019 at 2:13 pm

    Wth In England one of those size bottles would only be about £5 or free if prescripted

  • Reply zeedar412 May 14, 2019 at 6:08 pm

    Wasting the money of cancer-patients. That's low.

  • Reply OmegaMan May 16, 2019 at 5:15 pm

    I knew an elderly lady that had an issue producing tears so she wore swimming goggles all of the time and would purchase these enormous bottles of artificial tear solution

  • Reply Kasie Barrett May 17, 2019 at 8:34 pm

    Medicine is in food

  • Reply Theresa Rose May 18, 2019 at 2:08 pm

    Through the prevacid medicine for your stomach and lose your bone density.

  • Reply Robin L May 18, 2019 at 9:13 pm

    Watching these kind of videos makes me so more grateful that i live in a country where health care is as good as free 🙂

  • Reply Mikkel Aaholm Bennetsen 2j May 22, 2019 at 8:35 pm

    C'mon America. Get it together, i'll bet that u are the only country thats having these issues. why? because y'all taxes is too low too support a free healthcare system. plz look at france, danmark etc. everybody should be intitled to free and effektive healthcare :-/

  • Reply Debbie Nandalall May 23, 2019 at 11:16 pm

    765billion guys that's how much they are wasting. So much food that could have bought for persons in Africa. (EDITED) WELL NOT JUST AFRICA BUT MANY OTHER COUNTRY

  • Reply Backinblack Bunny May 25, 2019 at 7:34 am

    The problem with videos like this is that they get me SO ANGRY and bc I know I'm going to be infuriated for the rest of the day after I watch them, I end up never watching them. I used to catch myself screaming at my kids even hours afterwards for the slightest provocation. I wished I could be informed and not be going grey from the knowledge rage.

  • Reply Peter Sorensen May 26, 2019 at 9:59 pm

    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!

  • Reply Rick Steegers June 1, 2019 at 12:34 am

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

  • Reply Deepak D'Souza June 1, 2019 at 3:59 pm

    Last year when I video came out, I didn't watch it. Now I'm dependent on eye drops.

  • Reply Cao Tuan Vo June 1, 2019 at 5:30 pm

    How the US suck even more

  • Reply Jaxz June 1, 2019 at 10:54 pm

    we are not paying for nothing NHS!!!

  • Reply Michael Hammer June 5, 2019 at 3:58 pm

    How come every problem seems to come back to some greedy assholes?

  • Reply Skingott June 7, 2019 at 11:54 am

    Tbh if I moved to the US I would get health care insurance.

  • Reply axpuaa June 8, 2019 at 7:31 pm

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

  • Reply Pangaea Menslijk June 10, 2019 at 1:43 am

    Why can't people get around these problems just by putting the drugs in their own containers?

  • Reply ALEJANDRO RAMÍREZ June 11, 2019 at 2:48 am

    ¿Quieres ver gotitas o ver gototas? XD

  • Reply Marcel Walter June 14, 2019 at 10:26 am

    Well, you can't get enough coke

  • Reply Manda Anne June 15, 2019 at 11:18 pm

    Jokes on you big pharma, I’ve learned how to use just the right amount of pressure to get a half a drop

  • Reply Alisa Nundez June 16, 2019 at 1:54 am

    Me:……
    Guy in eye commercial: "WoooOOow"

  • Reply Nawake June 16, 2019 at 2:05 pm

    Sounds like an American problem.

  • Reply Wholesome Meli June 17, 2019 at 12:41 am

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

  • Reply Hunter Forsberg June 17, 2019 at 3:21 am

    Where can I buy a microdrop bottle even an empty one

  • Reply TOGScrimmages June 17, 2019 at 3:59 am

    Canada's healthcare system is better

  • Reply M Tauf June 17, 2019 at 4:44 am

    Didn't want to interview? Why not 😂😂

  • Reply Dr. Steve Phil June 17, 2019 at 5:23 am

    Bruh I use eyedrops and can relate

  • Reply izhar June 17, 2019 at 7:58 am

    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

  • Reply Sarah J June 17, 2019 at 9:09 am

    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

  • Reply Kayleigh Hooker June 17, 2019 at 5:25 pm

    And capitalism is a miracle huh? God y'all are lying to yourselves.

  • Reply Casper de With June 18, 2019 at 8:57 am

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

    *ahem*

  • Reply Greg P June 19, 2019 at 6:34 am

    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.

  • Reply T T June 20, 2019 at 9:32 pm

    With every day I am glad to live in a country with a good health care system

  • Reply João Paulo Oliveira Gomes Queiroz June 21, 2019 at 12:31 pm

    We should burn those mo fos

  • Reply Stray Orion June 21, 2019 at 4:16 pm

    Capitalism is rotten to the core

  • Reply Paul Chabot June 22, 2019 at 12:40 pm

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

  • Reply PuffMaster420 June 24, 2019 at 12:23 am

    You gotta put that thing on the corner of your eye and it rolls right in

  • Reply axeblue June 29, 2019 at 6:22 am

    Maybe the PBM formula includes bigger the better and more wasteful the merrier.

  • Reply nerdswag21 June 30, 2019 at 9:52 am

    where would i find the graphs and info depicted in the video? the sources are something id like to read

  • Reply ExtraFormula June 30, 2019 at 6:41 pm

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

  • Reply Jacque Johnson June 30, 2019 at 6:58 pm

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

  • Reply City of Roses 1845 July 6, 2019 at 12:19 am

    As if I needed yet anther reason to HATE BIG PHARMA!!!!

  • Reply Guanqiao Wang July 9, 2019 at 5:55 pm

    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.

  • Reply DoctorChained July 10, 2019 at 8:52 pm

    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.

  • Reply Elie Cottin July 11, 2019 at 1:15 pm

    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.

  • Reply A July 12, 2019 at 3:19 am

    healthcare has turned into a business. people only care about the money, not the patient’s health.

  • Reply Bryan July 13, 2019 at 3:47 pm

    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.

  • Reply Victoria Chuzhina July 19, 2019 at 6:48 pm

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

  • Reply Riot Grrrl July 25, 2019 at 4:38 pm

    And some people really think greed is a force for good.

  • Reply Vroom vroom July 27, 2019 at 5:45 am

    Who after watching this video went and purchased eye drops?

  • Reply Kosemart July 29, 2019 at 6:48 pm

    Nothing but stoners watching

  • Reply Patrick Baranowski August 1, 2019 at 6:26 pm

    Meanwhile in the UK you can pick up eye drops for £1

  • Reply peanut12345 August 2, 2019 at 1:11 am

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

  • Reply PEEKatCHU August 4, 2019 at 10:32 am

    *God left

  • Reply Ectos August 6, 2019 at 8:26 pm

    That's why i stick to my local dealers

  • Reply Keyboard Warrior August 8, 2019 at 5:45 pm

    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

  • Reply pinkfreud62 August 11, 2019 at 12:15 pm

    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.

  • Reply spunk v August 12, 2019 at 11:21 am

    Can we sell a third party cap with microdrop
    Or some DIY projects?

  • Reply Squanchmaster Squanch August 19, 2019 at 3:29 am

    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

  • Reply Chris Chapel August 23, 2019 at 7:08 pm

    They WILL be held accountable for their deeds when they stand before The Most High.

  • Reply Left Morningstar August 28, 2019 at 9:57 am

    How drug companies are even worse than you thought

  • Reply Rosie Delap August 30, 2019 at 12:12 pm

    i <3 the nhs

  • Reply Gonzalo H August 30, 2019 at 3:50 pm

    is this a thing from the US, because I have never experienced that with eyedrops

  • Reply NEGRODAMUS August 31, 2019 at 7:34 am

    Do people other than pot smokers really use eyedrops?

  • Reply Federico Olivares September 4, 2019 at 7:50 pm

    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

  • Reply Hunter Gold September 6, 2019 at 4:06 pm

    that’s why we’re red eye jedis

  • Reply Arvi Pascual September 9, 2019 at 11:28 pm

    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.

  • Reply R D September 10, 2019 at 5:30 am

    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?

  • Reply free2saywhatever September 10, 2019 at 7:03 pm

    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.

  • Reply 420 Dab September 12, 2019 at 8:11 am

    Just put some plastic wrap or tin foil over it and poke a smaller hole if you're really on that level of coupon mom mentality

  • Reply jfdd43 September 12, 2019 at 11:25 pm

    They should sell those micro drop bottles on their own. Customers can transfer the meds by themself

  • Reply emme turensky September 13, 2019 at 5:29 am

    i blinked so much during this video

  • Reply fouraces1949 September 18, 2019 at 6:37 am

    Rohto brand has the perfect dropper 👌🏼

  • Reply Cambodia September 23, 2019 at 12:10 am

    Not only such practices are for consumers, it is just as bad for our environment. 🙁

  • Reply Unisporn September 27, 2019 at 1:57 pm

    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.

  • Reply yellooh October 7, 2019 at 7:30 pm

    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?

  • Reply Your Boy Mr Mac October 11, 2019 at 11:33 pm

    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.

  • Reply Aly pixar October 20, 2019 at 8:21 am

    Great video

  • Reply djcrazy!! !! October 21, 2019 at 2:45 pm

    i went to an eye doctor for drops bc my eye was too dry, now the same eye won't stop dripping!!

  • Reply djcrazy!! !! October 21, 2019 at 2:47 pm

    drug companies have the cures but if ur cured then they won't make money off of selling all those meds!!

  • Reply Frank V October 22, 2019 at 8:13 am

    The government should sanction them for throwing away medicine

  • Reply Keerthi Chandra October 25, 2019 at 4:16 am

    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.

  • Reply K D November 2, 2019 at 5:28 am

    Why don’t you make eyedroppers that don’t waste the medicine. Like stop complaining

  • Reply Brendan McCabe November 26, 2019 at 8:32 pm

    Happy I’m not American

  • Reply United Martians December 3, 2019 at 3:28 am

    They buried the lede here with the cancer drug waste bit in the middle

  • Reply Michael Gray December 6, 2019 at 10:27 pm

    Awh the free market

  • Reply 5445 December 24, 2019 at 7:59 pm

    MEDICAL INDUSTRIAL COMPLEX

  • Reply i_c__hearts fuk 3m January 23, 2020 at 12:56 pm

    Oh look another video you know nothing about

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