The Myth of Drug Expiration Dates (propublica.org)

schwit1 shares a report from ProPublica: Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer. The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates -- possibly toxic, probably worthless. But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term "expiration date" was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don't necessarily mean they're ineffective immediately after they "expire" -- just that there's no incentive for drugmakers to study whether they could still be usable.

Tests on the decades-old drugs including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers. The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations. Experts say the United States might be squandering a quarter of the money spent on health care. That's an estimated $765 billion a year.

Comments

This is the sort of testing the Feds should do.

[Anonymous Coward]

The manufacturers have zero incentive to do these sorts of tests, and private individuals have no way to force the expiration dates to be changed, so this is exactly the sort of testing that the FDA should be funding.

But a more interesting question than the fact that several of the medications were at near 100% effectiveness, how many medications were actively harmful (as opposed to just less effective)?

Re:This is the sort of testing the Feds should do.

[darkain]

Sometimes I wish Slashdot had the ability to pin comments right to the top of the entire thread. This is probably the most useful piece of information I've read on any post at all today. Thanks for the info!

Re:This is the sort of testing the Feds should do.

[gumbi west]

The problem with pre-existing conditions is actually that they are expensive to cover. So, if you do find a way to cover them it involves other people paying for them somehow. If it is other people who are healthy directly paying for them, some of them will realize that the healthcare is not worth the cost--they're literally paying for a benefit they don't get--insurance for chronic conditions. Then folks will drop out, that will raise rates even more... that's death spiral.

The only way to deal with chronic conditions is to require only rich people to have them or for the government to pay for them.

Inventory Management Much?

[TechyImmigrant]

If the expiration dates are 2-3 years from the date of manufacture, presumably pharmacies could do a little better inventory management and not have to throw any out. 2 years warning is plenty. Just keep 1 year's supply on hand. If demand drops, don't buy any more until you need to.

Re:Inventory Management Much?

[Dan East]

There are many drugs kept only for emergencies, in settings that have few emergencies, that must be thrown out and replaced when they expire. A good example is a general practitioner's office. They will keep a defibrillator, epinephrine, atropine, D50W, etc for medical emergencies, and may never use them over the course of a decade or two.

Another example is the now infamous EpiPen. People that have severe allergic reactions must keep them on hand to ward off anaphylaxis, but they are usually so diligent about avoiding their allergens that they never need them. Thus they expire before they are used.

Think of all the times patients are prescribed a medication but they cannot finish taking them (there are side affects, or the medicine isn't effective so another med is prescribed, etc, etc) and there are full pill bottles sitting around that could be used to treat other family members when they become ill. That would be.... efficient, would it not?

Re:Inventory Management Much?

[DutchUncle]

There are many drugs kept only for emergencies, in settings that have few emergencies, that must be thrown out and replaced when they expire. A good example is a general practitioner's office. They will keep a defibrillator, epinephrine, atropine, D50W, etc for medical emergencies, and may never use them over the course of a decade or two.

This category calls for more active management (which would never work in our real world because it would require cooperation and security). Each doctor's office small supply of these drugs could sit on the shelf for, say, half of their useful life, and then be transferred to the ambulance squad which will go through them before they expire. Instead the ambulance squad buys its own, and the office supply is wasted, for a net waste of money and supplies, because the transfer would count as an unlicensed re-sale or is prohibited (rather than treating it as an inter-pharmacy transfer or whatever the law calls it).

Original sealed container

[Anonymous Coward]

Most patients don't get their prescription pills in the original sealed container of hundreds of tablets or capsules that is shipped to the pharmacy, but in a non-sealed container that is subject to high humidity and large temperature variation when stored at home. So the at-home longevity is less, although still almost always at least a couple years longer than marked on the retail vial.

Re:So to solve the health care crisis...

[Phics]

I'm pretty sure that this experiment didn't set out to prove the FDA is corrupt and is maliciously slapping arbitrary expiry dates on drugs so you would waste your money. The FDA's primary goal isn't drug stability over 15 years, for example, it's what is safe in a reasonable amount of time for those drugs to be consumed. Do you really want to pay the FDA to do decades long studies on all prescription drugs with the intent of seeing how many generations you can pass your prescription drugs cache down?