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February 2018

A Policy That Encourages Wastage of Expensive Medications—The JW Modifier

Author Affiliations
  • 1Davidoff Cancer Center, Rabin Medical Center, Petach Tikvah, Israel
  • 2Winship Cancer Institute, Emory University, Atlanta, Georgia
  • 3myStrength, Denver, Colorado
JAMA Oncol. 2018;4(2):155-156. doi:10.1001/jamaoncol.2017.3997

Gold is a precious metal with a high market price. When goldsmiths create a piece of jewelry, small shreds of gold often are not used. However, these precious shreds do not go to waste; they are carefully collected, melted, and used to craft subsequent jewelry. Similarly, many medications have a high market price and should be considered to be precious. However, what happens to unused injectable drugs that are left over in single-dose vials? Are they carefully collected, or are they wasted? Significant wastage often occurs, perhaps unintentionally encouraged by legislation that permits payment for wastage. With the current interest in the high societal cost of medications, it is important to understand policies and processes related to decreasing wastage and thus saving societal resources. In this article, we explore the legislation that allows payment for wastage of injectable medications.

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