The Myth of Drug Expiration Dates • Hacker News Board

Re: The Myth of Drug Expiration Dates

#71

Post by bcook » Tue, Jul 18, 2017, 6:46 PM UTC

cujo wrote: post #26

bcook wrote: post #8

I always assumed that the expiration date was partly legal, in the way that you only have 1 year within which you can legally have the drug in your system. I mean, if I am prescribed oxycontin, can I legally have the drug in my system for the rest of my life?

I thought it it was illegal to have certain controlled substances past the prescription. So if you were prescribed a month's supply of oxycontin and got pulled over with it on your passenger seat a year later, you were breaking the law.

I hope not because my doctor prescribes me with a "30 day" supply, as wrote on the prescription, which he tells me to use over 3 months. Either way, the unknowns about potential felonies scares me...

Re: The Myth of Drug Expiration Dates

#72

Post by zajd » Tue, Jul 18, 2017, 6:47 PM UTC

gnaritas wrote: post #44

zajd wrote: post #33

Earlier quoted context omitted.

Or we could just make it illegal. Then again, with today's political climate it wouldn't surprise me if someone was unironically opposed to regulating drug manufacturers.

Laws are merely barriers to work around, incentives guide what's going to be attempted. Making something illegal adds some negative incentive, but isn't nearly as good a solution as simply having positive incentive to do the right thing.

What makes you think laws aren't incentives? "Merely barriers to work around" kind of misses why laws exist in the first place. Making something illegal is what society should do if we collectively agree that behavior is to the detriment of society without any positive gain. What do we gain by allowing drug manufacturers to put false expiration dates on their products?

Re: The Myth of Drug Expiration Dates

#73

Post by dekhn » Tue, Jul 18, 2017, 6:48 PM UTC

agumonkey wrote: post #68

slr555 wrote: post #66

This issue is a conundrum. Most drugs don't fall off a cliff of efficacy when they reach their expiration date. There are drugs such as tetracyclines that should never be used past their expiration dates because they degrade into toxic compounds. Certain classes of drugs such as anti-arrhythmics or drugs like warfarin are dosing critical to the point where I would not want them if they were out of date. I worked in p…

I wonder if a single rule 'no consumption past date' is a safeguard to insure simple behavior from population. If people started to think some drugs can and some cant they might indulge into trying random stuff.

yes, that's a big part of it. It's a simple rule that's easy to follow, which can often be better in terms of health overall.

Re: The Myth of Drug Expiration Dates

#74

Post by barking » Tue, Jul 18, 2017, 6:49 PM UTC

At one time we were required to keep an extensive list of emergency drugs at work.

Off the record, it was generally accepted that we should never, under any circumstances, use any of those drugs, bar adrenalin, for fear of doing more harm than good.

The cost was substantial and one company seemed to have the monopoly on supplying them. They also kept a record of the expiry dates and supplied replacements as stocks went out of date.

The most annoying thing was that they seemed to deliberately supply drugs with most of their lifespan expired.

They of course denied that this was a policy.

Re: The Myth of Drug Expiration Dates

#75

Post by pipio21 » Tue, Jul 18, 2017, 6:52 PM UTC

Most of the time the drug handles time well but the excipient degrades. This makes it very hard to control how those drugs will work. It opens so many variables.

It is like not using the seat belt could save your life if you are thrown away of the car at some specific circumstances, like happened to a person I know. But they are there because it works better most of the time as engineers could design safety with less variables.

My father had an emergency immune problem(that we have already identified as it is recursive) and the only required drugs in house were expired for some years. He took those before we bought the new ones and the old ones were like 1/3 potency of the new ones.

Given that most of the price of drugs come from intellectual property and patents and each pill cost dollar cents to make, I don't see the urgency of taking expired drugs.

If Hospitals trow away expired drugs then it is a good reason to take into account in the global negotiation process, and I bet they already do in countries that buy drugs in bulk.

Re: The Myth of Drug Expiration Dates

#76

Post by schrodinger » Tue, Jul 18, 2017, 6:54 PM UTC

kchr wrote: post #39

schrodinger wrote: post #14

Earlier quoted context omitted.

I'm pretty sure it's never illegal to have a drug in your system (besides something secondary like a DUI). It's only possession that's illegal.

Not really, there are lots of countries having "zero tolerance" policy laws which include ingesting and being under the influence of illegal drugs.

Ah, ok. I was thinking specifically in the US. My apologies!

Re: The Myth of Drug Expiration Dates

#77

Post by gumby » Tue, Jul 18, 2017, 6:55 PM UTC

(former pharmaceutical developer here). This article makes it sound like there's a big conspiracy, which there isn't.

A very few drugs (like erythromycin) become toxic so should be discarded.

Some drugs become less efficacious over time, but nobody really knows the shape of the curve as they are simply tested to see if they have the same efficacy on day E as they did on day 0. Well of course all drugs will become worthless as t approaches ∞ but you can guess that since tablets have a very low moisture content, if they are kept in a cool dark place it's likely they'll last a very long time. I also happily keep expired drugs in a controlled environment and use them; all drugs in my car's and backpack's first aid kits get replaced annually because they are exposed to harsh environments.

(Stockpiling drugs doesn't prove anything BTW: if you are stockpiling them against an emergency the presumption is that some efficacy is better than none).

Nobody is going to do accelerated life testing beyond what they have of course. I think extending the required lifetime is a good idea, though I question the size of the economic return claimed in the article.

The expiration dates on food are slightly more scandalous: the FDA doesn't require the same level of testing as they do on the medical side so they are mainly set stupidly short. Last week purchased some vacuum-packed lamb that had a manufacturer label with an expiration date a month away, but was prominently labeled to expire this week. And of course US egg producers take steps that reduce the storage time of eggs, which can be months old when you get them -- and then "expire" a week after getting home.

Re: The Myth of Drug Expiration Dates

#78

Post by dragonwriter » Tue, Jul 18, 2017, 6:56 PM UTC

rhblake wrote: post #36

schrodinger wrote: post #14

Earlier quoted context omitted.

I'm pretty sure it's never illegal to have a drug in your system (besides something secondary like a DUI). It's only possession that's illegal.

Depends on the country. In Sweden it's illegal to have certain drugs in your system. E.g. if THC is found in your blood you can be convicted for a minor drug offense. We're sadly pretty extreme with regards to drugs though.

Is it illegal to have THC in your system or is having THC in your system admissible as rebuttable evidence of possession/use of illegal drugs? Either would support the outcome you describe, but they are meaningfully different.

E.g., with alcohol, the “in the blood is illegal” rule would criminalize auto-brewery syndrome occuring in those legally denied alcohol (e.g., due to age), while the “in the blood is admissible as evidence of use” would not, though those with the syndrome might need to present evidence of it to avoid charges.

Re: The Myth of Drug Expiration Dates

#79

Post by lostcolony » Tue, Jul 18, 2017, 7:02 PM UTC

Greed wrote: post #34

harshreality wrote: post #4

> 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. What kind of reporting is this? Anything less than 100% is not "as potent as when manufactured", and the sentence implies some of those dozen weren't close to 100%. > The idea that drugs expire on specified dates goes back at…

I work for a company that has some periphery exposure to FDA-regulation, and as a result we have to do a lot of very similar scientific calculations to satisfy their archival records. A big part of why most medicines still expire (at least for medicines available over the counter) much earlier than they should is that a majority of the testing is done to determine the expiration date at a controlled temperature, pres…

Beyond that, what is the incentive on the part of the company? No one is evaluating medications based on shelf life. Longer expiration dates -at best- do nothing favorable for the company, and at worst both reduce the purchase of more of the drug, -and- open the company up to litigation in the even it's dangerous. Why take that risk? There is simply no economic pressure to.

Re: The Myth of Drug Expiration Dates

#80

Post by learn_more » Tue, Jul 18, 2017, 7:06 PM UTC

jessriedel wrote: post #45

This article has some shoddy logic. For the vast majority of drugs, the actual marginal manufacturing price per pill is essentially zero. That means that when the expired pills are thrown away and new pills are manufactured, there is no true economic loss. Rather, all that potentially happens is a transfer between the consumer and the manufacturer. If pill prices were set by some external force, this could at least b…

The cost model is like a time limited software license. If there is some new trick to extend the license, the drug companies would likely just charge more up front.