Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The Myth of Drug Expiration Dates

propublica.org

Post reply on HN
Print view View original

201–210 of 275 posts

Re: The Myth of Drug Expiration Dates

#201

Post by lovemenot »

PixelB wrote: post #169
lovemenot wrote: post #165

Due to complexity it doesn't seem realistic to try to save money by using legacy drugs. On the other hand, the economics of pharma industry are such that manufacturing cost is usually a very small proportion of price. Therefore a better solution would be to introduce a mandatory new-for-old trade-in policy. So they wouldn't lose money on the deal, pharma companies would be rewarded at mfg cost. I.e. sans profit, mark…

Great idea, never going to happen. Why would they sign up for that when they can just as easily charge full price for those replacement drugs (as they do now)? The only people out there who can change this are making huge profits from the system currently in place, so why would they?

There might be some up-side in terms of reputation gain, but it would have to be imposed by a regulator.

Re: The Myth of Drug Expiration Dates

#202

Post by techthroway443 »

Kalium wrote: post #161
techthroway443 wrote: post #155

Earlier quoted context omitted.

Seems simple enough, just extend the expiration dates on the meds that don't turn toxic and that still work. The issue here though is that it's not in the drug manufacturers interest to have super long dates. Putting labels that expire sooner means they can push higher volume.

There's also the not-irrelevant issue that testing is slow and potentially other than free. How do you find out when a drug expires? You have a bunch of it sit around and test it periodically, right? I assume that would be done after bringing a drug to market, otherwise drugs could easily be delayed 10+ years if they're shelf-stable.

Nobody said they need to find the absolute last day the drug expires before they can get it to market.

If it's a new drug and they can only say for sure that it lasts 6 months then put that on the label and ship it out. But assuming the drug will be out for 10+ years they should be continually testing the expiration date and updating as they've had more time to make that determination.

But like I said initially (and as you nicely pointed out) that costs money so why bother?

Re: The Myth of Drug Expiration Dates

#203

Post by jessriedel »

valuearb wrote: post #171
jessriedel wrote: post #124

Earlier quoted context omitted.

This is addressed in my second paragraph.

No it's not. Essentially you are saying it's ok to have an "expiration tax" and that it doesn't change the market. I'm saying the expiration tax does change the market, and raises the cost for the consumer, even if it's factored into their purchase. Typically consumers don't have the ability to substitute complements, and manufacturers products are patent protected, so it's another way to raise prices and increase ma…

I explicitly point out in my original comment that this applies for monopoly markets! To spell it out in gory detail: in a simple monopoly, the price is that which maximizes the supplier surplus for a given demand curve, and the demand curve will be proportional to probability that any single pill is consumed. If you have a more complicated model, then by all means explain it to us, but do not just assert the contrary with no explanation.

Re: The Myth of Drug Expiration Dates

#204

Post by learntofly »

criley2 wrote: post #56
JohnJamesRambo wrote: post #46

Earlier quoted context omitted.

And to add into that, dosage studies are rarely adequately done for most drugs. The dose we take is often a best guess and may be twice or more than we need, so 10% is even more inconsequential.

This is completely wrong. Dosage studies happens between Phase 2 and Phase 3 trials (and Phase 4 "post marketing" too) and are the most expensive, longest and most scientific process that arguably any business engages in in the entire world. Phase 1 is a safety test in healthy ~men. These seek to find the maximum dose before adverse effects appear in the healthiest humans. Phase 2 is a safety/dosage test in a much la…

Why are drugs almost exclusively dosed in multiples of 5, ie 50mcg, 250mg? Surely this introduces a margin of error vs the "perfect" dose.

Re: The Myth of Drug Expiration Dates

#205

Post by jessriedel »

jkern wrote: post #134
jessriedel wrote: post #125

Earlier quoted context omitted.

Exactly. The price is set by the willingness to pay (the demand curve), which accounts for the fraction of purchased pills that will actually be consumed.

It seems like this would be true if everything were working perfectly and there was a gradient of purchasing options across price/expiration. As it is consumers really don't have any choice wrt expiration date since as far as I'm aware the option to pay more for longer lasting drugs doesn't really exist.

It doesn't require a gradient. Suppose that, instead of expiry issues, half of all pills were inert duds for whatever manufacturing reason. (You look in the bottle and the duds are black.) This would make the pills half as valuable to consumers, and manufacturers would simply sell twice as many for half the price. It does not require that consumers have access to pills that have a higher or lower dud rate. And yes, it's possible to construct a model where there are frictional losses from duds (increased spending on pill bottles!), but to assert that you'd need to try to write down some numbers.

Re: The Myth of Drug Expiration Dates

#206

Post by dekhn »

zentiggr wrote: post #140
dekhn wrote: post #106

Earlier quoted context omitted.

But there are too many details in how the drug could fail depending on its individual storage.

A big chunk of this article's message is that those considerations seem to not have anywhere near as much of an effect as currently assumed. (EpiPens viable 50 months past their marked date) I would push two prongs: reinforce that expiration dates are serious, and at the same time test and extend any/all dates to the actual behavior of each drug. turn a one year into 5, 10, 20? Hell yes. Pretty obvious that big chunk…

I don't completely agree with the article's message. I think people who deal with statistical quantities of product and do extensive quality control testing probably have some wisdom about what's really safe. The article refers to a paper (which I've skimmed) that leaves a bunch of unanswered important questions.

Re: The Myth of Drug Expiration Dates

#207

Post by emodendroket »

techthroway443 wrote: post #155
t0mbstone wrote: post #152

Earlier quoted context omitted.

Wouldn't the real solution here be to put real expiration dates on things that can harm you, and real expiration dates on things that haven't actually expired? Like a "dangerous to use after 01/01/2019" label on things that actually are dangerous. Other items could have labels like, "Safe for use until 01/01/2025 - Effectiveness may be degraded after 09/05/2019"

Seems simple enough, just extend the expiration dates on the meds that don't turn toxic and that still work. The issue here though is that it's not in the drug manufacturers interest to have super long dates. Putting labels that expire sooner means they can push higher volume.

I would assume there's also liability to think about. If something goes wrong with a medicine after the expiration date it has to be better for the manufacturer. Also you probably want to leave some room for suboptimal storage

Re: The Myth of Drug Expiration Dates

#208

Post by skinnymuch »

deelowe wrote: post #177
ballenf wrote: post #94

Earlier quoted context omitted.

The article states with absolute certainty that no patient has ever been harmed by an expired drug. Not doubting your point about tetracycline, but how much would a patient need to ingest to be harmed? Then there's the argument that the reason no one's been harmed is because the policy is working. Harm due to unavailability of drugs or higher costs are much harder to track, of course. Yet another case of a balance be…

I thought antibiotics lose their efficacy part there due date

Other drugs lose efficacy at different times too, of course. But most still won't do you any harm (except for not helping the issue you're seeking to remedy), which was the OP's point, right? Or am I misunderstanding things.

Re: The Myth of Drug Expiration Dates

#209

Post by kiahjw »

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…

sirum.org (YC W15) helps redistribute surplus drugs that are often short-dated. Our online platform allows orgs to register, upload their surplus, and we connect them to charitable clinics and pharmacies. Check us out!

Re: The Myth of Drug Expiration Dates

#210

Post by agumonkey »

hrktb wrote: post #158
agumonkey wrote: post #89

Earlier quoted context omitted.

Yeah unless we put something better in place, maybe a dedicated QR code website to quickly verify if that box is 1, 2, 10, toxic

In principle this would be a god send. In practice I think this will be so drawn in legalese it will take incredible amount of effort to get valuable information. There is already a super long information sheet in each of the drugs I take, and each time I read them to get a better grasp of how I should take them I'm flooded by useless warnings (could be all summed up by 'you might get worse taking this. If it happens…

Oh yeah, I agree on the fuzzy feeling when reading the folded sheet. It's mostly "potential side effect side effect annnd side effect".

It's hard to design middle ground solution for this. Between no information and too much and too complex information...

Come on worl, we have machine learning, we can find something.

Post reply on HN