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The Myth of Drug Expiration Dates

propublica.org

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Re: The Myth of Drug Expiration Dates

#231

Post by djrogers »

jws wrote: post #12
djrogers wrote: post #3

It seems that a law simply allowing private testing of drugs for efficacy, the same way the federal government is allowed to, would go a long way to saving money here. Hospital systems and HMOs are large enough to save millions for a bit of testing, and once enough data is gathered they can easily and safely adjust their retention policies.

Hospital systems and HMOs turn their inventory fast enough that inventory control can probably handle their problem. Small hospitals and pharmacies probably suffer more from expirations.

> Hospital systems and HMOs turn their inventory fast enough that inventory control can probably handle their problem.

Doesn’t sound like it from the article...

Re: The Myth of Drug Expiration Dates

#232

Post by BurningFrog »

readams wrote: post #185
BurningFrog wrote: post #144

Earlier quoted context omitted.

Here's a startup idea: Develop an "indicator pill" that changes color at the same rate as an individual medication. It would be in (or part of) the bottle with the other pills, and be customizable to react to humidity, temperature and time in the same way as the particular medication.

The main problem is that there just isn't data on how much these drugs degrade. The expiration date is based on some preliminary measurements and conservative guesstimates. Neither the FDA nor the drug companies really cares or wants to see these dates extended.

There probably is no data in part because there is no good way to use such data.

Re: The Myth of Drug Expiration Dates

#233

Post by DugFin »

sliverstorm wrote: post #192
BrandoElFollito wrote: post #147

Earlier quoted context omitted.

I live in France and cannot remember the last time I saw pills not in a blister pack. I remember vaguely having seen pills in bottles maybe 20 or 30 years ago. Again this is for France, I know that e.g. in the US one gets refills. Which by the way I find great because the waste of pills is tremendous. It would have been much better to get the specific number prescribed.

It is a waste of pills- but in many cases the marginal production cost of a pill is incredibly small. See generic asprin, many hundreds of pills for a few dollars at an ordinary grocery store. More than you need, but the packaging & marketing probably still costs more than the pills. Over here, benadryl is the main over-the-counter drug I see in blister packs. They say it's to slow down the meth cookers.

That's not the reason. Benadryl being in blister packs long predates its use in meth cooking, like by 30 years. The real reason is more likely marketing. If they sold them in a bottle, the amount they charge for those few tiny pills would seem outrageous. A blister pack gives the packaging more volume.

Re: The Myth of Drug Expiration Dates

#234

Post by TheKarateKid »

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.

If scientists are able to calculate the longevity of chemicals, food, and other products without having to wait the actual time period, I don't see how or why pharmaceutical drugs would be any different.

It's very likely it is not favorable to companies to look into this, just as it was revealed that the EpiPen expiration date was not really true.

Re: The Myth of Drug Expiration Dates

#235

Post by vacri »

skinnymuch wrote: post #208
deelowe wrote: post #177

Earlier quoted context omitted.

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.

> except for not helping the issue you're seeking to remedy

... which is harm. If you've applied appropriate medication to deal with the issue, but that medication has gone bad, then you're in a position where you think you've applied a remedy but haven't.

Even if you later find out that the medication was bad, you have no idea how much effectiveness there was left, which affects future dosage calculations.

Re: The Myth of Drug Expiration Dates

#236

Post by r00fus »

ekianjo wrote: post #221
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"

I worked on expiration dates studies in pharma. It's well known that you could probably always extend the shelf life to 3-4 years for most drugs that are supposed to expire within 2 only, because tablets for example tend to be very stable. But nobody wants to run long stability studies, because that costs a lot of money (i.e. several batches that have to be analyzed in regular basis, documented, reported, QA'ed, insp…

How did they come to an expected shelf-life of 2 years in the first place?

Some medication that expires quickly can be extended simply by refrigerating it. I wonder what other environmental controls could extend the shelf life of common, expensive medication?

Re: The Myth of Drug Expiration Dates

#237

Post by AstralStorm »

chillwaves wrote: post #228
civilitty wrote: post #142

Earlier quoted context omitted.

You and the GP talking about entirely different things. You're talking about how investigators choose the initial dose for the clinical trials, he's talking about the dosage that is actually prescribed by doctors. Hence the 'The dose we take is not a "BEST GUESS"' (emphasis mine). Unless you're a lab animal or a person in a clinical trial, the does you take is the end result of lots of money spent on first figuring o…

> Antidepressants are a unique group of drugs because the dosage is highly dependent on each person's unique brain chemistry and a huge part of a good psychiatrist's job is working with their patients to find the right dosage and combination. How does one accomplish this absent trial and error? This fact undermines the entirety of your argument. "Best guess" is exactly what they do.

It is not a guess. It is statistics. Typically, the dose is either effective or partially effective and often on the smaller side as Phase 3 also looks at side effects.

Re: The Myth of Drug Expiration Dates

#238

Post by AstralStorm »

learntofly wrote: post #204
criley2 wrote: post #56

Earlier quoted context omitted.

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.

Come on, metabolism itself is reasonably variable even with controlled diet and perfect adherence. In reality, even more so.

Re: The Myth of Drug Expiration Dates

#239

Post by AstralStorm »

pacaro wrote: post #61
13of40 wrote: post #47

Earlier quoted context omitted.

Any idea whether the chemicals they decompose into are ever more harmful than the original?

Aspirin is a bad actor in this regard. It tends to revert back to salicylic acid, which is ok for some specific topical uses, but has potential to be pretty harmful orally. Sniffing an old bottle of aspirin will tell you whether they're still good enough

It's not that harmful if you know what you're dealing with. Have to be careful about liver toxicity and dosage but in a pinch it will work just fine as an antipyretic. It was used before aspirin has been invented.

Re: The Myth of Drug Expiration Dates

#240

Post by AstralStorm »

TuringNYC wrote: post #176
Florin_Andrei wrote: post #52

Earlier quoted context omitted.

> What kind of reporting is this? Anything less than 100% is not "as potent as when manufactured" Relax, this is the real world, not a computer based series of 0s and 1s. Any such compound begins drifting off from the original specs as soon as it leaves the factory - and in a very real sense it's not exactly at 100% at any time post the moment of manufacture. The question is what kind of deviation can be tolerated.

Well said. Another aspect: Having the option of a 90% effective drug vs a 100% effective drug you DONT have because you cannot afford. There was a time in my life where our family lived dollar to dollar and skipped medical care due to cost. We would easily settle for 90% efficacy.

It is not even 90% effective. You could adjust the dosage in many cases.
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