美国国家公共电台 NPR That Drug Expiration Date May Be More Myth Than Fact（在线收听）

DAVID GREENE, HOST:

Hospitals and pharmacies are required to throw away drugs that have passed their expiration date, no matter how expensive or vital those drugs may be. But the Food and Drug Administration and others have long known that many drugs remain safe and potent long after they've expired. Investigative reporter Marshall Allen of the nonprofit newsroom ProPublica has been looking into this as part of a series on medical waste, and he joins me from Denver. Marshall, good morning.

MARSHALL ALLEN: Good morning.

GREENE: So can I start with a story in your report that was just completely fascinating? It's a pharmacist who found a box of old prescription drugs that were three or four decades old. What was the situation here?

ALLEN: Yeah. These drugs were stashed in the back of a pharmacy and discovered after they had been in basically a back closet for decades. I mean, these were like Elvis-era drugs almost.

GREENE: (Laughter) That's amazing.

ALLEN: So he got curious, and he contacted a researcher to say, let's test these drugs and see how potent they actually are. There were 14 different compounds in those drugs, and 12 of them were still potent up to current standards. And so that's many decades old, and the drugs were still potent.

GREENE: Does that mean that it is safe for me to keep my drugs as long as I want to and try to take them and see if they work?

ALLEN: You know, no one's going to recommend that people take expired drugs. But I called different poison control experts to ask about it, and they do not have recorded cases of people being harmed by taking expired drugs. But they may not be potent enough to do what you need them to do, and so that could be a problem.

GREENE: Are there some types of drugs, Marshall, where expiration dates are really crucial because they - drugs that, you know, seem especially to lose their potency?

ALLEN: Absolutely, especially things like inhalants or solutions might not be as potent and might not keep their potency as long. Just because some drugs are having their expiration dates extended does not mean that every drug can safely have its expiration date extended.

GREENE: So who is benefiting from having these laws in place that are so strict in saying you have to throw these things away at a certain time?

ALLEN: Well, the experts I talked to, many of them said the drug industry benefits just because they continue to sell more new drugs.

GREENE: I see.

ALLEN: And, you know, the industry, when I talked to them, I mean, they said that they're most focused on the safety of the drugs. And what the expiration date actually means is that they've tested the drug, and they've made sure that it's safe and effective up to that date. But that does not mean that it's bad after that date. And so that's why so many of these drugs get thrown away.

GREENE: So the industry could, in theory, test the drugs to see if it could last five or six years instead of one or two years, but they might not have any incentive to do that because they make a lot of money by selling new drugs.

ALLEN: Well, exactly. They have no incentive to do it. They're not required to do it, and so they don't. I contacted some of the biggest pharmaceutical companies, and they said they don't check their drugs to see how long they actually last. And they said there's no incentive for them to do it also because it's a huge regulatory burden for them to actually extend the expiration dates. So when they get the initial approval for the drug, it's for two or three years - expiration date. And they said to extend it beyond that is a big regulatory burden, so that's why they also say they don't check.

GREENE: There has to be a lot of money at stake here. I mean, how much money is being wasted when hospitals and pharmacies are throwing away drugs that could still be usable?

ALLEN: Well, like a lot of things in American health care, no one is actually keeping track, and so we can estimate. Like, I got contacted by a pharmacist up in a hospital in Boston about this, and he was saying that he throws away - in their hospital - about $200,000 a year in expired drugs. And if that were kind of calculated out across the country...

GREENE: Every hospital in the country, yeah.

ALLEN: Yeah. There's about 4,000 hospitals nationally. I mean, you'd be at about $800 million right there just of drugs being tossed.

GREENE: You said the government knows that this issue exists, and isn't that in part because the government has held stockpiles of drugs for a long time in case of emergency, and they've kind of experimented with whether some of these could be used even after they've expired?

ALLEN: Exactly. You know, the only reason this is a story is because the federal government for decades has been testing expired drugs and then extending the expiration dates. And they do that because they have a stash of drugs all over the country, stockpiles of them, just in case there's a public health emergency or some other problem. And these drugs are worth billions and billions of dollars. And so what they do is they hire the FDA to run a program where they test these drugs that are expired. And then when they find that they're still good, which most of the time they do, they extend the expiration date. And they'll often extend the expiration date for years.

GREENE: So is anyone putting pressure on the government or policy makers and saying, look, the FDA knows how to do this potentially to save money. They should be doing this a lot more often with hospitals, with pharmacies.

ALLEN: No, I didn't find anyone who is formally putting pressure on, but I talked to several scientists who worked previously on this FDA program where they extended drugs. And they said something like this could easily be done, especially in the hospital-pharmacy world, where the drugs are kept in really good conditions. And the return on investment is huge. The Department of Defense in 2016 spent about 3.1 million to test their drugs, and they saved about 2.1 billion in the cost of replacing expired drugs.

GREENE: Does this all tell us something about the health care industry in the United States?

ALLEN: Absolutely it does. I mean, our health care system in the United States is extremely fragmented. And so, you know, nobody's really responsible for a lot of things. And there's a lot of different entities and agencies who are incentivized to do things that could benefit everyone but because we have this fragmentation, it doesn't really happen.

GREENE: Marshall Allen is an investigative reporter with ProPublica. Marshall, thanks a lot.

ALLEN: Thank you so much, David.