美国国家公共电台 NPR That Drug Expiration Date May Be More Myth Than Fact

 

DAVID GREENE, HOST:

Hospitals and pharmacies¹ are required to throw away drugs that have passed their expiration² 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 potent³ 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 prescription⁴ drugs that were three or four decades old. What was the situation here?

ALLEN: Yeah. These drugs were stashed⁶ in the back of a pharmacy⁷ 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 potency⁸?

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 incentive⁹ 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 pharmaceutical¹⁰ 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 stash⁵ 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 makers¹¹ 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 previously¹² 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 Defense¹³ 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 entities¹⁴ 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.

1 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网

2 expiration   

n.终结，期满，呼气，呼出物

参考例句：

• Can I have your credit card number followed by the expiration date?能告诉我你的信用卡号码和它的到期日吗?
• This contract shall be terminated on the expiration date.劳动合同期满，即行终止。

3 potent   

adj.强有力的，有权势的；有效力的

参考例句：

• The medicine had a potent effect on your disease.这药物对你的病疗效很大。
• We must account of his potent influence.我们必须考虑他的强有力的影响。

4 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

5 stash   

v.藏或贮存于一秘密处所；n.隐藏处

参考例句：

• Stash away both what you lost and gained,for life continues on.将得失深藏心底吧，为了那未来的生活。
• That's supposed to be in our private stash.这是我的私人珍藏。

6 stashed   

v.贮藏( stash的过去式和过去分词 )；隐藏；藏匿；藏起

参考例句：

• She has a fortune stashed away in various bank accounts. 她有一大笔钱存在几个不同的银行账户下。
• She has a fortune stashed away in various bank accounts. 她在不同的银行账户上秘密储存了一大笔钱。 来自《简明英汉词典》

7 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

8 potency   

n. 效力，潜能

参考例句：

• Alcohol increases the drug's potency.酒精能增加这种毒品的效力。
• Sunscreen can lose its potency if left over winter in the bathroom cabinet.如果把防晒霜在盥洗室的壁橱里放一个冬天，就有可能失效。

9 incentive   

n.刺激；动力；鼓励；诱因；动机

参考例句：

• Money is still a major incentive in most occupations.在许多职业中，钱仍是主要的鼓励因素。
• He hasn't much incentive to work hard.他没有努力工作的动机。

10 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

11 makers   

n.制造者，制造商（maker的复数形式）

参考例句：

• The makers of the product assured us that there had been no sacrifice of quality. 这一产品的制造商向我们保证说他们没有牺牲质量。
• The makers are about to launch out a new product. 制造商们马上要生产一种新产品。 来自《简明英汉词典》

12 previously   

adv.以前，先前（地）

参考例句：

• The bicycle tyre blew out at a previously damaged point.自行车胎在以前损坏过的地方又爆开了。
• Let me digress for a moment and explain what had happened previously.让我岔开一会儿，解释原先发生了什么。

13 defense   

n.防御，保卫；[pl.]防务工事；辩护，答辩

参考例句：

• The accused has the right to defense.被告人有权获得辩护。
• The war has impacted the area with military and defense workers.战争使那个地区挤满了军队和防御工程人员。

14 entities   

实体对像； 实体，独立存在体，实际存在物( entity的名词复数 )

参考例句：

• Our newspaper and our printing business form separate corporate entities. 我们的报纸和印刷业形成相对独立的企业实体。
• The North American continent is made up of three great structural entities. 北美大陆是由三个构造单元组成的。