REFUND Act addresses wasted Medicare spending on discarded medications from excessively sized single-dose drug vials

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WASHINGTON, D.C. – Today, U.S. Senate Majority Whip Dick Durbin (D-IL) and U.S. Senator Rob Portman (R-OH) announced that their bipartisan bill to reduce wasteful spending on discarded medications that are the result of excessively large, single-use drug vials has passed the Senate as part of the Infrastructure Investment & Jobs Act. The Recovering Excessive Funds for Unused and Needless Drugs (REFUND) Act will enable Medicare to recoup money from drug companies who are paid for wasted medications, and provide savings to seniors enrolled in Medicare.

“For years, Big Pharma packaged expensive drugs in over-sized vials and made seniors and taxpayers foot the bill for excess medication thrown in the trash. This outrageous profiteering from discarded drugs is now coming to an end. I am pleased that this provision from our bipartisan REFUND Act will help save patients and Medicare billions of dollars,” said Durbin.

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“I am pleased that the REFUND Act has passed the Senate as part of the Infrastructure Investment and Jobs Act,” said Portman. “Our health care system should be reimbursing for value and only paying for products that patients are actually using. This smart legislation that’s good for seniors and taxpayers, and I believe it will improve health care outcomes and lower costs for all patients.”

In 2019, Medicare alone spent $753 million on medications that are literally thrown in the trash because the drugs are packaged in vials that hold too much medication for most patients. A recent report from the National Academies of Science, Engineering, and Medicine found that this wasted spending on these high cost pharmaceuticals was a major driver in increased drug costs. Including Medicaid and commercial insurance, an estimated $3 billion is spent each year on wasted cancer medications. The Senators introduced a version of this legislation in 2019, which was reported out of the Finance Committee then on a bipartisan basis.

This bipartisan legislation is endorsed by AARP, American Hospital Association, Patients for Affordable Drugs Now, and Campaign for Sustainable Rx Pricing.

The provision passed by the Senate requires:

  • HHS Secretary to aggregate the total discarded amount of Part B medications each quarter. This data is already reported on Medicare Part B claims sent by doctors;
  • HHS Secretary to calculate the total cost of the discarded medications, based off the Average Sales Price (or Wholesale Acquisition Cost if not available);
  • HHS Secretary to notify the drug’s manufacturer that they are required to provide a rebate to HHS for 100 percent of the amount of discarded medication that was recorded above a 10% low-volume threshold. This rebate would be deposited to the Medicare Trust Fund (failure by a manufacturer to provide a timely rebate would incur civil monetary penalties).

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