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Medications in Single-Dose Vials: Implications of Discarded Drugs (2021)

Chapter: Appendix E: Disclosure of Unavoidable Conflicts of Interest

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Suggested Citation:"Appendix E: Disclosure of Unavoidable Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2021. Medications in Single-Dose Vials: Implications of Discarded Drugs. Washington, DC: The National Academies Press. doi: 10.17226/25911.
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Appendix E

Disclosure of Unavoidable Conflicts of Interest

The conflict of interest policy of the National Academies of Sciences, Engineering, and Medicine (http://www.nationalacademies.org/coi) prohibits the appointment of an individual to a committee authoring a Consensus Study Report if the individual has a conflict of interest that is relevant to the task to be performed. An exception to this prohibition is permitted if the National Academies determines that the conflict is unavoidable and the conflict is publicly disclosed. A determination of a conflict of interest for an individual is not an assessment of that individual’s actual behavior or character or ability to act objectively despite the conflicting interest.

Dr. Harold Paz has a conflict of interest in relation to his service on the Committee on Implications of Discarded Weight-Based Drugs because he currently owns shares of stock of United Surgical Partners International and CVS Health. Dr. Paz received financial remuneration from CVS Health through the end of May 2020. Also, he receives financial remuneration for his service on the United Surgical Partners International advisory board.

Mr. Kenneth Silverman has a conflict of interest in relation to his service on the Committee on Implications of Discarded Weight-Based Drugs because he is currently employed by a pharmaceutical manufacturer, AstraZeneca, as the director of packaging technology, global technical operations. Also, Mr. Silverman is the single patent holder for a senior-friendly single-dose dispensing package (WO2009149267).

In each case, the National Academies determined that the experience and expertise of the individual was needed for the committee to accomplish the task for which it had been established. The National Academies could

Suggested Citation:"Appendix E: Disclosure of Unavoidable Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2021. Medications in Single-Dose Vials: Implications of Discarded Drugs. Washington, DC: The National Academies Press. doi: 10.17226/25911.
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not find other available individuals with the equivalent experience and expertise who do not have a conflict of interest. Therefore, the National Academies concluded that the conflict was unavoidable and publicly disclosed it through the National Academies Projects and Activities Repository (https://www8.nationalacademies.org/pa/projectview.aspx?key=51747).

Suggested Citation:"Appendix E: Disclosure of Unavoidable Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2021. Medications in Single-Dose Vials: Implications of Discarded Drugs. Washington, DC: The National Academies Press. doi: 10.17226/25911.
×
Page 155
Suggested Citation:"Appendix E: Disclosure of Unavoidable Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2021. Medications in Single-Dose Vials: Implications of Discarded Drugs. Washington, DC: The National Academies Press. doi: 10.17226/25911.
×
Page 156
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Every year, significant amounts of expensive drugs are discarded. This is due in part to the growing number of prescription drugs that are administered in variable doses (rather than fixed or flat doses) based on a patient's weight or body size. Strict regulations and guidance generally prohibit or severely restrict the acceptable time frame for sharing medication from single-dose vials among patients, and so the unused amount will typically be discarded. Due to the current system for producing, administering, and paying for drugs in the United States, significant - but indeterminate - amounts of expensive prescription drugs are discarded each year.

At the request of the Centers for Medicare & Medicaid Services, Medications in Single Dose Vials: Implications of Discarded Drugs explores the federal health care costs, safety, and quality concerns associated with discarded drugs that result from the weight-based dosing of medicines contained in single-dose vials.

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