I 
115TH CONGRESS 
2D SESSION 
H. R. 5867 
To authorize a joint action plan and report on drug waste. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 17, 2018 
Mr. DOGGETT (for himself and Ms. PINGREE) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To authorize a joint action plan and report on drug waste. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Reducing Drug Waste 
Act of 2018’’. 
SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) On May 23, 2017, the Department of 
Health and Human Services, acting through the Of-
fice of the Inspector General in a letter to Senators 
Klobuchar, Durbin, and Shaheen, found that dif-
ferent vial sizes in addition to those currently ap-
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proved and marketed in the United States could 
sometimes significantly reduce the amount of drug 
discards, or waste, from single-use vials. 
(2) The Office of Inspector General analyzed 20 
single-use vial drugs with the highest amounts of 
identifiable reimbursement for discarded drugs dur-
ing 2013 and 2014 and found that the Medicare 
part B program paid $11,600,000,000 for these 
drugs, $2,100,000,000 of which was for drugs billed 
in 
increments 
of 
other-than-full 
vials, 
and 
$195,000,000, or nearly 10 percent, of the 
$2,100,000,000 billed in increments of other-than- 
full vials was reimbursed for discarded drugs. 
(3) During the Food and Drug Administra-
tion’s review process for a drug’s safety and efficacy 
before a drug is approved for marketing in the 
United States, the Food and Drug Administration 
reviews the manufacturer’s proposed vial size. 
(4) As of January 1, 2017, the Centers for 
Medicare & Medicaid Services requires all physi-
cians, hospitals, and other providers submitting 
claims to Medicare to separately identify the dis-
carded amount of a drug from a single-use vial (the 
JW modifier) on its claim for reimbursement by 
Medicare. The new requirement does not change the 
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amount the providers are reimbursed for single-use 
drugs. 
SEC. 3. JOINT ACTION PLAN AND REPORT ON DRUG WASTE. 
(a) JOINT ACTION PLAN.—The Commissioner of 
Food and Drugs, in coordination with the Administrator 
of the Centers for Medicare & Medicaid Services, shall de-
velop a joint action plan, in consultation with health care 
providers and patient advocates (including relevant Fed-
eral advisory committees) that— 
(1) utilizes data from Medicare claims on how 
much of a single-use drug was not administered, 
comparing single-use vial sizes in other countries, 
and through analysis during the drug approval proc-
ess of alternative vial size safety and efficacy, to re-
duce drug waste and better manage costs; and 
(2) includes quantifiable metrics and specific 
timelines. 
(b) REPORT.—Not later than 1 year after the date 
of enactment of this Act, the Commissioner of Food and 
Drugs, in coordination with the Administrator of the Cen-
ters for Medicare & Medicaid Services, shall submit to 
Congress the joint action plan described in subsection (a) 
and a report containing recommendations for any legisla-
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tive action needed to reduce drug waste and better manage 
costs. 
Æ 
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