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> Gee, you get to just hand-wave an entire manufacturing process and supply chain into insignificance, but I need a model, huh?

Nope, for this you just need a number! (In my comment, the "model" part referred to how monopoly pricing was done.)

> So 11 cents/pill just to run a pill through the supply chain and then dispose of it.

Good, your estimate process is a reasonable one, and I accept this number.

> $330 million/year...I dunno, seems potentially significant, at least to an order of magnitude level.

Ok, let's compare to what the article says:

> Experts estimate such squandering eats up about $765 billion a year — as much as a quarter of all the country’s health care spending.

So we see that our cocktail napkin math has been extremely useful, and that the article has overstated the size of the issue by some three orders of magnitude! (25% --> 0.01%) The many suggestions in the article that this is important on the level of the entire health care system is absolute bunk.

Thank you for engaging in this exercise with me!

View on HN

ProPublica has been researching why the U.S. health care system is the most expensive in the world. One answer, broadly, is waste — some of it buried in practices that the medical establishment and the rest of us take for granted. We’ve documented how hospitals often discard pricey new supplies, how nursing homes trash valuable medications after patients pass away or move out, and how drug companies create expensive combinations of cheap drugs. Experts estimate such squandering eats up about $765 billion a year — as much as a quarter of all the country’s health care spending.

Tossing such drugs when they expire is doubly hard. One pharmacist at Newton-Wellesley Hospital outside Boston says the 240-bed facility is able to return some expired drugs for credit, but had to destroy about $200,000 worth last year. A commentary in the journal Mayo Clinic Proceedings cited similar losses at the nearby Tufts Medical Center. Play that out at hospitals across the country and the tab is significant: about $800 million per year. And that doesn’t include the costs of expired drugs at long-term care pharmacies, retail pharmacies and in consumer medicine cabinets.