The vial that's too valuable to waste, and too restricted to move
A single short-dated vial can be worth thousands of dollars, with nowhere compliant to go.
It was ordered for a patient whose therapy changed, or it arrived as an overage on a limited-distribution drug. It can't be dispensed here, the manufacturer won't take it back, and reverse distribution returns pennies on a very expensive dollar. So it sits in the refrigerator, counting down.
Another verified specialty pharmacy needs exactly that drug right now, and the trade can be fully documented, cold chain and all.