Thursday, October 11, 2012

14 dead; 170 sick--Article points out compounding pharmacists also work for veterinary practices


Meningitis outbreak: What is a compounding pharmacy?

By Jacque Wilson, CNN
updated 2:20 PM EDT, Thu October 11, 2012
CNN) -- News of a recent meningitis outbreak has sent many Americans into panic mode.
As of Thursday afternoon, 170 people in 11 states had become sick with the noncontagious fungal meningitis; 14 of those have died. Health officials expect those numbers to rise as the investigation continues.
The cases have been linked to injections of contaminated steroid medication made by the Massachusetts-based New England Compounding Center.
"I'll be skipping my allergy shot," @TheAnchorMom tweeted.
"Maybe this is crazy but ever since the meningitis outbreak I am scare(d) to get a flu shot even (thinking) it will be contaminated," Lana Flores posted on Facebook.
The Centers for Disease Control and Prevention says as many as 13,000 people may have received the contaminated steroid injections.
The idea that a medication created to fix health problems could potentially harm people is frightening, especially when that medication was contaminated in something called a compounding center.
Typically medications are mass-produced by drug manufacturing companies. So what's a compounding center, and why are we getting our medications from it?
Compounding pharmacists customize medications to fit an individual's needs. Doctors prescribe these custom medications when the manufactured drug won't work -- for example, when a dosage is too large, or a patient has an allergy to a dye or ingredient in the original product.
Pharmaceutical compounding is a common practice, said David Miller, executive vice president and CEO of the International Academy of Compounding Pharmacists. In fact, compounding is the way all medications were made up until about the 1950s, when mass manufacturing of medications began.
"That was the only way that medications could be filled for people -- having pharmacists making it from scratch," Miller said.
Now compounding pharmacists work in pharmacy centers like the New England Compounding Center, in hospitals, in small independent drugstores, and in drugstore chains like Walgreens or CVS across the country. But only 1% to 3% of all prescriptions currently dispensed in the United States are compounded, according to the IACP.
Dr. Jennifer Shu, a pediatrician in Atlanta, said she regularly writes prescriptions for compounded medications for her child patients.
Sometimes it's to ask the pharmacist to turn a manufactured pill into liquid form so children can take it easily. Other times the compounding pharmacist adds a flavor to the medication to make it more appealing.
"That's just our only option," Shu said, "unless you want to sneak it into their food."
Hospitals often ask for compounded drugs to receive the correct dosage for specific surgeries. If the manufactured bottle contains too much, they would have to waste the rest of the medication since the sterilized seal has been broken. Compounding pharmacists also work for veterinary practices. Many of the same medications we take can be customized for our pets or the animals in zoos.
Kevin Outterson, an associate professor of health law and bioethics at Boston University, said there's been a recent increase in reliance on compounding pharmacies in the United States. Physicians and clinics are increasingly getting material from compounding pharmacies because they can sell drugs at a lower cost than major manufacturers, he said.
Compounding pharmacies usually make only a couple of doses for a specific patient, which can lower the cost of production. Of course, the opposite can also be true -- if the compound is a complex cancer drug, producing just a few doses would be exponentially more expensive than mass production.  To continue reading click here

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