Comments Being Posted to Wall Street Journal Regarding Express Scripts Decision to End Coverage for 1000 compounded drug ingredients are all across the board from Compounders make snake oil, they are greedy and ruin for all to some , Pharmacists calling out the compounding system and others who blame Express Script and argue they need the medications

http://blogs.wsj.com/pharmalot/2014/07/01/express-scripts-ends-coverage-for-1000-compound-drug-ingredients/tab/comments/

Here are a few: 

Bill,RPh,PhD wrote:

These so called compounded medications do not have the support of clinical trials. In many cases, there is no evidence to support that topical products are absorbed to the extent that a pharmacologic response can be expected. Where are the ethical pharmacists that are looking out for the patient? What did you learn in pharmacy school about absorption? Please stop hiding behind the PCCA front.

• • 12:21 pm July 7, 2014
  • Bill,RPh,PhD wrote:
  Harold, do you have the integrity to list the prices of these APIs? I do not think you do. Pain creams with one or two ingredients are one thing. For instance, this is from the current 2014 PCCA catalog, 1 gram of capsaicin is $88. 10 g of capsaicin is $646. If the starting concentration was 0.1%, and it usually is not this high, you could make 1000 g (approximately 2.2 pounds) of product from the 10 g of starting material. Pharmacy students learn to make creams in 2 – 3 hours. How do compounding pharmacists justify their billing? PCCA may have had their philosophy in line with providing excellent patient care at one time. Now they are fronting for pharmacists charging exorbitant fees for products.

• • 12:43 pm July 7, 2014
  • Whip, RPh, PhD wrote:
  Bear in mind also that AWP is an imaginary price provided by ingredient manufacturers to help the compounder justify an unrealistically high cost for the medications. The actual acquisition cost is invariably much less than AWP. AWP minus 10% may represent a huge profit on the mixture, even without the “meager dispensing fee.”