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Editorial: The price of a life and pharmacy education?

Academic and organizational pharmacy have been promoting the practice of clinical pharmacy since the 1960s (for about 50 years). In the 1970s and 1980s there was a significant change in the curricula of colleges of pharmacy to become more clinically oriented. These changes resulted in the removal of a significant number of science-based classes and laboratories that acquainted and instilled the importance of the science behind drug dosage forms and drug delivery systems and their manufacture, compounding, and actual use. A few schools have retained compounding and laboratories but some are optional; some schools have NO compounding course or laboratories.

Let's fast-forward to today. We now have compounding pharmacy that has significantly grown since the 1980s and sterile compounding since the 1990s. For example, let's look at the following:

• Almost 70,000 pharmacies are involved in compounding (e.g., independents, chains, hospitals, nuclear, specialty).
• Compounding is a $22 to $25 billion dollar industry annually.
• Over 80% of independent pharmacies compound.
• Generally all hospital pharmacies perform compounding.

These numbers simply emphasize that compounding pharmacy is a vital and growing part of health care today! The training of pharmacists has long been handled by colleges of pharmacy. However, we are in a situation where the colleges of pharmacy in most universities are not adequately training pharmacists to do the exact thing for which pharmacists are known, and there is no other profession charged with this responsibility.

Yes, there have been many unfortunate events in the past couple of years. The question remains, "Why are pharmacists not being trained to be proficient in both nonsterile and sterile compounding?" Since this is a significant part of pharmacy practice, is this a situation of "malpractice" at the college of pharmacy level or just slow response? When confronted with the question of why compounding isn't taught, college deans often say it costs too much! It almost looks like a price is being placed on a human life.

Let's hope that the "powers that be" will begin the process of re-incorporating the sciences, compounding, and sufficient laboratory experiences to properly train pharmacists in both nonsterile and sterile compounding; patients' lives depend on it! We can all work together to enhance the quality of pharmacy practice by changing to a curriculum that prepares students for the current practice of pharmacy!

Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
International Journal of Pharmaceutical Compounding
Remington: The Science and Practice of Pharmacy Twenty-second edition

Androgen Replacement Therapy Growing
Forty-years and older American men have tripled their use of androgen replacement therapy between 2001 and 2011; this includes a greater than 5-fold surge in use of the hormone testosterone as a topical gel. The findings, published in a research letter in the August 12/26 issue of JAMA Internal Medicine, studied prescription drug claims data; some 10.74 million men aged 40 years or older were included in the study population. Androgen use rose from 0.81% in 2001 to 2.91% in 2011.
http://www.medscape.com/viewarticle/809321

More than Half Psoriasis Patients Surveyed are Dissatisfied
Psoriasis affects millions of Americans, but a new study suggests it remains woefully undertreated. In 2011, between 30% and nearly 50% of patients said they had no treatment for their psoriasis. Nontreatment and undertreatment of psoriasis patients is a significant problem in the U.S. The undertreated patients might be using only a topical cream to ease their psoriasis, when the addition of a systemic drug might help even more. Discontinuation of therapy is widespread (the most common reason given was unwanted side effects) followed by the inability to obtain adequate insurance coverage.
http://consumer.healthday.com/diseases-and-conditions-information-37/psoriasis-news-621/many-psoriasis-patients-going-without-treatment-study-finds-679240.html

Two More Patents Revoked by India
India has revoked two patents on Allergan's ophthalmic products; the latest in a series of intellectual property setbacks suffered by PHARMA companies. These revocations follow last week's rebuttal of GlaxoSmithKline Plc's Indian patent on the breast cancer drug Tykerb.
http://articles.economictimes.indiatimes.com/2013-08-09/news/41240724_1_patents-drugmakers-eye

Detailing Physicians More Difficult
The most restrictive specialty for pharmaceutical sales representatives is oncology; for the second year in a row. A report found that about 65% of oncologists in the U.S. placed moderate-to-severe restrictions on visits from pharmaceutical sales reps. For comparison, about 58% of cardiologists and 47% of primary care physicians restrict representatives access to the same degree. It should be noted that in 2008, only 17% of oncologists restricted access. The average representative can see an oncologist only seven or eight times per year. Access rates vary across the country.
http://www.fiercepharma.com/press-releases/oncology-remains-most-restrictive-specialty-second-year?utm_medium=nl&utm_source=internal

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�that human history becomes more and more a race between education and catastrophe? (H.G. Wells)

A professional education does not prepare one for a lifetime but rather to enter the profession competently; it is also the beginning of a life-long learning process.

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