Hardly a week goes by that a call is not received at IJPC related to statistics of pharmaceutical compounding. One can find many different statistics related to compounding, making one wonder "How can so many different numbers be accurate?"

It basically depends upon the "universe" from which prospective pharmacists are selected to fill out the survey questions, what questions are asked, and how accurate the participants' responses are. Also, it depends on the "type of compounding" that is included in the survey. For example, many surveys list very low numbers for the "extent" of compounding. What these surveys omit is the very large amount of compounding done in hospitals, cancer clinics, home care, nuclear pharmacies, chain pharmacies, veterinary pharmacies, etc. Pharmacy compounding is not limited to community pharmacies; it is very widespread and is a vital component of modern health care.

Good statistics are needed to support the different efforts being conducted to improve the scope, extent, reimbursement, regulatory, and other issues related to patient access to compounded medications. Please take a few minutes to complete the following survey so we can begin to find out "Where are we now."

News

USP <800> Announcement
As announced in this newsletter a few weeks ago, the newly revised version of USP <800> Hazardous Drugs—Handling in Healthcare Settings is available for review and comment. Please review it carefully and respond as you wish; numerous changes have been made. Here is the link to the proposed revised chapter to access and print out.
http://www.usp.org/usp-nf/notices/general-chapter-hazardous-drugs-handling-healthcare-settings

Why are Costs of Generic Drugs Skyrocketing?
The Texas Medical Association (TMA) is joining the call for a Congressional investigation into the suddenly skyrocketing costs of generic drugs. Generics are a life line for many low- and middle-income families who can't afford the prohibitive costs of name-brand drugs. TMA President Dr. Austin King says there is no known reason for price jumps like the one of the asthma drug Albuterol; the generic version of the drug jumped in the past year from $11 per month to $434. "I don't see that there is any reason for the price levels which are being paid for a lot of these generic drugs," King said. The generic drug makers have no R&D expenses, so King says there is no reason for them to suddenly jack up drug prices. The financial records of 14 generic drug makers have been subpoenaed by a Congressional committee.
http://www.woai.com/articles/woai-local-news-sponsored-by-five-119078/why-is-the-cost-of-generic-13022271/

Private Oncologists in Private Practice Being Forced Out; Patients Facing Higher Bills
When Dr. Jeffery Ward, a cancer specialist, and his partners sold their private practice to the Swedish Medical Center in Seattle, the hospital built them a new office suite 50 yards from the old place. The practice was bigger, but Dr. Ward saw the same patients and provided chemotherapy just like before. On the surface, nothing had changed but the setting. But, treatments suddenly cost more with higher co-payments for patients and higher bills for insurers. Another difference is that cancer patients and their insurers buy chemotherapy drugs from their medical providers. Swedish Medical Center, like many other others, participates in a federal program that lets it purchase these drugs for about half what private-practice doctors pay, greatly increasing profits. One thing is clear: The private-practice oncologist is becoming a vanishing breed, driven away by the changing economics of cancer medicine.
http://www.nytimes.com/2014/11/24/health/private-oncologists-being-forced-out-leaving-patients-to-face-higher-bills.html?ref=health&_r=1

Lawmakers Looking to Reduce Rising Cost of Generic Drugs
A Senate panel has been convened to investigate price increases for generic drugs. One half of generic drugs increased in price between last summer and this summer; of these, about 10% more than doubled in cost in that time and some common drugs increased by over 500% (From the Congressional hearing). The cost of many generics increased so much over the past year that prices for many common generic drugs in the U.S. have surpassed those of their brand-name equivalents in other developed countries.

As an example, a 90-day supply of digoxin sells for $187 in New York; the branded version, Lanoxin, sells for $24.30 in Canada; a month's supply of a generic steroid to treat inflammatory bowel disease sells for $1,625 in the U.S. while the branded version sells for $155.70 in Canada.
http://www.nytimes.com/2014/11/25/us/lawmakers-look-for-ways-to-provide-relief-for-rising-cost-of-generic-drugs.html?ref=us&_r=0

New York AG Demands Reason for High Cost of Heroin Antidote
With a sudden and sharp increase in the price of naloxone, New York AG Eric T. Schneiderman wrote to the CEO of the company making the drug, demanding an explanation for what he called an "unacceptable" rise. The strongly worded letter amplifies growing concerns of police and public-health officials from Georgia to San Francisco about a recent jump in the cost of the drug; in some cases the price more than doubled. The generic version of the drug has steeply increased in price in recent weeks, and "These increases threaten to curtail access to a drug just when it is needed most," Mr. Schneiderman wrote to Jack Y. Zhang, the chief executive of Amphastar. "To date, Amphastar Pharmaceuticals has failed to provide any satisfactory explanation for dramatically increasing the price of a critical lifesaving drug."
http://www.nytimes.com/2014/12/02/nyregion/new-york-attorney-general-critical-of-heroin-antidotes-cost.html?ref=health&_r=0

Top 10 Lists of Pharma Companies in 2013

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Did You Know ...

�that pharmacists are HOT!!!? The Scoville scale (developed by pharmacist Wilbur L. Scoville, the author of numerous editions of The Art of Compounding beginning in 1885) developed this "HEAT SCALE" in 1912. It is the measurement of the heat of chili peppers or other spicy foods; it is reported in Scoville heat units (SHU), a function of capsaicin concentration. The scale is known as the Scoville Organoleptic Test. The Scoville scale is an empirical measurement dependent on the capsaicin sensitivity of testers. In his method, an exact weight of dried pepper is dissolved in alcohol to extract the heat components (capsinoids), then diluted in a solution of sugar water. Increasing concentrations of the extracted capsinoids are given to a panel of five trained tasters, until a majority (at least three) can detect the heat in a dilution. The heat level is based on this dilution, rated in multiples of 100 SHU.

Tip of the Week

Scoville numbers that are very high can actually be dangerous and should not be used for pranks, etc. They do serve as a good guide for selecting the "heat level" of the hot sauces frequently used.

Looking Back

Pull off the road,
To change a flat!
Protect your life,
No spare for that!
     Burma Shave