Well, it's just a couple of days until we will celebrate another Christmas. A lot has happened this past year in our profession, society, country and world; some has been good and some has not been good. One thing is apparent however, and that is the following: "The individual or group that talks the strongest, exerts the most energy and is dedicated and committed to what they are trying to accomplish, often gets the job done against all odds".

In pharmacy, it seems that we are always facing an up-hill battle for recognition, reimbursement and rights.

Recognition: This year we moved back up in the Gallop Poll for our standing as among the most respected profession. However, we have not made significant strides in being recognized for our clinical roles as evidenced by reasonable reimbursement for our cognitive clinical services. We are recognized among many health professionals for our contribution to individualized patient care through compounding and we continue to make strides in this arena. We still need to become more vocal in who we are, what we do and how it positively impacts healthcare at the individual patient level.

Reimbursement: This is a "mixed bag." Reimbursement levels for dispensing commercial products is ridiculously inadequate. Why must we sell candy, cosmetics and cards to make money to stay in business so we can give prescription drugs away at less than our cost? Reimbursement for compounding is minimal and we may want to continue to stay out of the insurance-reimbursement arena because we have no assurance that we would ever get a fair and reasonable price for the efforts we expend in compounding quality prescription preparations. It seems to work reasonably well for the patient to pay and then be reimbursed by the third party payor. How long is it going to take for third parties to realize that compounding pharmacies, properly compensated, can save them millions of dollars in providing individualized care?

Rights: We are a profession established by the laws within each individual state. Pharmacy should never seek licensing at the national level because states will lose control and states have unique circumstances that must be individually addressed; this cannot be done at the national level. Many seek to infringe upon the rights of pharmacy for their own economic gain; namely some pharmaceutical companies such as Wyeth-Ayerst, Chiron, etc. It seems ridiculous that these companies that make hundreds of millions of dollars are concerned about compounding pharmacies that service their own patients with safe and effective quality compounded prescriptions. It might be nice if they spent their effort and money on finding new drugs rather than attacking pharmacy by spouting untruths and misrepresentations and spending hundreds of millions of dollars on direct-to-consumer advertising to influence the drug market. Pharmacists must protect their rights to practice pharmacy and their rights to service their patients with appropriate prescription medications, whether they are manufactured or compounded.

In summary, we have come a long way in enhancing the quality of compounded medications and are performing a great service in our individual communities. However, don't ever think that we can't lose our recognition, reimbursement and rights in just a matter of a few days, weeks or months. We must be constantly vigilant, active and vocal so that we will be around in the future to practice pharmacy and to serve our patients.

We at IJPC want to wish all a Merry Christmas and hope you have time to spend it with family and friends.

Loyd V. Allen, Jr., Ph.D., R.Ph
Editor-in-Chief

CompoundingToday.com is constantly adding tools and resources. Here are ten reasons to set your browser on CompoundingToday.com and keep it there:

• Dec 16th - NEW Disinfectants Tool features information on 12 general classes and 16 specific disinfectant products.
• Dec 9th - Newsletter - FDA and HHS National Leaders Support Individualized Medications!
• Dec 8th - 2 citations/ abstracts on Treatment of Osteoarthritis
• Dec 1st - 35 citations/abstracts on Sports Medicine and Musculoskeletal Injuries
• Nov 30th - Keyword Search Feature for Standard Operating Procedures
• Nov 23rd - Newsletter - Orphan Drugs: Part I
• Nov 23rd - 33 Citations for Compatibility and Stability Articles
• Nov 18th - Newsletter - Acacia is Not Just Used in Drugs?
• Nov 18th - New Book Review for Salt: Your Way to Health
• Nov 17th - 31 Additional Citations/Abstracts on Urogenital and Sexual Disorders in Menopausal Women

This week on the Compounders Network List pharmacists discussed the following topics:

• Marketing Tips
• Progesterone related to the California regulations
• Ethambutol suspension formula for ICU patient
• Stability of tissue plasminogen activator (tPA; alteplase, Activase) for catheter clearance
• Stir bars

Find "Overcoming Arthritis" and more than 100 other books related to pharmacy, compounding and business on CompoundingToday.com's Book Reviews Section.

Overcoming Arthritis by David Brownstein, M.D., 2001
Medical Alternatives Press, West Bloomfield MI 48323 ($15)

Book Review by Betty Jo Grajeda, M.D.

This 228-page book is a must read for those who have challenging patients with difficult to treat inflammatory states such as arthritis, fibromyalgia, vasculitis, thyroiditis, lupus, ulcerative colitis and chronic fatigue syndrome.

Arthritic conditions may be caused by infectious etiologies. The infection may be the cause of the symptoms. Serum testing for viral and bacteria antibodies can help determine if a patient is suffering from a chronic infection. Treatment by antibiotics may be necessary to eradiate the offending organism and allow a patient to return to good health.

In his practice, Dr. Brownstein has successfully treated Rheumatoid Arthritis, Fibromyalgia, Chronic Fatigue Syndrome, Lupus and a variety of other inflammatory states with antibiotics. Thirty case studies are discussed which illustrates the benefits of antibiotic therapy in selected cases.

We are introduced to The Road Back Foundation (www.roadback.org), which has been instrumental in carrying on the work of Dr. Thomas McPherson Brown, who believed that infection was the cause of many inflammatory diseases and he successfully treated many patients with antibiotics.

Nutritional Deficiencies are often seen in chronically ill patients. Nutrient levels can be evaluated with blood tests, urine tests and hair tests. Chronically ill patients are commonly found to be deficient in B vitamins, Vitamin D, Magnesium, Selenium and essential fatty acids.

Patients with chronic inflammatory diseases tend to develop more allergies. An electro-dermal computerized system is used to evaluate allergies. Allergies can be treated with an acupressure technique called Nambudripod Allergy Elimination Technique. NAET is named after is Dr. Devi Nambudripod and has provided amazing results.

Dr Bronstein discusses the approach and treatment of patients in a comprehensive manner. He encourages us to look at diet, heavy metal toxicity, infection, nutrient status, hormonal balance, thyroid function, adrenal function and discusses the testing and treatment of these.

I found the book extremely valuable in helping me to look at infection as a cause of arthritis. This concept makes so much sense and could benefit many patients who are struggling with traditional therapies, which yield them no results.

I highly recommend this concise easy to read book which can be understood by both patients and health professionals. I believe it will help to ease the suffering of many if healthcare providers take these lessons to heart.

This Regulatory Update has been provided by the International Academy of Compounding Pharmacists. For more information, www.iacprx.org.

BHRT Under Attack!
Wyeth Pharmaceuticals recently petitioned the Food and Drug Administration (FDA) to impose harmful restrictions on the compounding and dispensing of bio-identical hormone replacement therapy (BHRT). Wyeth asks for strategic restrictions that, if granted, would put an end to all pharmacy compounding. In addition, Wyeth has unleashed an organized campaign to fuel support for its efforts. We need your help to stop this attempt by pharmaceutical manufacturers to restrict access to compounding and BHRT! Visit http://www.iacprx.org/SaveBHRT.html for information on how you can help.

Keeping Up with Small Parts
Are small equipment parts hard to keep up with? Simply place parts for a certain piece of equipment in a plastic baggie and label it with a marker or printed label. Whenever a part is needed for a specific piece of equipment, simply remove the baggie from its storage drawer or cabinet and all the parts will be together and easily identified, clean and ready to use. It also makes it easy to order replacement parts if the parts in the bag are listed on the bag itself.