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Editorial: ASHP Clinical Midyear Lacks Compounding Programming

Having just returned from the 2011 ASHP Clinical Midyear Meeting in New Orleans, promoted as the largest gathering of pharmacists in the world, one wonders what the programming committee considers as important topics.

In a year where the number of drugs in short supply exceeds 250, and profiteering rampant among those greedy companies that can purchase and then resell at up to 4000% profit, one wonders why there was no dedicated programming on compounding of drugs in short supply or criteria involved in selecting a compounding pharmacy for outsourcing, both nonsterile and sterile.

Actually, there appeared to be only about 3 posters related to compounding and only one podium presentation. There were untold numbers of sessions on therapeutics, automation, administration and other topics that are covered in detail every year.

With hospitals implementing USP <797> and many actually outsourcing compounding to those pharmacies that can service them, one wonders what is the reason for the lack of programming related to pharmacy compounding. Is it that many pharmacists have not been trained in compounding and realize its importance? Or, they are so busy with distributive, administrative and clinical duties they don't have time to worry about the drugs that are required for their patients? After all, without the drugs, there is not much need for pharmacists. Or, is it that many consider the highly technical and scientifically based compounding practice can be done by technicians; some of which are good but they do not have the background necessary for formulation, quality assurance, etc. And none have the knowledge base or the responsibility of final approval that a pharmacist has.

It was a very disappointing meeting from the standpoint of educational sessions. There were a significant number of compounding support companies in the exhibit hall and their presence was quite significant. However, to me it seems that there is a disconnect between ASHP programming and the critical needs of patients for their pharmaceuticals.

Just as a note, the Jan/Feb issue of IJPC will provide formulations for ten electrolyte solutions listed as being in short supply.


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

AZ cuts 1,150 jobs in US, adds on in China
It seems that more and more pharmaceutical manufacturers are announcing job cuts in the U.S. and expansions in Asia in almost the same breath. Eli Lilly (fall 2009), saying it would cut 5,500 jobs in U.S. and other established markets as it doubled its sales force in China; Novartis (Nov 2011) disclosed plans to slash 2,000 jobs, including more than 1,000 in Switzerland, while adding 700 jobs in China, India and other low-wage countries.

Now, AstraZeneca just announced it would cut its U.S. sales operation by 1,150 jobs, about 24% of the salesforce. These cuts are in addition to the 400 U.S. job losses announced in October. The company also announced a deal to buy Chinese generics maker Guangdong BeiKang Pharmaceutical. It's AstraZeneca's second outright acquisition of a generics company, although it has inked partnerships with Aurobindo Pharma and other emerging market firms. And it's the company's latest expansion move in China, where it's already the second-biggest foreign pharma. AstraZeneca has recently said it would invest $200 million into a manufacturing facility there.
http://www.marketwatch.com/story/astrazeneca-expands-in-china-buys-antibiotic-firm-2011-12-08
http://www.reuters.com/article/2011/12/07/astrazeneca-jobs-idUSL5E7N74JQ20111207

Scalping Cancer Drugs
Some companies are purchasing critical cancer medications in short supply and then attempting to resell them at inflated prices ranging from 650 percent to 4,000 percent over the usual cost. This "gray market" does not violate the law and could even be in a position to expand further following the presidential signing of an executive order that attempted to correct the problem. However, it may have only widened the loophole.
http://www.pharmacistelink.com/index.php/drugs-and-treatment/651-cancer-drug-scalpers-corner-us-market

Bayer Withheld Yasmin Data
The former head of the FDA reported that Bayer withheld findings by company researchers of increased reports of blood clots in users of its Yasmin birth-control pills.

Bayer presented a selective view of the data that obscured the potential risks associated with Yasmin and the company also promoted the oral contraceptive for unapproved uses, particularly for treatment of premenstrual syndrome.

Bayer faces more than 10,000 lawsuits over injuries allegedly caused by the contraceptives. Lawyers suing the drugmaker cited FDA reports of at least 50 deaths from 2004 to 2008.
http://www.bloomberg.com/news/2011-12-05/bayer-withheld-yasmin-clot-risk-data-from-u-s-ex-agency-head-tells-court.html

FDA Approves Hangover Medication
The FDA has approved a new OTC hangover medication called Blowfish. It combines 1,000 milligrams of aspirin, 120 milligrams of caffeine and a "stomach-soothing agent" into two effervescent tablets taken the morning after a night of heavy drinking. The drug costs $2.99 for a single dose.
http://articles.nydailynews.com/2011-12-03/news/30473060_1_hangover-tablets-aspirin

� that according to reports, some hospitals have up to two full-time pharmacists now involved in sourcing drugs that are in short supply?

Vital Curriculum
Encourage your alma mater to re-evaluate their curriculum as it relates to the sciences, calculations and compounding/formulation/physical pharmacy laboratories. This time-honored part of pharmacy is now more important than ever!

Brother Speeder,
Let's Rehearse,
All together,
Good morning, Nurse!
-Burma Shave

Specialty Compounding - Initial Accreditation: Ray Solano, RPh, PIC; Sterile and Nonsterile Compounding

Reed's Compounding Pharmacy - Reaccreditation: Tom Reed, RPh, Owner; Sterile and Nonsterile Compounding

Patients, prescribers, and payers now have 135 accredited pharmacies from which to choose!