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Editorial: Are Our Pharmacy Leaders Missing an Opportunity?

With 19 deaths and over 250 sickened due to contaminated injections (10/18/12), we have heard interviews with physicians, nurses, some pharmacists, patients, and a lot of the news media, but we seem to be lacking interviews from many of the leaders in pharmacy, with the exception of IACP which has done an excellent job in keeping many informed.

However, what about the larger picture and the reputation of pharmacy? I have received numerous telephone calls and e-mails from pharmacists wondering why there has been very little input on the situation from our leaders. It appears we may be losing an excellent opportunity to educate the public on the importance of compounding. (Please refer to last week's newsletter for additional information.)

Many in the public are "knee-jerking" and saying that "something must be done"! However, the bottom line is that pharmacists must obey the laws and regulations, and meet the required standards for whatever practice of pharmacy in which they are involved. If this happens, then the public is protected and the pharmacist has a successful practice in serving their patients.

No matter what laws, regulations, and standards are in place, if they are not followed, the public is put at risk, and death and sickness may result! It is important to let the public know that the majority of pharmacists adhere to the laws, regulations, and standards and we have the safest medication supply in the world. However, those that enforce the law may need to do a better job. I don't believe we really need any new laws or regulations, but we need better enforcement of those we already have; we also need reasonable clarification on differentiating compounding from manufacturing (i.e., when does a compounding facility become a manufacturing facility?).

In summary, there are many ways our leaders in pharmacy could be "hitting the airways" in this terrible situation to help educate the public and not rely on non-pharmacists to give their (often inaccurate) opinions!


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

Compounding Pharmacies Rise in Popularity Amid Safety Questions
Pharmacy compounding, the way drugs were made available for centuries, was a quaint activity depicted on drugstore calendars from the 1950s. However, it has roared back in the 21st century, driven by numerous unrelated factors. Today, nearly every place medical care occurs—hospitals, doctor's offices, home-health companies—now gets at least some of its medications that are unavailable from the pharmaceutical industry. What's not in dispute is how much U.S. medicine has come to rely on this part of the economy. As with everything, there are risks and benefits that must be considered.
http://www.washingtonpost.com/national/health-science/compounding-pharmacies-rise-in-popularity-but-bring-questions-about-safety/2012/10/13/e87f8cc2-14a0-11e2-ba83-a7a396e6b2a7_story.html

Cost Matters in Cancer Care
Memorial Sloan-Kettering Cancer Center recently decided they are not going to give a very, very expensive new cancer drug to their patients. The reasons are simple: (1) the drug, Zaltrap, has proved to be no better than a similar medicine already used for advanced colorectal cancer, and (2) its price—$11,063 on average for a month of treatment—is more than twice as high.
http://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html?_r=0

Pharmacists Indicted in Oxycontin Case
New federal charges have been filed in a Los Angeles controlled substance case. According to an indictment, from about August 2008 to February 2010, Mike Mikaelian and Anjelika Sanamian headed a Westlake operation where Oxycontin was prescribed more than 10,833 times, which resulted in a distribution of more than 900,000 Oxycontin pills on the streets. The Oxycontin was then allegedly routed back to clinic operators and sold on the street. Millions of dollars in false claims were also billed to Medicare and Medi-Cal. Five others, including four pharmacists, were charged in the new indictment which alleges a conspiracy to distribute controlled substances, a conspiracy to commit healthcare fraud, money laundering, and structuring financial transactions. According to court documents, the defendants used the proceeds from the sales to gamble at casinos, purchase cars and jewelry, and obtain more Oxycontin.
http://latimesblogs.latimes.com/lanow/2012/10/federal-indictment-charges-five-new-people-in-multi-million-dollar-pill-ring.html

NASA Signs Agreement to Develop Nasal Spray for Motion Sickness
NASA's Johnson Space Center in Houston and Epiomed Therapeutics Inc. of Irvine, California have signed an agreement to develop and commercialize a fast-acting nasal spray containing scopolamine for the treatment of motion sickness. Lakshmi Putcha, developer of the innovative treatment strategy at Johnson, stated,

"NASA and Epiomed will work closely together on further development of INSCOP to optimize therapeutic efficiency for both acute and chronic treatment of motion sickness which can be used by NASA, the Department of Defense and world travelers on land, in the air and on the seas."

A gel formulation was previously developed and tested under a Space Act Agreement between Johnson and the Naval Aerospace Medical Research Laboratory in Pensacola, Fla.
http://www.fiercedrugdelivery.com/press-releases/nasa-signs-agreement-develop-nasal-spray-motion-sickness

(Editor's Note: Maybe they should have contacted a compounding pharmacist and saved a lot of taxpayer money!)

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...that if you try to say the alphabet without moving your lips or tongue, every letter will sound about the same?

Get your talking points from reliable sources such as IACP and respond to your patients questions in a compassionate and informative way.

The Practitioner's Quick Reference to Nonprescription Drugs
2nd ed.
Dlugosz CIK, ed.
APhA; 330 pages; October 2012; $34.95

The second edition of this book contains information from APhA's comprehensive 17th edition. The information has been edited and formatted to include only the content that practitioners are most likely to need during self-care consultations with patients. It covers 25 common self-treatable conditions including acne, common cold, cough, fever, and headache. Each chapter contains the treatment algorithm, clinical pearls and tables, bulleted key points, and a detailed index. It is a valuable resource for busy pharmacists.

Henry the Eighth
Prince of friskers,
Lost five wives
But kept his whiskers.
      Burma Shave