Meningitis outbreak: What is a compounding pharmacy?
updated 2:20 PM EDT, Thu October 11, 2012
CNN) -- News of a recent meningitis outbreak has sent many Americans
into panic mode.
As of Thursday afternoon, 170
people in 11 states had become sick with the noncontagious fungal meningitis; 14 of
those have died. Health officials expect those numbers to rise as the
investigation continues.
The cases have been linked to
injections of contaminated steroid medication made by the Massachusetts-based
New England Compounding Center.
"I'll be skipping my allergy
shot," @TheAnchorMom tweeted.
"Maybe this is crazy but ever
since the meningitis outbreak I am scare(d) to get a flu shot even (thinking) it
will be contaminated," Lana Flores posted on Facebook.
The Centers
for Disease Control and Prevention says as many as 13,000 people may have
received the contaminated steroid injections.
The idea that a medication
created to fix health problems could potentially harm people is frightening,
especially when that medication was contaminated in something called a
compounding center.
Typically medications are
mass-produced by drug manufacturing companies. So what's a compounding center,
and why are we getting our medications from it?
Compounding pharmacists customize
medications to fit an individual's needs. Doctors prescribe these custom
medications when the manufactured drug won't work -- for example, when a dosage
is too large, or a patient has an allergy to a dye or ingredient in the original
product.
Pharmaceutical compounding is a
common practice, said David Miller, executive vice president and CEO of the International Academy of Compounding
Pharmacists. In fact, compounding is the way all medications were made up
until about the 1950s, when mass manufacturing of medications began.
"That was the only way that
medications could be filled for people -- having pharmacists making it from
scratch," Miller said.
Now compounding pharmacists work
in pharmacy centers like the New England Compounding Center, in hospitals, in
small independent drugstores, and in drugstore chains like Walgreens or CVS
across the country. But only 1% to 3% of all prescriptions currently dispensed
in the United States are compounded, according to the IACP.
Dr. Jennifer Shu, a pediatrician
in Atlanta, said she regularly writes prescriptions for compounded medications
for her child patients.
Sometimes it's to ask the
pharmacist to turn a manufactured pill into liquid form so children can take it
easily. Other times the compounding pharmacist adds a flavor to the medication
to make it more appealing.
"That's just our only option,"
Shu said, "unless you want to sneak it into their food."
Hospitals often ask for
compounded drugs to receive the correct dosage for specific surgeries. If the
manufactured bottle contains too much, they would have to waste the rest of the
medication since the sterilized seal has been broken. Compounding pharmacists
also work for veterinary practices. Many of the same medications we take can be
customized for our pets or the animals in zoos.
Kevin Outterson, an associate
professor of health law and bioethics at Boston University, said there's been a
recent increase in reliance on compounding pharmacies in the United States.
Physicians and clinics are increasingly getting material from compounding
pharmacies because they can sell drugs at a lower cost than major manufacturers,
he said.
Compounding pharmacies usually
make only a couple of doses for a specific patient, which can lower the cost of
production. Of course, the opposite can also be true -- if the compound is a
complex cancer drug, producing just a few doses would be exponentially more
expensive than mass production. To continue reading click here
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