Drug compounding used to be a corner-shop business, in which local pharmacists would mix a batch of drugs for specific patients with particular needs — and detailed prescriptions. That still happens. But over the years, compounding also turned into a much bigger industry. Some compounders now operate more like large-scale drug manufacturers than small-time pharmacists, which is how the tainted back-pain injections found their way from a Framingham, Mass. compounding center to all over the country last year. Yet these operations don’t face the same scrutiny from the Food and Drug Administration (FDA) as do big drugmakers, and state-level regulation is inconsistent.
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