Wednesday, June 4, 2014

Results from Iowa Inspections of Non Resident Compounding Pharmacies

Iowa/NABP Pharmacy Inspection Project

Results



The Board recently completed a special project in which nearly

80% of nonresident (out-of-state) pharmacies licensed to do business

in Iowa were inspected. Between December 1, 2012 and December

31, 2013, a total of 538 nonresident pharmacies were surveyed with

the assistance of the field services division of the National Association

of Boards of Pharmacy® (NABP®).



The pharmacies that were inspected were located in 42 states.

The top 10 states were:

♦ Florida: 69 pharmacies

♦ Illinois: 45 pharmacies

Nebraska: 41 pharmacies

♦ California: 31 pharmacies

♦ Pennsylvania: 30 pharmacies

♦ Minnesota: 26 pharmacies

♦ Missouri: 22 pharmacies

♦ Tennessee: 21 pharmacies

♦ Texas: 20 pharmacies

♦ Ohio: 20 pharmacies



A total of 263 pharmacies (49%) were found to be engaged in some

form of compounding. One hundred thirteen pharmacies (21%) were

found to be doing both sterile and nonsterile compounding. Eighty five



pharmacies (16%) were doing only nonsterile compounding,

while 65 pharmacies (12%) were doing only sterile compounding.

Of those pharmacies that were engaging in sterile compounding,

the following was observed:

♦ High-risk preparations by prescription: 93 pharmacies

♦ High-risk preparations without a prescription: 40 pharmacies

♦ Medium-risk preparations by prescription: 121 pharmacies

♦ Medium-risk preparations without a prescription: 24 pharmacies

♦ Low-risk preparations by prescription: 134 pharmacies

♦ Low-risk preparations without a prescription: 23 pharmacies



In addition, 158 pharmacies (29%) were found to be performing

bulk compounding without a prescription in anticipation of receiving

prescriptions. There were 14 pharmacies that were also licensed as

a distributor, with internal movement of compounded product from

the pharmacy to the distributor.

These pharmacies ranged in size from 65 square feet to 163,000

square feet. The size of their compounding areas ranged from two

square feet to 1,000 square feet.

The number of pharmacists per facility ranged from one to 258,

while the number of pharmacy technicians ranged from one to 668.

Some facilities dispensed up to 90,000 prescriptions per day. The

number of prescriptions dispensed to Iowa patients ranged from

one to 1,285 per day.

Interestingly, 47 of these same pharmacies (8.7%) were also

inspected by Food and Drug Administration (FDA) during the

same time period. Twenty-six of those pharmacies (4.8%) received

a warning letter from FDA.

One hundred nine pharmacies (20%) were found to be operating

under a waiver granted by their home state board of pharmacy. The

types of pharmacies inspected included the following:

♦ Traditional retail/Community

Health Maintenance Organization/Pharmacy Benefit Management



only

♦ Institutional (hospital or long-term care)

♦ Mail order

Central fill/Central processing

♦ Internet pharmacy

♦ Telepharmacy



The results of these inspections have been reviewed by the Board.

In some cases, nonresident pharmacies have been issued letters of

education or administrative warnings. In other cases, nonresident

pharmacies have been issued a Statement of Charges and Notice

of Hearing, which initiates the formal disciplinary process. More

information will be released as it becomes available.

As of April 22, 2014, Iowa has 685 nonresident pharmacies actively

licensed to do business in Iowa.
quoted from here


No comments: