PHARMACY

How tough should compounding oversight be?

BY Jim Frederick

When considering new, stiffer regulations governing the compounding of medicines in the wake of the meningitis outbreak, tread carefully and don’t throw the baby out with the bathwater.

That’s the message chain pharmacy had for Congress as lawmakers mull new restrictions on drug compounding by pharmacists.

Both the House and Senate held hearings last week on a deadly outbreak of a rare strain of fungal meningitis whose origin is tied to several batches of steroids produced by the New England Compounding Center in Massachusetts. Federal investigators found contamination from mold and bacteria at the center, and some congressional lawmakers from both parties are vowing to write new legislation to boost the authority of the Food and Drug Administration over compounding pharmacies.

As of mid-November, the disease had already sickened 438 people in 19 states and killed 32. Members of the U.S. Senate Committee on Health, Education, Labor and Pensions and the U.S. House Committee on Energy and Commerce grilled FDA Commissioner Margaret Hamburg about the FDA’s actions leading up to shipments of the tainted steroids, but Hamburg defended the agency, saying its authority over compounding pharmacies is limited and unclear.

Hamburg told lawmakers the FDA needs the legal power to adopt a tiered approach to overseeing compounding centers that separates them into “traditional” compounders – which fall under the authority of state boards of pharmacy – and “nontraditional” compounding pharmacies. Nontraditional centers like the NECC, she argued, should be treated as manufacturers and required to register with the FDA and forced to subscribe to other guidelines for drug manufacturers.

Chain pharmacy leaders, however, are worried Congress will take a legislative sledgehammer to the problem of poorly regulated compounding pharmacies. In a Nov. 14 letter to the Republican and Democratic heads of both committees, the National Association of Chain Drug Stores reminded lawmakers that compounding is part of pharmacy’s basic DNA and has been a core part of the profession since its earliest days. What’s more, NACDS noted, “Compounding services are the only source of critical medications for millions of patients with unique health needs. For these patients, there are no commercially manufactured preparations available. Through compounding, pursuant to a prescription, pharmacies provide these patients with personalized medications.”

The group also pointed out that “the type of compounding tied to the recent meningitis outbreak — sterile compounding — is a much smaller subset of compounding, and sterile compounding must be performed in very controlled settings. Sterile compounding is not the kind of compounding that is typically available to a patient who walks into a chain pharmacy to fill a prescription.”

Also urging caution at last week’s Senate hearing was David Miller, CEO of the International Academy of Compounding Pharmacists. Miller said he was “very concerned” over calls for a tiered approach to regulation of compounding pharmacies. “The more complex we make this and the more we get into the shuffle between who is accountable…we will not resolve this problem,” he told panelists. “Either you are a pharmacy or you are a manufacturer."

How should compounding be regulated to prevent any future meningitis outbreaks or other tragedies? Click the link below to share your thoughts.

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Pfizer, Cystic Fibrosis Foundation Therapeutics partner in drug-discovery initiative

BY Alaric DeArment

BETHESDA, Md. — The drug-discovery division of the Cystic Fibrosis Foundation is teaming up with drug maker Pfizer to find new treatments for patients with the most common genetic mutation of the disease.

Cystic Fibrosis Foundation Therapeutics announced a $58 million partnership with Pfizer to discover new drugs for CF patients whose disease has the Delta F508 mutation, present in nearly 90% of patients, in which a defective protein called CFTR does not fold correctly and is unable to reach the cell surface so it can maintain proper flow of salt and fluids into the airways. Because of this, thick secretions form in the airways, leading to serious lung infections and damage.

"We are excited to expand our efforts with Pfizer to accelerate the development of more therapies that treat the root cause of CF and benefit the greatest number of people with the disease," CF Foundation president and CEO Robert Beall said. "Pfizer brings impressive technical and scientific expertise, along with its commitment to improving the lives of people with cystic fibrosis."


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FDA approves GSK drug for hepatitis C patients with low platelet counts

BY Alaric DeArment

LONDON — The Food and Drug Administration has approved a drug for a condition that can complicate treatment for hepatitis C.

GlaxoSmithKline said Monday that the FDA had approved Promacta (eltrombopag) for treating low blood-platelet counts, also known as thrombocytopenia, to allow patients with hepatitis C to undergo and maintain interferon-based therapy. The drug already had FDA approval to treat chronic immune thrombocytopenia. 

"Some chronic hepatitis C patients suffer from low blood platelet counts," GSK Oncology president Paolo Paoletti said. "Commonly prescribed interferon-based therapies can worsen the problem of low blood-platelet counts. Today’s FDA approval of Promacta gives doctors a tool to address the low platelet challenge."


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