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The voice for pharmacy compounding | July 30, 2021

THIS EDITION SPONSORED BY PCCA

Every day, we make a choice to define ourselves by high quality, not low price. We want to do everything we can to help you give your patients reproducible results and the best clinical outcomes possible — because your patients and your pharmacy matter to us. That’s why we choose to go above and beyond what is required and hold ourselves to The PCCA StandardTM. Learn more about this commitment, and why “quality” is not just a word to us, at thepccastandard.com.

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From APC’s CEO

They really really like us

APC President Michael Blaire is away recovering from his daughter’s wedding, so this week’s column is again from CEO Scott Brunner....

 

This past week, a single Facebook ad, part of our campaign to save compounded hormone therapy, garnered:

That’s just one ad among the hundreds our campaign is funding on Facebook and LinkedIn, targeting compounders, patients, prescribers, and policymakers. In addition, traffic at the campaign landing page, compounding.com, has risen exponentially in July, and we’re up about 100 new testimonials for the month. Best of all, those patients are sharing their stories with members of Congress, and we can track visits to the site and clicks by congressional staffers who are visiting.

Point is, our $1.5 million campaign to save cBHT is beginning to hit its stride. Only thing lacking is the last $40,000 that will put us over goal — and allow us to fully implement the remaining ad buys.

If you’ve invested in this effort, thank you. We wouldn’t be where we are without you. Consider now whether you can do more — just a bit more? And if compounded hormones are part of your practice but you’ve not yet given to our campaign: Stop hitchhiking. Stop allowing others to bear the burden of saving your bacon (so to speak). Invest now, do your part, and you just may put us over goal.

Best,
Scott


Thoughts? Concerns? You can reach Scott Brunner at scott@a4pc.org.

This Week

MOU: Reining-in the rumor mill

We’ve been hearing several rumors about the FDA’s interstate-shipping MOU. Please help us make sure state boards of pharmacy are clear on the facts.

As a reminder, we believe the MOU has serious flaws. It’s the subject of litigation that could result in its being withdrawn — but that’s far from a certainty. But by taking action now, state boards of pharmacy can avoid severe curtailment of patient access to compounded medications if they don’t sign by the FDA’s October 2021 deadline.

Rumors to correct:

Individual states cannot negotiate their own customized MOU with FDA. There is only one version of the MOU; it’s a take-it-or-leave it document for every state. This is the MOU.

Signing the MOU absolutely does not commit the state board of pharmacy to review every single compounded prescription from a pharmacy. Rather, via NABP’s data collection tool, boards of pharmacy will require compounders to attest to data on out-of-state shipments once annually. Based on that attestation, the state board will report to FDA any compounder shipping more than 50 percent of compounded preparations out-of-state.

It’s NOT a done deal that the FDA will extend the enforcement deadline. A flurry of extension requests, including from APC and members of Congress, is pretty clear — and has been heard by FDA. CDER director Gail Bormel has mentioned publicly that they’re seriously considering an extension, but it’s far from a sure thing. Boards of pharmacy need to continue to act as if the October 2021 deadline is carved in granite.

Our request of boards of pharmacy hasn’t changed:

  1. Determine now if the board has the authority to sign and comply with the MOU. If state law must be amended, the board should notify FDA immediately and request a delay in enforcement. It should also advise FDA if it has concerns about costs associated with complying with the MOU.
  2. If the board has authority to sign and comply with the MOU, it should prepare to sign it — but wait until just before the deadline to do so to allow the litigation to run its course, and also to delay for the state having to comply with the MOU before its effective date.

We appreciate any help you can give keeping this high on your pharmacy board’s radar — and correcting any misperceptions!

Don’t miss this Stat op-ed

...and not just because it was penned by APC CEO Scott Brunner. "On compounding, the FDA marches to the beat of its own biases" is a detailed, point-by-point look at how often the agency’s puts its own agenda ahead of everything else.

[T]he FDA impugns pharmacy compounding by insinuating that because each of the millions of individually compounded preparations are not FDA-approved (which is true) they are therefore unsafe (which is a logical fallacy). Never mind that Congress specifically and intentionally exempted compounded medications from FDA approval.

No, you’re not safe from ransomware

If they can cripple a massive national oil pipeline, your pharmacy probably isn’t safe — and ransomware attacks are targeting pharmacies and other healthcare facilities.

You need to learn the threats to your practice, where you’re likely vulnerable, and what you can do about it. Conveniently, APC is offering a new live CE webinar, "Modern-day Cyber-security Threats for Pharmacies," that will help you do just that.

It’s October 26 from 2:00–3:00 EDT, but you can learn the details and sign up today at A4PC.org/cybersecurity.

Don’t forget to claim your customized video

If you gave $5,000 or more to APC’s cBHT media campaign, don’t forget that you can receive customized 30- and 60-second "Compounding the Joy of Living" videos.

You should have received an email with details for getting the video. If you've misplaced it, please send a note to info@a4pc.org and let us know so we can send you the details.

Remember, the deadline to upload your information is September 15, 2021, and production won’t start until you provide everything in the proper file formats.

If you haven’t contributed $5,000, there’s still time. Go to https://A4PC.org/cbhtcampaign and increase your total support to $5,000 (or more) before we reach our $1.5 million goal, and you’ll receive a custom video as well.

Attention, Letco shoppers

Don’t forget that one last click before you check out — contribute to APC’s media campaign to protect cBHT!

Alabama compounder to run for state legislature

This week, APC member Philip Rigsby announced his campaign for the Alabama House of Representatives. He’s running for the Republican nomination to represent the state’s 25th district (Madison and Limestone counties in North Alabama).

“As a pharmacist, I have learned to listen to my patient’s issues, even when it seemed no one else would,” Rigsby stated in his announcement. “As a compounding pharmacist, I can think outside of the box to become an advocate and problem solver for them.”

Philip is the owner of two pharmacies in Huntsville: Huntsville Compounding Pharmacy and the Medicine Shoppe Pharmacy. As his campaign is not yet accepting donations, you can help by – per Philip’s request – praying for him. Sending him a check at the proper time wouldn’t hurt, either.

The primary is on May 24, 2022. At this time, Rigsby is the only announced candidate.

Short Takes

"Big Pharma’s Little Secret": Drug Cross-Contamination Is Rampant, Bloomberg explains. When a factory is turning out millions of pills, even when their machines are cleaned properly, there’s still a chance that traces of one drug will remain when another one is produced. Not too surprisingly, their machines aren’t always cleaned properly.


DEA clears Form 222 confusion: Do you order controls? Have you woken in the middle of the night worrying who is supposed to enter the supplier’s DEA registration number on Form 222? Worry no more! The DEA has clarified: Either you or the supplier can enter it.


Skip the stimulants: When treating preschool kids with ADHD, it’s probably better to skip the Ritalin and start with A2As like guanfacine and clonidine. A study out of Boston Children’s Hospital found that A2As work just as well for the young uns, but have fewer side effects than, say, methylphenidate. Moodiness, loss of appetite, sleep problems — they all showed up less with A2As.


Remember "pharma bro" Martin Shkreli, former head of Turing Pharma, now in prison for securities fraud? He owed a $7.4 million fine for defrauding investors, but it’s been paid off ... from (get this) the sale of his one-of-a-kind Wu-Tang Clan album "Once Upon a Time in Shaolin." (Only a single copy was ever produced, and Shkreli bought it at auction for $2 million in 2015.)

Coming Up

October 20–23PCCA ISTX, Houston

October 26 — 2:00–3:00pm EDT — APC CE: Modern-day Cyber-security Threats for Pharmacies

November 2–3Compounders on Capitol Hill, Washington, D.C. (mark your calendars!)

November 5–6Quality Compounding Summit (virtual)

November 8–10 — Informa Connect’s Compounding Pharmacy Compliance East In Person, Silver Springs, Md.

November 15–17 — Informa Connect’s Compounding Pharmacy Compliance East Virtual