As a physician, I assume the medications I prescribe and administer are safe. However, the recent fungal meningitis outbreak has made me, my fellow physicians, hospitals, legislatures and the public concerned. The Centers for Disease Control and Prevention have reported a total of 39 deaths and 656 cases due to contaminated vials of steroids that were manufactured by the New England Compounding Center. There were 46 reported cases in the state of New Jersey. Approximately 17,500 vials that potentially harbored Exserohilum rostratum were shipped by the NECC to 76 health care facilities in 24 states. Although extremely tragic (and unnecessary), we were fortunate that these numbers were not significantly higher.
Compounding pharmacies have served a special and important patient service during drug shortages and for patient-specific needs. "Traditional" compounding pharmacies provide medications for an individual patient in response to a practitioner's prescription. The pharmacist combines, mixes or alters various drug ingredients in order accommodate a patient allergy, need for a liquid form, or flavoring. Some pharmacies, however, have metamorphosed into manufacturing drugs. They function as miniature drug companies and no longer specifically formulate a medication to a specific patient's need. Doctors and hospitals have turned to these "manufacturing" or "non-traditional" pharmacies because of drug shortages or lower prices compared to major manufacturers.
In 2012, a study showed that 98 percent of anesthesiologists experienced drug shortages in the past year. When a particular drug is not available, we have one of three options: Stop providing anesthesia services, utilize alternative medications that may have dangerous side effects, or attain medications from compounding pharmacies. The last option is the most logical.
However, after the fungal meningitis outbreak, a glaring light has been shined on compounding pharmacies and revealed that they fall into a regulatory and legal loophole. Trade associations that represent the sector have sidetracked attempts at regulation on the federal level. As it currently stands, regulation of compounding pharmacies fall under state boards of pharmacy. Although some state boards have strong requirements for compliance with quality standards, they can vary considerably.
New Jersey has become the first state to take a positive step toward enhancing patient safety by requiring oversight of traditional compounding pharmacies. Sen. Jeff Van Drew, D-Cape May, Cumberland, Atlantic, recently introduced the "Compounding Pharmacy Quality Assurance Act (S2365)," which would require all traditional compounding pharmacies in the state of New Jersey to receive accreditation from the Pharmacy Compounding Accreditation Board, or PCAB.
Even as a physician, I was not aware of the PCAB accreditation until the fungal meningitis outbreak.
PCAB accreditation is currently the "gold standard" to ensure that a compounding pharmacy meets nationally accepted quality-assurance, quality-control and quality-improvement standards.
It serves as a form of external validation. The process involves a review of facilities, equipment, records and procedures required to prepare quality compounded medications, and the program for testing compounded preparations.
It also involves verification that the pharmacy uses ingredients from sources registered with and/or licensed by the Food and Drug Administration, is not on probation for issues related to compounding quality, public safety or controlled substances, and is properly licensed in each state it does business in.
Additionally, the bill would require that any traditional compounding pharmacy in another state be PCAB accredited in order to provide medications to residents of New Jersey. Nontraditional or manufacturing pharmacies are not included in the bill because the FDA is requesting Congress to grant it powers to regulate them.
The American Medical Association has called on state pharmacy boards to require all compounding pharmacies to be accredited by the PCAB. However, until Van Drew's bill, no state legislature has attempted to enforce this.
Physicians, patients and hospitals should be able to expect and demand the drugs they prescribe or receive are sterile, stored appropriately, not expired and appropriately labeled. This bill would enhance the safety of residents in New Jersey without increasing the size of government or government spending. It is just plain common sense.
Dr. Nina Radcliff, of Galloway Township, is a member of the American Society of Anesthesiologists.
Dr. Nina Radcliff / Bill has right prescription for compounding pharmacies in N.J. - pressofAtlanticCity.com: Commentary
1-877-773-7724
SubscriberServices@pressofac.com
Breaking News
Dr. Nina Radcliff / Bill has right prescription for compounding pharmacies in N.J.
Posted: Monday, January 21, 2013 12:01 am
Dr. Nina Radcliff / Bill has right prescription for compounding pharmacies in N.J.
As a physician, I assume the medications I prescribe and administer are safe. However, the recent fungal meningitis outbreak has made me, my fellow physicians, hospitals, legislatures and the public concerned. The Centers for Disease Control and Prevention have reported a total of 39 deaths and 656 cases due to contaminated vials of steroids that were manufactured by the New England Compounding Center. There were 46 reported cases in the state of New Jersey. Approximately 17,500 vials that potentially harbored Exserohilum rostratum were shipped by the NECC to 76 health care facilities in 24 states. Although extremely tragic (and unnecessary), we were fortunate that these numbers were not significantly higher.
Compounding pharmacies have served a special and important patient service during drug shortages and for patient-specific needs. "Traditional" compounding pharmacies provide medications for an individual patient in response to a practitioner's prescription. The pharmacist combines, mixes or alters various drug ingredients in order accommodate a patient allergy, need for a liquid form, or flavoring. Some pharmacies, however, have metamorphosed into manufacturing drugs. They function as miniature drug companies and no longer specifically formulate a medication to a specific patient's need. Doctors and hospitals have turned to these "manufacturing" or "non-traditional" pharmacies because of drug shortages or lower prices compared to major manufacturers.
In 2012, a study showed that 98 percent of anesthesiologists experienced drug shortages in the past year. When a particular drug is not available, we have one of three options: Stop providing anesthesia services, utilize alternative medications that may have dangerous side effects, or attain medications from compounding pharmacies. The last option is the most logical.
However, after the fungal meningitis outbreak, a glaring light has been shined on compounding pharmacies and revealed that they fall into a regulatory and legal loophole. Trade associations that represent the sector have sidetracked attempts at regulation on the federal level. As it currently stands, regulation of compounding pharmacies fall under state boards of pharmacy. Although some state boards have strong requirements for compliance with quality standards, they can vary considerably.
New Jersey has become the first state to take a positive step toward enhancing patient safety by requiring oversight of traditional compounding pharmacies. Sen. Jeff Van Drew, D-Cape May, Cumberland, Atlantic, recently introduced the "Compounding Pharmacy Quality Assurance Act (S2365)," which would require all traditional compounding pharmacies in the state of New Jersey to receive accreditation from the Pharmacy Compounding Accreditation Board, or PCAB.
Even as a physician, I was not aware of the PCAB accreditation until the fungal meningitis outbreak.
PCAB accreditation is currently the "gold standard" to ensure that a compounding pharmacy meets nationally accepted quality-assurance, quality-control and quality-improvement standards.
It serves as a form of external validation. The process involves a review of facilities, equipment, records and procedures required to prepare quality compounded medications, and the program for testing compounded preparations.
It also involves verification that the pharmacy uses ingredients from sources registered with and/or licensed by the Food and Drug Administration, is not on probation for issues related to compounding quality, public safety or controlled substances, and is properly licensed in each state it does business in.
Additionally, the bill would require that any traditional compounding pharmacy in another state be PCAB accredited in order to provide medications to residents of New Jersey. Nontraditional or manufacturing pharmacies are not included in the bill because the FDA is requesting Congress to grant it powers to regulate them.
The American Medical Association has called on state pharmacy boards to require all compounding pharmacies to be accredited by the PCAB. However, until Van Drew's bill, no state legislature has attempted to enforce this.
Physicians, patients and hospitals should be able to expect and demand the drugs they prescribe or receive are sterile, stored appropriately, not expired and appropriately labeled. This bill would enhance the safety of residents in New Jersey without increasing the size of government or government spending. It is just plain common sense.
Dr. Nina Radcliff, of Galloway Township, is a member of the American Society of Anesthesiologists.
Posted in Commentary on Monday, January 21, 2013 12:01 am.
Similar Stories
Most Read
Opinion Home
Editorial Cartoons
Commentary
Editorials
Letters
Recent Polls
Your Lawmakers
Connect with us
By Dave Enscoe, Advertising Department More »
SEARCH PROPERTIES
Place A Classified Ad »
By Tim Spell, Motor Matters More »
SEARCH CARS+
Place A Classified Ad »
Most of the nation’s casino markets have finally recovered from the recession, propelling revenue from slot machines and table games to near-record levels in 2012, according to a new report on the economic health of the gambling industry. More »
SEARCH JOBS+
Place A Classified Ad »
PLACE YOUR CLASSIFIED AD IN PRINT
AND ONLINE TODAY »
Browse Classified Categories
Place A Classified Ad »
Featured Businesses
Add your business here »One Stop Bait & Tackle
Atlantic City, NJ 08401 [Map]
609-348-9450
Captain Andy's Marina
Margate City, NJ 08402 [Map]
609-822-0916
Beachcomber Coins & ...
Egg Harbor Twp, NJ 08234 [Map]
609-645-1031
Sport Hyundai Dodge
Egg Harbor Township, NJ 08234 [Map]
609-646-1200
Up The Creek Tavern ...
Keyport, NJ 07735 [Map]
732-739-0214
Wild Styles/Boost Mo...
Rio Grande, NJ 08242 [Map]
609-846-7030
Coastal Designer Outlet
Ocean View, NJ 08230 [Map]
609-624-1544
Permanent Makeup by Amy
Egg Harbor Twp , NJ 08234 [Map]
609-383-2769
Grace Energy
Rio Grande, NJ 08242 [Map]
609-465-5545
Maynard's Cafe
Margate City, NJ 08402 [Map]
609-822-8423
Foglio's Abbey Floor...
Marmora , NJ 08223 [Map]
609-390-3876
Thompson Marine & En...
Egg Harbor Township, NJ 08234 [Map]
609-927-2415
Fish Finder the
Brigantine, NJ 08203 [Map]
609-264-0918
Buck Tails Outfitters
Mays Landing, NJ 08330 [Map]
609-829-2229
Ventnor Heights Auto...
Ventnor City, NJ 08406 [Map]
609-823-0520
C-Jam Yacht Sales
Somers Point, NJ 08244 [Map]
609-927-1175
Bennett Chevy
Egg Harbor Twp., NJ 08234 [Map]
609-641-0444
Carl “Luke” Roth of ...
Villas, NJ 08251 [Map]
609-886-8200
Access Roofing & Con...
Atlantic City, NJ 08401 [Map]
888-661-0333
Frankie's Pizza II
Mays Landing, NJ 08330 [Map]
609-625-7566
Rio Nails And Spa
Rio Grande, NJ 08242 [Map]
609-463-8868
English Creek Supply
Egg Harbor Twp, NJ 08234 [Map]
609-641-6168
Shore Orthopaedic Un...
Somers Point, NJ 08244 [Map]
609-927-1991
Bob's Garden Center
Egg Harbor Township, NJ 08234 [Map]
609-641-6306
Pappy's Fishin' Stuff
Ocean City, NJ 08226 [Map]
609-398-6996
Handcrafted Cabinetr...
West Creek, NJ 08092 [Map]
609-891-0166
Avalon Limousine Ser...
Egg Harbor Township, NJ 08234 [Map]
609-646-0008
Surrey Beach House ...
Ventnor City, NJ 08406 [Map]
609-822-6550
Mouse Trap Bowling A...
Woodbine, NJ 08270 [Map]
609-861-2695
Schooner Island Marina
Wildwood, NJ 08260 [Map]
609-729-8900
Foschi Studio
Linwood, NJ 08221 [Map]
609-927-3044
Tackle Direct
Somers Point, NJ 08244 [Map]
609-788-3819
Cape May County Hear...
Cape May Court House, NJ 08210 [Map]
609-465-9199
Up The Creek Marina
Absecon, NJ 08201 [Map]
609-272-9252
Duke O'fluke
Somers Point, NJ 08244 [Map]
609-926-2280
Frank’s Jewelers
Egg Harbor Twp , NJ 08234 [Map]
609-641-4252
The Boat Shop
Manahawkin, NJ 08050 [Map]
609-597-1271
Perfect Solutions So...
Northfield, NJ 08225 [Map]
609-601-5252
Montreal Inn
Cape May, NJ 08204 [Map]
609-884-7011
Gutter Giants LLC
Egg Harbor Township, NJ 08234 [Map]
Ladies Invitational ...
Absecon, 08201 [Map]
Newkirk Family Veter...
Egg Harbor Township, NJ 08234 [Map]
609-645-2120
Tuckahoe Bike Shop
Woodbine, NJ 08230 [Map]
609-628-0101
Professional Physcal...
N. Cape May, NJ 08204 [Map]
609-884-9800
Historic Cold Spring...
Cape May, NJ 08204 [Map]
609-898-4504
Crabby's Restaurant
Mays Landing, NJ 08330 [Map]
609-625-2722
Raff's Recycling
Cape May Court House , NJ 08210 [Map]
609-465-7406
Skelly's Hi Point Pub
Absecon, NJ 08201 [Map]
609-641-3172
On a Mission
Pleasantville, NJ 08232 [Map]
609-646-4483
...
Egg Harbor Township, NJ 08234 [Map]
609-788-8789
Dolfin Dock Inc
Somers Point, NJ 08244 [Map]
609-927-1730
Richard T Fauntleroy Pc
Pleasantville, NJ 08232 [Map]
609-646-4466
Fioretta Llc
Northfield, NJ 08225 [Map]
609-241-8628
Royal Suites Healthc...
Galloway, NJ 08205 [Map]
609-748-9900
Absecon Bay Sportsme...
Absecon, NJ 08201 [Map]
609-484-0409
Bloomingsales
Brigantine, NJ 08203 [Map]
609-266-6667
Simple Escape Spa
Galloway, NJ 08205 [Map]
609-464-2313
Eddie's Auto Body Shop
Erma, NJ 08204 [Map]
609-884-4613
Mays Landing Golf &...
Mays Landing, NJ 08330 [Map]
609-641-4411
Copiers Plus
Egg Harbor Township, NJ 08234 [Map]
609-645-7587
Oreck Floor Care Center
Mays Landing, NJ 08330 [Map]
609-272-7590
Boardwalk Honda
Pleasantville, NJ 08232 [Map]
609-428-4475
Mama Mia Of Eht
Egg Harbor Township, NJ 08234 [Map]
609-484-8877
Vip Skindeep Llc
Pleasantville, NJ 08232 [Map]
609-677-9900
Designer Consignment
Egg Harbor Twp , NJ 08234 [Map]
609-646-5444
Citywide Towing
Atlantic City, NJ 08401 [Map]
609-517-3871
Keeper Back Bay Fishing
Margate City, NJ 08402 [Map]
609-576-5998
Linwood Care Center
Linwood, NJ 08221 [Map]
609-927-6131
JBS Solar and Wind LLC
North Cape May, NJ 08204 [Map]
609-884-7373
Matt Blatt Kia
Egg Harbor Township, NJ 08234 [Map]
609-573-3100
M & S Produce Outlet
Egg Harbor Township, NJ 08234 [Map]
609-383-8323
KAS Website Design C...
Absecon, NJ 08201 [Map]
609-703-4696
Pier 47
Wildwood, NJ 08260 [Map]
609-729-4774
Jack Facciolo, D.O.
Rio Grande, NJ 08242 [Map]
609-886-0800
Cape Regional Medica...
Cape May Court House, NJ 08210 [Map]
609-463-2000
Sunnyland Child Care...
Ventnor City, NJ 08406 [Map]
609-823-4110
Atlantic Limousine, Inc
Atlantic City, NJ 08401 [Map]
800-348-3484
Sack O' Subs
Ocean City, NJ 08226 [Map]
609-525-0460
Black Horse Auto Sales
Egg Harbor Township, NJ 08234 [Map]
609-272-1877
Mangos Restaurant Llc
Margate City, NJ 08402 [Map]
609-487-7450
Rio Auto
Palermo, NJ 08225 [Map]
609-390-0001
Find Local Businesses
Popular Categories
Sections
Services
Contact Us
Contacts By DepartmentThe Press of Atlantic City Media Group
PO Box 3100
1000 West Washington Ave.
Pleasantville, NJ 08232-3100
1-877-773-7724
609-272-7000 SubscriberServices@pressofac.com
Search
© Copyright 2013, pressofAtlanticCity.com, Pleasantville, NJ. Powered by BLOX Content Management System from TownNews.com. [Terms of Use | Privacy Policy]