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Compounding Concerns

Cheryl Clark, for HealthLeaders Media, October 14, 2013
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But the New England Compounding Center incident sped that process along, says Kenneth Scott, executive director of Scripps pharmacy operations. When Scripps leaders realized in October 2012 that the system had purchased some 11 products from NECC—from ophthalmic syringes and cardioplegia solutions to lidocaine ointments—they understood how close the issue came to impacting them.

While none of those products was among those connected to the fungal contamination of steroid drugs from that pharmacy, Scripps promptly returned all unused products or destroyed them, Scott says. Officials called all the doctors who had administered drugs from those lots and notified all patients who had received them to make them aware of the issues.

In the meantime, Scripps took steps to reduce its risks in other ways. It canceled contracts with all but two compounding pharmacies and brought a number of operations in house as it sped up plans to start its new central pharmacy, complete with the latest in robotic technology, and scheduled it to go live sometime this month.

"We began planning and constructing it because—the bottom line—we recognized that we prefer to provide products to our patients that are under our control," Scott says.

But there was another reason. "It was in line with our strategic objectives of standardization and operational efficiency, safety, and improved quality as we looked at our opportunities to improve cost," Scott says.

The new pharmacy project, which involves gutting and converting existing leased space in a nearby biotech industrial park, will save the hospital an estimated $1.2 million a year because it is cheaper to compound drugs within Scripps than to outsource.

In many operations, Scott says, "a human being won't even touch the products. From both from a sterility and stability aspect, we will be able to produce products probably better than those that are being outsourced and probably better than what we're doing in our inpatient pharmacy site."

Scripps President and CEO Chris Van Gorder says the move to a centralized compounding pharmacy was part of a conversion from "a fragmented and siloed approach" to one in which care is delivered with more integration.

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