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Hospitals Address Compounding Concerns

Cheryl Clark, for HealthLeaders Media, November 11, 2013

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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2 comments on "Hospitals Address Compounding Concerns"


John Barton (1/21/2014 at 4:33 PM)
Compounding pharmaceutical activities are coming under rapidly accelerating scrutiny from the FDA and USP797 due to the unfortunate fungal meningitis out break at The New England Compounding Pharmacy and others such as Francks Compounding Pharmacy in Ocala, Fla., that also experienced a serious fungal outbreak.Direct regulation of the industry is inexorable and inevitable. Forward thinking, innovative companies are strategically planning for this scenario by implementing comprehensive decontamination protocols to preempt outbreaks at their facilities. Studies have shown that even the best terminal manual cleaning protocols only achieve a 40-60% reduction in residual bioburden. Many companies are turning to hydrogen peroxide fogging systems such as the Sanosil Halo Fogging System. Med Effect, Inc. offers the Sanosil Halo Hydrogen Peroxide Fogging System, which can be used for room/area or equipment decontamination. The Sanosil Halo Hydrogen Peroxide Fogging System is lightweight, portable, colorless, odorless, quiet, eco friendly, effective, and economical.The Halo Fogging System assures a homogeneous mist of ionized particles that migrates to areas that regular cleaning can't or don't reach, to include high touch areas around doors, behind window treatments , and even under desks and beds. The Halo Fogging System will kill 99.99 % of bacteria, viruses, and fungi on pre-cleaned surfaces, without harming sensitive electronics, surfaces or substrates. The Sanosil Halo Fogging System is EPA Registered, No. 84526-1. For additional information, please refer to our website at http://www.medeffect360.com and our industrial video at http://www.youtube.com/medeffect .

Dr. Brent S. Stogdill PharmD, BS, RPh (11/12/2013 at 11:50 AM)
I will never disagree that patient safety is paramount and I commend the institutions in this article for their efforts to achieve just that. Based on this article though, are your efforts and money being used wisely? Consider the following: First, lets address the elephant in the room. This article and so many like it sensationalize the deaths and illnesses from the fungal infections in the context that the New England pharmacy was COMPOUNDING the medication. This is dragging our whole healthcare system through the mud. It is FACT that the New England pharmacy was engaged in illegal MANUFACTURING not compounding. They were breaking rules and the board of pharmacy in that state and the FDA knew it or should have known it. Neither entity (BOP or FDA) needed more authority, they were just negligent in performing procedures they already had authority and obligation to do. Drag the BOP and the FDA through the mud not legitimate, law abiding compounding pharmacies (my profession). Second, lets address this article's statistics. It states that since 2001 (12 years) there have been 77 deaths linked to compounding pharmacies, and it says 60 of those deaths are from the New England pharmacy incident. That leaves 17 deaths caused by compounding pharmacies in the last 12 years. Now, how many of those deaths can be linked to compounding pharmacies that were engaged in similar or the same practices as the New England pharmacy? And, just for fun, lets also determine, in those same cases, whether the BOP and FDA did or did not properly inspect and follow through with procedures that they already have the authority and obligation to do? I am certain that will leave us with a number of deaths less than 17 in the last 12 years attributed to legitimately run compounding pharmacies. Now, compare that number to the number of hospital deaths caused by medication errors in that same 12 year period. Which issue needs the healthcare system to spend more time and money on? If the healthcare system does not already know the answer to that question I have pity on the whole system. This countries healthcare system desperately needs some good, old-fashioned common sense, politically and professionally?