Schaffner says that in addition to acquiring critical drugs during shortages, hospitals and doctors have reached out to compounding pharmacies because traditional source products often "contain preservatives that some physicians thought impaired the drug's function—like alcohol with a steroid might produce more root nerve irritation."
Additionally, some providers may not need the large quantities of some drugs that traditional suppliers require them to buy, he says.
Professional pharmacy organizations know something must be done, but they're not sure what. One possibility is greater emphasis on accreditation.
According to Joe Cabaleiro, executive director of the Pharmacy Compounding Accreditation Board, only 162 of the 5,000 to 7,500 compounding pharmacies in the nation meet their credentials. The pharmacy implicated in the current meningitis outbreak, the New England Compounding Center in Framingham, isn't one of them.
Need for tighter regulation is up for debate
If regulators severely tighten restrictions, "it could have a bad impact on the ability (of providers) to meet certain patients' needs when they're completely reliant on these compounded medications. Whatever regulation comes—and no doubt it appears that something is necessary—regulators cannot afford to completely eliminate compounding pharmacies. We just need to have something that draws the line between compounding and manufacturing."
David Miller, chief executive officer of the International Academy of Compounding Pharmacists, worries that those who cry for greater regulation may be overlooking the fact that existing laws would have prevented the current event if they had been followed.