The latest episode prompts Cynthia Reilly, of the American Society of Health System Pharmacists, to warn hospitals and other providers, "in most situations, you're really dealing with something that's 'buyer beware.'" Hospitals should now be working hard to check where their drug supplies are coming from because more hospitals are relying on these pharmacies for products.
"In the last decade, we do see more hospital pharmacies contracting out some of their services, maybe because particular products are hard to compound or [because they] may be high risk products, or because of drug shortages that's the only way to get them," Reilly says.
Her organization offers tools for providers to double-check their suppliers for certain quality criteria.
The 5% Rule
Hospitals and other purchasers looking to buy these supplies might go by one standard, Reilly says, which is that "if more than 5% of the product that they're making is for an undetermined patient—that is, it's not pursuant to a prescription that's either available or anticipated—then we suggest in those instances, if they're making more than 5% for an unknown patient, then they should be dealing with a manufacturer."
Hospital trade groups have been uncharacteristically quiet on this issue. Marie Watteau of the American Hospital Association responded to questions by e-mail saying that anecdotally, compounding pharmacies are not the first place to which hospitals turn when they need a drug. "But in a severe shortage, compounding pharmacies may be the only source for a drug their patients need."