I've Spent A Lot Of Time Telling You About Big Pharma Pud Sucking. It's a New Year. Maybe I Should Spend Some Time On Little Pharma.

Tiny Pharma actually. Microscopic Pharma almost. Specifically, the "custom compounding pharmacies" that have proliferated, in the rich parts of town, over the last 20 years or so.

"Oh, here's where the Drugmonkey tells us how we are the last bastions of the profession, keeping the flame of pharmacy alive as it comes under assault from the chain corporate beast who envisions the profession as nothing more than a glorified fast food cashier. Yay Drugmonkey!!" The proprietors of these compounding pharmacies are saying to themselves.

Except that's not what I'm going to say. Not even close.

Now there's nothing wrong with a lot of what these places do. Like the name implies, they butter their bread by making specialized preparations of things not commercially available. Odd strengths of prescription meds, making a liquid when there is only a capsule on the market, capsules when there is only liquid on the market, unique flavors so your pet and/or child can get their medicine down. Some of their work is actually laudable. Some of it is simply catering to the more money than brains demographic, so the affluent and stupid can say things like "MMMYYY Prozac is custom made just for meeeeeeeeee!!!! Because I am a special person who can take neither 10 nor 20 milligrams. Neither can someone of my social status be expected to break a tablet in half. So I shall pay 3 times as much as you for my meds. Because I am rich and special and you are not. " Which isn't really laudable, but is kinda funny and karmic.

Then there are the products that take advantage of the loophole that these compounds don't have to be proven effective. Like the promethazine gel this month's Pharmacist's Letter says hasn't been proven to be absorbed or to actually work. That's neither funny nor karmic.

Oh but it gets worse. Many of these places have built up a good part of their business hawking "bioidentical" hormones. Estrogens and such. When I first made my break for the coast I interviewed with one of these compounding places, and as part of his recruiting package, the store's owner handed me the brochure he gave to customers asking about his "bioidentical" estrogens. They were the exact same hormones found naturally in your body it said, and stated unequivocally that therefore his compounded stuff was safer than commercial products such as Premarin and Prempro. There were no studies that backed this up that I was aware of, so I asked the owner on what basis he was making this claim.

"The amount of money I make on the compounds" was his reply. Which was merely unprofessional back then.

Today however, we know there is an undisputed link between estrogen exposure and breast cancer. We know that the number of breast cancer cases fell almost immediately when this news broke and doctors backed off on the estrogen prescriptions. 

"But our stuff is different!!! Say the compounders."It is natural and bioidentical!!"

Except that we also know that women who have a higher lifetime exposure to estrogen naturally, such as those who started their menstrual cycles early and/or ended them late...also have a higher than average risk of breast cancer. Which would imply the "bioidentical" stuff really isn't all that different as far as the breast cancer goes.  If you have a pharmacy license you should know this. If you don't you are negligent and should be out of our profession. If you do, and are marketing these things anyway by implying they are safer, in my eyes you are criminal, and belong in jail.

Because loving your money more than your mother should most definitely be a crime.
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I've Spent A Lot Of Time Telling You About Big Pharma Pud Sucking. It's a New Year. Maybe I Should Spend Some Time On Little Pharma.
I've Spent A Lot Of Time Telling You About Big Pharma Pud Sucking. It's a New Year. Maybe I Should Spend Some Time On Little Pharma.
Reviewed by malaria
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Rating : 4.5