Recently a pt share this hyperlink https://www.drugs.com/comments/acetaminophen-hydrocodone/for-pain.html?status=1
A couple a years ago Barb had a “no efficacy ” with her C-II , when we had it fill at the Winn Dixie close to our FL condo. It was made by Rhodes – which at the time was owned by Purdue Pharma. I talked to the PIC at the pharmacy and she stated that was the ONLY BRAND that Winn Dixie allowed them to purchase from the wholesaler.
The pt that shared that the generic company that she got was Camber https://www.camberpharma.com/ Its parent company, Hetero of Hyderabad India, this website https://www.drugs.com/manufacturer/camber-pharmaceuticals-inc-219.html had this statement “Camber Pharmaceuticals, Inc. manufactures, markets and/or distributes more than 93 drugs in the United States. Medications listed here may also be marketed under different names in different countries. Non-US country and region specific information is not available on this page.” does that last statement mean that the same meds, in the same bottle – just has a different label/name on the outside of the bottle ?
here is another hyperlink https://reviews.birdeye.com/camber-pharmaceuticals-inc-163457133420189 and Camber got a 2.2 overall rating with 84 out of 126 reviews was a ONE – maybe because there was no option to give them a ZERO ?
Some pt have asked me… if they could get the potency of their meds tested… of course they can, I understand such tests are $200 -$300 each time….however if the med is produced off shore … how are they going to sue someone in India or Pakistan ? The FDA is not going to do anything… if you complain to your insurance company – for paying for “defective meds”… they will just tell you to get a med from a different pharma.
The FDA years ago created the ORANGE BOOK https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book and in it.. the FDA has determined what medication(s) a pharma makes is bioequivalent to the brand name product and gives he generic/pharma a “grade” as bioequivalent or NOT.
It is ILLEGAL for a pharmacy to compound meds that are commercially available… but compounding a product that has been independently tested is not meeting the FDA requirement that a med must be between 95%-105% of what is stated on the label.
However, a compounding pharmacy and a doc could come to some sort of an agreement about a specific combination of meds to be compounded. Because compounding pharmacies are allowed to do anticipatory compounding and keep 7-14 days on hand and there are ways to basically do this in a semi-automated process… not how making compounded meds and putting them in capsules – BACK IN THE DAY.
Hydrocodone is not available in a 12.5 mg dose and there use to be a commercially available product that was Demerol and Phenergan… but it was finally figured out that long term use of Demerol created some toxic by products, but Phenergan/Promethazine is known to potentiate the effects of opiates… same thing could be done with Oxycodone … there is no 7.5 mg or 12.5 mg commercial dose.
Insurance companies don’t like to pay for compounding meds, but if the pt clinically showed BETTER PAIN MANAGEMENT with the compounded med than the generic they were taking… could give enough valid reasons for the insurance to pay for the compounded med. IMO, Medicare Part D & Medicare Part C… has a very well defined appeal process and following their rules on appeals, the vast majority of pts seeing a benefit out of a compounded med… perhaps at least 90% would end up getting their meds paid for..
The pt is going to have to start the discussion with their doc that has a lot of pain pts… here is a link to find a independent compounding pharmacy by zip code and radius https://ncpa.org/pharmacy-locator these “poor” generic meds may cause a pt to end up showing “NO OPIATES IN THEIR URINE” and could get kicked from the practice.
Maybe everyone is HAPPY… the doc because the pt is getting better pain management, so is the pt, the compounding pharmacy is happy getting more business… the pharmacy that has been dispensing the cheapest meds they can buy – loses business and so does the generic pharma
Filed under: General Problems
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