PHARMACIST STEVE

video.html?freewheel=90017&sitesection=bostonherald&VID=23835775

This is a video about New England Compounding Center in MASS.

and here is the article http://news.bostonherald.com/jobfind/news/healthcare/view/20121006steroid_firm_was_investigated_by_mass_in_2006/srvc=home&position=also

Apparently this company was put on a one year suspension back in 2006 for their improper procedures. According to the article .. they were not even fined by the BOP.

I have a bit of first hand information on what is going on in the “pain clinic” industry… my wife is a chronic pain pt and the first pain clinic that she went to kept “shooting her up” with some type of steroid/lidocaine type drug.. and when insurance wouldn’t pay for that.. they would use botox.. and when the insurance wouldn’t pay for that they would do a “RF” procedure.. All the while, her PCP was providing her with oral opiates…

IMO.. these types of injections are good as a diagnostic aid.. to determine if the back pain is acute or chronic… after a couple of cycles of these types of therapy and the provide shorter than anticipated period of relief… then the pain is chronic and the risk of these types of therapy is more risky than just treating the pain with oral meds.. including opiates if necessary.

After a couple of years of repeating these cycles… I was convinced that the only option for my wife was an implanted pump… she went thru the primarily evaluation and having her pain go from 9+ to 0.5 in a matter of hours… she clearly met the insurance’s medical necessity of at least of 50% reduction in pain…

In talking to the pain clinic physician… it became obviously clear that the clinic’s policy was not even to try the only commercially available product (Infumorph) in the pump… they would be putting a “compounded” product in the pump…

The maker of the pump (Medtronics) had done stability tests on Infumorph in their pumps and determined a 6 month stability.. while the physician was telling me that the compounded product would have only a 60-90 day stability … meaning that an invasive procedure to refill the pump would happen 2-4 times more often than using the commercial product… and this product has to be both sterile and preservative free .. since it is going directly into the spinal fluid.

The physician knew that I was a Pharmacist and I expressed my concern about using ANY compounded product until me wife had failed on the commercially available product… I was told that “this was a BIG BOY issue”… “.. a liability issue…” and that I didn’t understand…

What the physician did not fully comprehend was that the immediate liability was that THIS BIG BOY … was going to kick his arrogant ass..

Before my testosterone overwhelmed my common sense… I walked out of the exam room…

I eventually found a pain clinic that would use the commercially available product and implant the pump and its benefits – over oral opiates – have been dramatic..

After some investigation… I found out that the typical “pain clinic” routinely used compounding pharmacies for injectables.. You would think that producing a commercially available product would be slightly illegal… well it is.. so they get around it by take a drug like Morphine and add a lidocaine type product… which made it a no longer commercially available product… and if you read the literature.. the addition of the lidocaine type product.. provides little/no therapeutic benefit…

HOWEVER… the compounding pharmacies were charging 10% -25% of the commercially available products and the physician was billing the insurance companies/Medicare/Medicaid using HCPCS codes… which has allowables more tilted toward the cost of the commercially available product. Think of it as providing a generic and legally billing for a brand name..

I just wonder how many patients have had meningitis from these pain clinics and compounding pharmacies and it is just “written off” as the risk of having spinal injections… could this one have “stood out”… because a rare fungus was involved.

Once again… all you have to do is follow the money trail….

 

 

 

Filed under: General Problems