I am not shocked and dismayed at the tone of Dr.
Allen Jacobs' response to my inquiry as to the
standards and practices for compounding
pharmacists. After all, he has growled at me in
this forum before! In no way did I portray the
practice as a "free for all" and I certainly did
not indict any such compounds as witches brews.
I never mentioned the FDA, and never compared
any compounded product to that of the "products
or therapies endorsed by Dr. Markinson in his
lectures." That in my opinion was a very cheap
shot. In fact, my query, if anything ,elevated
the practice of compounding pharmacy by
highlighting some of its intricacies. He takes a
simple inquiry and responds as if I attacked him
personally; and I am one of his friends!
His comment "Finally, the suggestion of Dr.
Markinson that compounding is anachronistic is a
reflection of his failure to recognize the
resurgence of peer reviewed literature and
advances in delivery techniques which have
resulted in the widespread, effective, and
resurgent utilization of these products in many
specialties dealing with pain, musculoskeletal
pathology, and neuropathy," does not change the
facts that although compounding may be enjoying
a resurgence, the overwhelming majority of Pharm
D's are applying their skills in chemotherapy
admixtures, total parenteral nutrition,
infectious diseases, polypharmacy management,
addiction medicine, transdermal delivery
systems, etc. and yes, even working at CVS and
Walgreens.
The percentage involved in compounding is
negligible. This is indisputeable. However, Dr.
Jacobs' response is not a total loss, as
somewhere in his diatribe he answers my question
in informing us about the PCAB and the CQI
certification of compounding pharmacies. That is
all i asked for in my post in the first place.
And just for the record, one such outfit has
contacted me on my private e-mail responding to
my post with sincere thanks for bringing
compounding pharmacy principles its deserved
attention and an offer to meet with me.
Disclosure: I am a former pharmacy student with
the highest degree of respect for pharmacists.
Bryan C. Markinson, DPM, NY, NY,
Bryan.Markinson@mountsinai.org
