Custom-mixed medicines such as the steroid shots suspected in a meningitis outbreak long have been a source of concern, and their use is far wider than many people realize.
These medicines are made in private and hospital pharmacies and are used to treat everything from cancer to menopause symptoms to vision loss.
Often these products are name-brand medicines split into smaller doses or drug combinations mixed from ingredients sold in bulk. That easily can lead to contamination if sterile conditions aren’t maintained. The germ suspected in the current outbreak can spread in the air.
A shortage of many drugs has forced doctors to stretch supplies and seek custom-made alternatives if the first-choice treatment is not available. The steroid suspected in the current outbreak has been in short supply.
Drug shortages are one reason for the remarkable growth of these custom-made products. More than 7,500 compounding pharmacies operate in the United States, up from 5,000 in 2009, said David Miller, executive vice president of the International Academy of Compounding Pharmacists, a trade organization.
They account for a $3 billion segment of the drug market and 3 percent of all prescriptions filled, he said.
Some say this industry needs more regulation.
“There’s not a lot of oversight of compounding pharmacies” compared to drug manufacturers, said Allen Vaida, executive vice president of the Institute for Safe Medication Practices, a suburban Philadelphia advocacy group that tracks medication errors.