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c/compounding·posted 1 year ago by u/rekha_mwangi

someone explain state board to me like I have not read a paper in years

Discussion Clean Column ×9 The Quiet One ×2 Long Haul ×2

Asking properly rather than in a comment on somebody else’s thread: someone explain state board to me like I have not read a paper in years.

Asked for the beyond-use date basis and got a real answer with a stability reference attached. Not universal, apparently.

Kept the label from every vial. When the shortage status changed, having the paper trail made the conversation much shorter.

Paid noticeably more at one clinic than another for what turned out to be the same facility behind both.

Ask me anything specific. Anything general I will probably get wrong.

16,551 up / 12,162 down58% upvoted38 commentsid 1osz4516 Oct 2024

38 comments

30 in this archive, depth 4

best — the order this archive was captured in

u/lukas_delgado603 points·1 year ago

Potency and sterility testing on the finished preparation are separate from any certificate covering the starting material. Ask which you are being shown.

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u/step_count_stan231 points·1 year ago

ask what the beyond-use date is based on

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u/rina_sobczak420 points·1 year ago

Small fix — 503B facilities register with the regulator; 503A pharmacies are licensed by the state board. Different mechanisms.

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u/medutest_mel579 points·1 year ago

I would not read the price difference as a quality signal. Most of it is the consultation model, not the vial.

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u/julia_erdogan150 points·1 year ago

I would not read the price difference as a quality signal.

Agreed — and the follow-up question is what the beyond-use date is based on.

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u/sofia_danquah332 points·1 year ago

The shortage list is the legal hinge: the permissions that allow certain compounding to happen at scale are tied to a drug’s shortage status, which changes.

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u/tove_ogunleye84 points·1 year ago

A beyond-use date derived from published stability data means something different from one assigned by default rule. Asking which is a fair question and the answer is usually available.

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u/pavel_kravchenko233 points·1 year ago·edited

Nothing in this thread is medical advice, and the choice between arrangements is one for you and a prescriber who knows your history.

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u/santiago_rasmussen182 points·1 year ago

potency testing on the finished preparation is the thing to ask for

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u/rekha_mwangiOP104 points·1 year ago·edited

the API source is the question nobody asks and everybody should

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u/dario_stanescu83 points·1 year ago

the pharmacy and the prescriber are two separate questions

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u/controversial_only36 points·1 year ago

The intake asked me three questions and none of them were about my history. That told me everything I needed to know about the model.

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u/marit_mwangi330 points·1 year ago

salt forms are the recurring argument and the answer is boring

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u/vikram_mbeki-17 points·1 year ago

shortage status changes and the whole arrangement changes with it

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[removed]1 point·1 year ago

[removed by moderator]

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u/ahmed_fonseca1 point·1 year ago

Concentration on the compounded vial was different from what I had been using and I nearly did the arithmetic on autopilot.

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u/rekha_mwangiOP1 point·1 year ago

Switched between two compounded preparations and the concentration on the label was different. Redid the arithmetic on paper before drawing anything.

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u/yannick_barros1 point·1 year ago

A 503A pharmacy compounds for an identified patient against a prescription. A 503B outsourcing facility registers with the regulator, may produce without patient-specific prescriptions, and is subject to current good manufacturing practice requirements. The two are governed differently and the difference is not cosmetic.

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u/elin_ferrari1 point·1 year ago

Correction: patient-specific refers to the prescription, not to a bespoke formulation. Common misreading and it changes the argument.

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u/rekha_mwangiOP1 point·1 year ago

503A is patient-specific, 503B is outsourcing facility, they are not the same thing

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u/teodor_duarte96 points·1 year ago

Compounded preparations are not approved products and carry no bioequivalence claim. That is a statement about regulatory category, not about quality.

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u/lina_ndiaye59 points·1 year ago·edited

Compounded preparations are not approved products and carry no bioequivalence claim.

This is the distinction the whole board runs on. Everything else follows from it.

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u/tobias_vukovic31 points·1 year ago·edited

a 503B has to register and report, so there is a paper trail to ask for

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u/ismael_pires13 points·1 year ago

the shortage list is the whole legal hinge and people skip it

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u/ruben_cabrera95 points·1 year ago

Yes. The shortage list is the legal hinge for the whole arrangement and its status is public.

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u/receptor_bias_rick76 points·1 year ago

do not assume the concentration matches the branded product

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About c/compounding

Compounded GLP-1s as a supply route: the 503A/503B distinction, the shortage-list mechanics that made compounding legal and then didn't, state board rules, telehealth prescriber models, and what a compounding pharmacy will and will not tell you about its API source.

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