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c/compounding·posted 2 years ago by u/marit_mwangi

three years of 503B threads, summarised so you do not have to read them

Pricing Well Actually ×5 The Quiet One ×1 Slow Clap ×3

three years of 503B threads, summarised so you do not have to read them. I have gone back and forth on this for months.

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.

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.

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

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

3,022 up / 367 down89% upvoted39 commentsid jqcgzg15 Mar 2024

39 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/ruben_cabrera164 points·2 years 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/zaid_grimaldi113 points·2 years ago

Yes — asking which facility, by name, is the single most useful question and most clinics will answer it.

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u/marit_mwangiOP80 points·2 years ago

salt forms are the recurring argument and the answer is boring

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u/marit_mwangi67 points·2 years ago

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

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u/marit_mwangiOP-21 points·2 years ago

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

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u/joaquin_trevino54 points·2 years 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/bilal_osei37 points·2 years ago

Asked for potency testing on the finished preparation. They had it. I had assumed they would not.

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u/camila_sandvik54 points·2 years 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/rania_diallo42 points·2 years 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/ismael_pires15 points·2 years ago

compounded is not generic, there is no equivalence claim

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u/usp_appendixMOD19 points·2 years ago

Removed the staff name. Facilities and clinics can be named here; individuals cannot.

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u/lift_heavy_thingsresistance training30 points·2 years ago

Salt form matters for mass: a preparation specified as one salt and dosed as the free base gives you a different amount of peptide for the same number on the label.

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u/priya_palacios28 points·2 years ago·edited

a telehealth intake that asks nothing has told you what it is

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[deleted]10 points·2 years ago

[deleted]

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u/tb500_tangent7 points·2 years ago

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

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u/lukas_delgado14 points·2 years ago

if a clinic will not name the facility, that is your answer

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u/quiet_moderatormod8 points·2 years ago

if a clinic will not name the facility, that is your answer

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

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u/marit_mwangiOP6 points·2 years ago

shortage status changes and the whole arrangement changes with it

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u/rohan_steiner3 points·2 years ago

Agreed on potency testing of the finished preparation. That is a different question from the purity of the starting material.

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u/runa_grimaldi2 points·2 years ago

the price difference is mostly the intake, not the vial

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u/rekha_mwangi4 points·2 years ago

Same view. If the intake asked you nothing, the intake was a formality and you should factor that in.

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u/priya_palacios2 points·2 years ago·edited

Same view.

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

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u/draw_up_dizzy1 point·2 years ago

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

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u/emeka_chowdhury14 points·2 years ago

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

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u/chidi_demir4 points·2 years ago

Agreed. The 503A versus 503B distinction changes who is allowed to make what, and almost every confused thread here starts by ignoring it.

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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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