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

why does nobody talk about shortage list

Explainer The Quiet One ×1

Genuine question, and the title is the question: why does nobody talk about shortage list.

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.

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

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.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

759 up / 22 down97% upvoted32 commentsid jqfmhf24 Oct 2023

32 comments

21 in this archive, depth 4

best — the order this archive was captured in

u/sofia_nascimento128 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/quiet_moderatormod-7 points·2 years 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/controversial_only1 point·2 years ago

Push back: "compounded is fine because a pharmacy made it" skips every question this board exists to ask.

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u/ruben_cabrera1 point·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/priya_palacios37 points·2 years ago

the pharmacy and the prescriber are two separate questions

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u/amara_kuipers97 points·2 years ago

the price difference is mostly the intake, not the vial

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u/zaid_grimaldi113 points·2 years ago

compounded is not generic, there is no equivalence claim

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u/eu_apotheke_a77 points·2 years 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/chidi_demirOP49 points·2 years ago

ask what the beyond-use date is based on

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u/kavya_kravchenko73 points·2 years ago

Who is the prescriber, and are they the same organisation as the pharmacy?

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u/controversial_only59 points·2 years ago·edited

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

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u/usp_appendixMOD37 points·2 years ago·edited

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

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u/lina_ndiaye42 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/santiago_rasmussen27 points·2 years ago

Was there potency testing on the finished preparation, or only on the starting material?

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u/formulary_fighterappeals13 points·2 years ago

ask which facility, then ask for their testing

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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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