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As a compounding pharmacist, I'd like to take issue with several points made by AstraZeneca executive Harvey Maldow in his letter to Drug Topics (July 11). First, the term pharmacy-manufactured is an oxymoron. We do not manufacture, we compound. Second, ethical compounders do not compound commercially available products. Third, we place stickers on all of our compounded prescriptions that say "Especially compounded for you by your pharmacist."

As a compounding pharmacist, I'd like to take issue with several points made by AstraZeneca executive Harvey Maldow in his letter to Drug Topics (July 11). First, the term pharmacy-manufactured is an oxymoron. We do not manufacture, we compound. Second, ethical compounders do not compound commercially available products. Third, we place stickers on all of our compounded prescriptions that say "Especially compounded for you by your pharmacist."

Mr. Maldow's letter stated, "Medications that are manufactured outside FDA oversight may pose real dangers to patients. The concern is not simply academic." FDA oversight is not the panacea that his letter suggests, as evident by his own company's example. I suggest that Mr. Maldow review FDA recall d-137-4 (a sterility issue), or d-349-2 (a super-potency issue), or d-340-2 (a stability and super-potency issue). These are all significant recalls of AstraZeneca's products.

Mr. Maldow suggested an indictment of an entire specialty because of some bad apples. Yes, there are bad eggs out there who call themselves compounders, when, in fact, they are manufacturers. These companies should fall under the auspices of the FDA, be required to meet the cGMPs for manufacturing, and be prosecuted accordingly.

Skip Lenz, Pharm.D., FASCP
Skip's Pharmacy
Boca Raton, Fla.
skipthepharm@aol.com

We need better representation

I read a recent article in Drug Topics expressing surprise over how many pharmacists are in favor of a union. If I had a choice between paying union dues or pharmacy association fees, I would choose union dues. A union would protect me and help me provide the best care for my patients. As pharmacists, we need some sort of protection from insurance companies and from big businesses trying to take away from our profession. In my years as a pharmacist, I think we have been a weak profession, getting pushed around, or even pushing ourselves around. I love my job and my profession; I just cannot see it existing very long in its current state.

There has been a labor shortage in our profession for years. Wouldn't it be easier now, in a time of shortage, to gain ground as a profession? It is frustrating to see nurses' and physicians' professional organizations gain strength as our own associations weaken. What, as a profession, have we done for our small business owners fighting to survive? What have we done as a profession to strengthen ourselves?

Robert M. Flickinger, R.Ph.
Holt, Mich.

Dialogue needed with AMA

Regarding your July on-line Instant Poll on whether federal legislation should be passed allowing physicians to dispense emergency contraceptives if there is no pharmacist able or willing to fill them in the area, my view is that it is already legal for physicians to dispense in most states. So it really isn't an issue. Physicians simply need to meet the requirements of the law in their respective states. Regarding the other side of the issue, pharmacists do need to make sure patient healthcare needs are properly addressed and in a timely fashion, according to professional and legal requirements, whether they elect to provide the services or not.

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