Compounding and Medical Tourism: What to watch out for.

After a short hiatus, I am back to writing, and today’s post concerns another issue that is plaguing the workers’ compensation industry in the US, the compounding of drugs.

Joe Paduda, whom I have mentioned before, wrote today about the problem in his Managed Care Matters blog. The article, entitled, Just how dangerous Is compounding?, says that compounding is much more dangerous than compounding pharmacies and their supporters have led the workers’ compensation and health care industries to believe.

He cites a Washington Post investigation that reported that  shoddy practices and unsanitary conditions at three pharmacies have sickened and killed patients.

Paduda also stated that compounding is a growing phenomenon, especially in workers’ comp, and pointed to research from the California Workers’ Compensation Institute (CWCI) and CID Review indicate that despite the lack of any evidence-based research justifying widespread use, compound meds are becoming a larger part of pharmacy spending

What has happened in California, Paduda says, can be used to forecast the future for compounding in other states.

He states that California recently tried to address the issue legislation which specifically focused on the ingredient cost. The result of that legislation was, the number of scripts dropped 35% (from 3.1% of all scripts to 2%)…however the cost per script zoomed.  Compounds now account for one out of every eight dollars spent on drugs…

(see CWCI’s February 2013 report for details on what happened and why)

Joe also cites David DePaolo’s blog that reported on a criminal case involving payments to physicians for prescribing compounds;

“The complaint, filed by the owners of a medical billing company in the U.S. District Court in New Hampshire, alleges that Cyrus Sorat is a part owner of Health Care Pharmacy and Deutsche Medical Services in Tustin, Calif., and paid 208 doctors to prescribe compound drugs to injured workers needing topical analgesics. Sorat promised to pay the doctors an unreported fee for each prescription they wrote, and also agreed to handle billing and recover receivables on behalf of the physicians, according to the complaint.”

Just like the prescribing of opioid medications, the compounding of drugs is a serious issue that medical tourism industry personnel need to be aware of, especially if they are going to pursue patients injured on the job from the U.S.

One needs to have their eyes open to the possibility that drugs prescribed for patients by doctors will be compounded by pharmacies, and that those drugs have been the cause of injury and death to patients.

As Joe rightly points out in his blog, there are scoundrels and charlatans around, and especially in workers’ comp, their last refuge.