Compounding Pharmacies and Fraud, Waste & Abuse

Compounding Pharmacies / FWA - Compound Requirements - Must be for medications for specific patients, for a specific condition, for a specific prescription - Compounding in bulk for multiple patients before prescriptions are received is manufacturing! - Limits - Patients will probably not know - Prescriber will not know unless they have a commercial arrangement with the pharmacy - Health Plans will only know when doing analysis of medication utilization - PBMs will only know when doing analysis of medication utilization - What are compounds? - Injectables with custom ingredients and dosing - Oral tabs/caps with non-manufactured ingredients - Oral liquids for custom dosing - Topical medications in different bases for better absorption or non-allergic - What are compounding pharmacies? - Regulated by State laws - Rationale: - Children’s medications - Allergic modifications - Dosing modifications - Mixing injectables - Animal treatments - Misc. - Limits on compounding - PBM restrictions on medications currently manufactured - State oversight - Lack of absorption or effectiveness - FWA - Small % of total dispensing - Physician prescribing for custom medications with a commercial motive - Pharmacists dispensing/manufacturing for multiple patients for custom medications with a commercial motive - Sterility problems ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks YouTube: https://www.youtube.com/user/ProPharmaEducation