Meningitis, Compounding Pharmacies and Workers' Comp

Wednesday, October 17, 2012 | 0

There’s one good thing coming out of the horrific and rising death toll from possibly-contaminated drugs produced by a small drug compounding firm. There’s nothing like a few deaths to concentrate the attention of policymakers.

If that sounds heartless and cruel, it is nonetheless quite true.

Much more attention will now be paid to the practice of compounding, bringing much-needed focus on the very real dangers inherent in the practice. To date, a dozen people have died as a result of the tainted drug, but the count may well increase: 13,000 people received the injections. Experts believe about 650 individuals will end up infected, up from 121 today.

Roberto Ceniceros reported that many of the facilities using the tainted drug treat workers' comp patients.

The reality is compounding is not tightly regulated; the FDA is responsible for ingredients, but individual states handle manufacturing and oversight. That’s not for a lack of trying; the FDA has repeatedly tried to increase its oversight of compounders, only to see those efforts blocked by compounders’ lobbyists (think of this when you listen to politicians ranting about regulatory burdens).

The meningitis outbreak is only the latest in a string of what the FDA reports is 200 “adverse events” associated with 71 compounded drugs, one of which blinded two veterans at a Virginia facility. Back in 2009, Dan Reynolds of Risk and Insurance wrote an extensive article on the problems with compounding, citing experts from PBM HealtheSystems.

Implications for workers’ comp

1.  The drug in question was typically injected into the back to relieve back pain. The procedure, known as an epidural steroid injection, is all too common in workers’ comp. It is highly likely that some of the victims were comp claimants. Here’s hoping the insurers for the victim(s) vigorously pursue legal action against the compounder.

2.  As the California Workers' Compensation Institute, the Workers Compensation Research Institute and others have reported, compounding is growing in workers' comp. There’s been a significant increase in California since the Golden State slapped controls on over-charging for repackaged drugs. One theory is the profiteers looked for another place to suck money out of the system. Hopefully regulators and legislators will now have the impetus they need to blow through compounders’ lobbyists and put stronger controls on the practice. 

Joe Paduda is owner of Health Strategy Associates, an employer consulting firm in Connecticut, and co-owner of CompPharma, a consortium of pharmacy benefit managers. This column was reprinted with his permission from his Managed Care Matters blog.