Endurance.Net Ridecamp Archives

> Hi all-
> I poked around the archives and found some info on
> Adequan IM vs Chondoprotec, but I didn't find anything
> about the 'generic Adequan' that I'm considering
> using, so here's my question. A vet told me that he
> can order a compounded drug (he called it generic
> Adequan) for about half the price of brand name
> Adequan. He said that they're chemically the same
> thing, and that he uses a compounder that he really
> trusts...I did some internet surfing on compounded
> medicines, and it sounds like the vet community is
> currently arguing about them and the ethics (not sure
> if that's even the right word to use) of using them.
> I'd love to hear our respected vets' opinions (Heidi,
> Susan, etc).
There are several ethical angles here.

1)  Is the drug on the market, but currently under patent?  If so, then it
isn't legal for the compounder to sell an off-label version.  But all
drugs do go off patent at some point, and when they do, then it is as much
fair game for a compounder to sell them as it is for any other competitor.

2)  If the drug isn't on the general market, what is the reason that it
isn't?  It is usually one of two reasons:

   a)  The drug doesn't command enough of a market to interest a major
pharmaceutical house, or

   b)  It has been pulled off the market for some reason or another.

If the problem is a), then I don't see any ethical dilemma at all in
having a compounder make it to order.  If the problem is b), then there
are generally two more possibilities:

          aa)  The drug leaves residues in the food chain, or

          bb)  The drug truly has toxic or abusive properities.

If the problem is aa), then the only ethical problem is whether or not it
is being used in such a manner that it will go into the food chain.  The
example I gave of the pig oral nitrofurazone suspension would fall under
this category--it would be unethical to go to a compounder and have a
bunch of it made up to feed to baby pigs that will eventually go to
market, but there is no ethical problem in using it as an intrauterine
flush in a broodmare or as a wound flush for a horse, provided neither is
destined for slaughter for human consumption.  If the problem is bb), then
the dilemma is a tougher one--is there truly no other drug that can do
what it does, and is the situation serious enough to warrant the risks of
using the drug?  Some of the estrogen products (diethyl stilbesterol) that
caused daughters of women taking them to have reproductive abnormalities
fall under this category--they are no longer on the market, but there ARE
occasional situations where their use is indicated.  In that case, if one
could get the drug from a compounder, it would be worth it for that one
rare case.

And in extreme cases of the latter, the drug isn't one that compounders
can legally sell, either--eg "street drugs" and that sort of thing.

There is nothing unethical about the compounding process or the existence
of compounding pharmacies per se--only about misuse of the products
obtained from them.

Heidi


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