# \[e-drug\] Two drug systems in the U.S. (7) **URL:** \ **Category:** e-drug\ **Created:** [October 20, 2004, 12:40pm UTC](https://talk.edrugplus.org/t/e-drug-two-drug-systems-in-the-u-s-7/20768 "2004-10-20T12:40:26Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Parrish\_Richard](https://avatars.discourse-cdn.com/v4/letter/p/9de0a6/32.png) [@Parrish\_Richard](https://talk.edrugplus.org/u/Parrish_Richard)\ **Post date:** [October 20, 2004, 12:40pm UTC](https://talk.edrugplus.org/t/e-drug-two-drug-systems-in-the-u-s-7/20768/1 "2004-10-20T12:40:26Z")
E-DRUG: Two drug systems in the U.S. (7) ---------------------------------------- Dear e-druggers, I completely understand the European position regarding drug development and use. In the US, drug regulation is really nebulous because of the union of the State and big PHARMA. The preparation of any medication for patient use by pharmacists and physicians is a matter for individual state (not federal) regulation and intervention. And the states have never done a very good job. In fact, the professions here do not routinely self-regulate even though we say we have self-governance via the State Boards of Medicine and Pharmacy. Thus, the impact of federalism in the US Constitution; the issue of drug preparation relates not only to commercial speech (First Amendment), but to treaty formation and the Commerce Clause (Article 8). In Germany, for example, the situation is very different because even though Germany is a federal republic, its governing structure (and therefore function) is different. See Arthur Daemmrich's book, Pharmacopolitics (Chapel Hill, NC: University of North Carolina Press, 2004) for more explanation and synthesis. The health professions in the US need to resume responsibility for their medication-use recommendations, or else step aside for a direct plebiscite from a safety-weary public. It is interesting to note the influence of Big PHARMA in the writing of the standards for drug discovery, access, and financing. I do not know whether compounded medications will be reimbursed by the Medicare scheme. Moreover, as Professor David Newton has suggested to me on several occasions, compounding-related morbidity and mortality are dwarfed in comparison to that caused by mass-produced pharmaceutical use! Compounding pharmacies have taken steps to self-regulate via a registry system similar to the Joint Commission on Accreditation of Healthcare Organizations; an international society exists to aid pharmacists involved in compounding at www.iacprx.org. Public Citizen has published an interesting report "The Medicare Drug War: Drug Companies and HMOs Led an Army of Nearly 1,000 Lobbyists to Promote Misguided Legislation" at www.citizen.org. Regards, Richard Richard H. Parrish II, Ph.D., R.Ph. Assistant Professor Department of Pharmacy Practice Bernard J. Dunn School of Pharmacy Shenandoah University Faculty Senate Secretary - 2004-5 1775 North Sector Court Winchester, VA 22601 USA tel: +1 540 678 4392 fax: +1 540 665 1283 email: RParrish@su.edu