Comment by roywiggins

18 days ago

It's basically a regulatory arbitrage, see here:

https://old.reddit.com/r/FamilyMedicine/comments/1nz5xkd/how...

> they get away with it because:

> In-house prescription

> legally registered 503A compounding pharmacy that is not selling bulk (individual prescription quantities)

> They can argue clinically distrinct compounding

> FDA does limited enforcement unless its unsafe or mass bulk production

Point 4 seems not to be holding anymore.

Any idea why they'd change their mind about point 4?

The regulatory agencies were understaffed for the work load even before recent layoffs. Why focus on this, of all the things they could put their effort into?

  • They didn't change their minds. The enforcement was consistent. It's the companies who scaled up their production to mass market levels who prompted the action.

    There have been several examples in the past 5-6 years of the FDA loosening regulations to benefit patients and companies rushing in to abuse the opportunity at scale.

    Another one that comes to mind is when the FDA loosened restrictions on telehealth prescribing of controlled substances during COVID. Several companies saw this as an opportunity to set up digital pill mills, advertising on TikTok and offering Adderall prescriptions as a service. Nurse practitioners were paid up to $60,000 per month to write prescriptions as fast as they could without interacting with patients.

  • Whoever isn’t making their profits when people buy them this way is directing the FDA to act. You can bet on it.

    • As they should.

      The companies who bet several billions of dollars in literal decades of research on this stuff should absolutely be swimming in cash until the end of their days. Hims & Hers should be sued into oblivion for stealing the rewards of other companies' ingenuity, risk-taking, and dedication toward helping patients.

      I am highly sympathetic to the argument that the government should just buy these patents and mass manufacture to increase availability, or just buy guarantee order vast amounts to scale up manufacturing and distribute cheaply, but the idea that a different private company ought to be able to profit in the way Hims & Hers has is absolutely flatly fucking insane.

      3 replies →

  • Because “this” is about the biggest in-your-face blatant disregard for FDA rules that has quite literally ever existed in history. The scale is unprecedented.

    If there was a single thing an understaffed FDA would go after it would be the compounding pharmacies and that whole ecosystem blatantly thumbing their nose at it all.

    Not that I agree with the rules - but if this is allowed it’s essentially an end-around the entire prescription drug regime as we know it.