On Sunday’s Last Week Tonight, John Oliver recruited an eclectic group of celebrities, including Method Man and Michael Bolton, to highlight the dangers of compounding pharmacies. Jimmy Kimmel, David Schwimmer, RuPaul, Kiefer Sutherland and Kristen Bell also appeared in the episode’s main segment, which detailed how lax oversight has turned these companies into the “Wild West” of the pharmaceutical industry — resulting in fraud and even “many, many people dying,” Oliver said.
Before the cameos, Oliver defined the compounding process and dove into the hazards that have made headlines. Compounding pharmacies, he explained, create drugs on-site for various reasons — like producing medicines in liquid form or in lower concentrations than what’s commercially available. While the failure rate for commercially manufactured drugs is around two percent, it’s around 33 percent for compounded drugs.
“To put that in perspective, compounded drugs have about the same failure rate as the Jonas Brothers,” Oliver cracked. “We all know which one I’m talking about, and it’s not you, Kevin! You’re doing great! (Shh — come on, guys. He’s been through enough!) You’re doing really great, Kevin! You’re actually my favorite! (Shhh!)”
Equally troubling are the unsanitary conditions found at many of the 7,500 compounding pharmacies nationwide, including loose pills stored near a toilet. “I’ve never been to pharmacy school,” Oliver joked, “but I’m pretty sure lesson one is, ‘Don’t put the pills where you poop.'”
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Given the lack of FDA oversight, state pharmacy boards are supposed to send inspectors to check for sanitary conditions. But some states have an extreme shortage: As of 2016, Hawaii had only one; Kansas had two; and Illinois had three, despite having nearly 2,700 such pharmacies.
That problem has already created deadly consequences. One compounding pharmacy produced bulk quantities — itself a violation — of a contaminated steroid injection that was shipped to 23 states, resulting in 100 deaths from fungal meningitis in 2012.
Regulations require compounding pharmacies to have individual prescriptions for each patient, so the company skirted around that rule by falsifying prescriptions with names like “Big Baby Jesus,” “Roy Rogers,” “Wonder Woman,” “Bud Weiser,” “Jimmy Kimmel,” “David Schwimmer,” “Michael Bolton,” “Jack Bauer,” “Sarah Marshall,” “RuPaul” and “Method Man.” Hence the guests on this segment.
Congress eventually passed a law toughening up regulations among compounding pharmacies, although they included some giant loopholes: Any pharmacy aiming to mass-produce drugs has to register as an “outsourcing facility,” but doing so is voluntary. Only 77 facilities — just one percent — are currently registered.
“When oversight is this weak, compounding pharmacies can hurt large numbers of people for a long time,” Oliver said. Illustrating that point, the host pointed to Texas company Guardian Pharmacy Services, which reportedly mass-produced medicine that was injected into people’s eyes and was found to contain formaldehyde and acetone — “two things pretty high up the list of things to keep away from your eyes, right above jalapeño peppers and just below the trailer for Cats,“ Oliver said.
“Compounding pharmacists play an important role, but that is all the more reason why they should be properly regulated,” Oliver said. “So at the very least, we need more inspectors at the state level; the outsourcing facility designation should not be voluntary; and compounders should have to alert regulators whenever they fuck up.”
The comedian closed by bringing home his message, recruiting the aforementioned celebrities to call out illegitimate compounding pharmacies.
“Please don’t use our names in your bullshit prescriptions,” Method Man said in a pre-filed bit.