Answering the narrow version, because the broad one does not have a single answer. Resolution therefore closed the doors unevenly, and the asymmetry follows from the bulks lists. For 503B the shortage clause was the only route to these molecules, so that route shut completely. A 503A pharmacy can still argue a doorway via "component of an approved drug" — but only for the substance in the form present in the approved product, which is exactly where the base-versus-salt argument lives, and it does nothing about the copy restriction, which came back into force on resolution.
Two pharmacies quoted me last year, one describing itself as 503A and one as 503B, and I assumed 503B just meant bigger until both stopped within weeks of each other.
What I am after is why a shortage listing created a legal pathway at all, since a shortage is a supply fact rather than a permission.
Happy to be told the question itself is wrong.
DanielChem_CHI said:Resolution therefore closed the doors unevenly, and the asymmetry follows from the bulks lists.
DanielChem_CHI has the substance of this right. The condition it depends on is worth stating. Worth adding the genuine exception, because it is real and narrow: a change made for an identified patient where the prescriber determines it produces a significant clinical difference for that patient. A grid of fixed doses offered to everybody is not that, whatever the intake form says.
Ask again with the specifics and you will get a better answer than this one.
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Shop Reference StandardsVanRx_Mike said:Two pharmacies quoted me last year, one describing itself as 503A and one as 503B, and I assumed 503B just meant bigger until both stopped within…
This matches mine closely enough to be worth saying so. The shortage clause is the answer to the second question and it is a subtraction rather than an addition. Both exemptions forbid compounding something that is essentially a copy of a commercially available approved product. A product FDA has listed as in shortage is not treated as commercially available, so listing removed the objection that otherwise blocked compounding. It never created a permission; it withdrew a prohibition, which is why it evaporated the moment the supply fact changed.
From the other side of the consultation, briefly.
503A vs 503B compounding pharmacies for compounded supply — this distinction matters enormously:
| Feature | 503A | 503B |
|---|---|---|
| Regulation | State Board of Pharmacy | FDA-registered |
| Prescription | Required (patient-specific) | Can compound without patient Rx |
| Testing | Varies by state | cGMP required |
| Scale | Small batches | Larger production |
| Quality consistency | Variable | Generally higher |
I strongly recommend 503B facilities. The FDA oversight and cGMP requirements mean more consistent product quality.