Is Compounding Right for Me and My Pharmacy?

For as long as people and their animals have been getting sick, there have been pharmacists to help find a remedy.  Even in early days of medicinal practices, medicine men created healing mixtures by understanding and utilizing the properties of the world around them. Though far more basic in its practice, this combining of various elements from their environment can be seen as the roots of modern compounding.

We’ve obviously come a long way since then! In the last hundred years alone we’ve seen massive technological advances and a marked shift to large-scale manufacturing of medicines. However, this mass-producing of drugs has evolved into what can most aptly be described as one-size-fits-all. Now patients are keen on having more choices- choices for dosage forms, choices for the strength of the dosage and a general individualization of their prescription medications. It is in part because of this call for a more a patient-centered approach that pharmacy compounding has regained popularity. Compounding can be a huge source of revenue for a pharmacy, but it isn’t necessarily the right choice for everyone.

Take the following into consideration when trying to weigh whether this is right for your practice:

• Compounding has been around even longer than mass-production pharmaceutical companies, showing it has significant staying power.
• PBM (pharmacy benefit manager) reimbursements have been squeezed to a minimum on generics and brands alike, but many compounds still reimburse very well. Compounding offers the pharmacist a creative way to increase reimbursements and become a more valuable part of the patient care mix than a non-compounding pharmacy.  Read more in this Drug Topics article published last spring.
• Additional revenue can be developed from cash-paying customers, reducing the pharmacy’s reliance on insurers and governments for reimbursement, improving cash-flow and eliminating administrative costs and headaches.
• Compounding offers a niche that most chains do not offer, making your pharmacy a more competitive player.
• Special skills and additional training are required from select personnel, ultimately making your staff more effective.
• The decision to pursue compounding provides opportunities for continued education in many categories, such as HRT, Pain Management, Hospice, Pediatrics, Veterinary, or Dermatology, making you highly employable.
• Often, a physician’s perception of a compounding pharmacists is that of a resourceful colleague in the patient-physician-pharmacist “triad”.
• Patients frequently seek out compounding pharmacies to provide customized therapy options, which means lasting relationships with them.
• Compounding pharmacies are the only ones equipped to provide alternatives during drug shortages. Find a list of up-to-date drug shortages on the FDA’s website.
• It’s also important to keep in mind that taking on the title of ‘Compounding Pharmacy’ does require sufficient space for equipment and supplies, along with ample workspace for laboratory technicians and an in-depth knowledge of rules and regulations are required, including USP <795> and <797>.

As a testament to the relevancy of compounding as a whole, the Compounding Quality Act contains provisions relating to the oversight of compounding human drugs. While the new law mainly affects pharmacies that do large volumes and/or sterile compounding, this and other key legislation should also be thoroughly considered before making the decision to adopt compounding into your pharmacy.