What is
Compounding?
Pharmacy compounding is
the art and science of preparing customized medications
for patients. Its practice dates back to the origins of
pharmacy; yet, compounding's presence throughout the
pharmacy profession has changed over the years. In the
1930s and 1940s, approximately 60 percent of all
medications were compounded. With the advent of drug
manufacturing in the 1950s and 60s, compounding rapidly
declined. The pharmacist's role as a preparer of
medications quickly changed to that of a dispenser of
manufactured dosage forms. Within the last two decades,
compunding has experienced a resurgence as modern
technology and innovative techniques and research have
allowed more pharmacists to customize medications to
meet specific patient needs. Today, an estimated one
percent of all prescriptions are compounded daily by
pharmacists working closely with physicians and their
patients.
How does compounding
benefit me?
There are several reasons
why pharmacists compound presciption medications. The
most important one is what the medical community calls
"patient non-compliance." Many patients are allergic to
preservatives or dyes, or are sensitive to standard drug
strengths. With a physician's consent, a compounding
pharmacist can change the strength of a medication,
alter its form to make it easier for the patient to
ingest, or add flavor to it to make it more palatable.
The pharmacist also can prepare the medication using
several unique delivery systems, such as a sublingual
troche or lozenge, a lollipop, or a transdermal gel. Or,
for those patients who are having a difficult time
swallowing a capsule, a compounding pharmacist can make
a suspension instead.
Can my child (or my
elderly parent) take compounded
medication?
Yes. Children and the
elderly are often the types of patients who benefit most
from compounding. Often, parents have a tough time
getting their children to take medicine because of the
taste. A compounding pharmacist can work directly with
the physician and the patient to select a flavoring
agent, such as vanilla butternut or tutti frutti, that
provides both an appropriate match for the medication's
properties and the patient's taste preferences.
Compounding pharmacists
also have helped patients who are experiencing
chronic pain. For example, some arthritic patients
cannot take certain medications due to gastrointestinal
side effects. Working with their physician, a
compounding pharmacist can provide them with a topical
preparation with the anti-inflammatory or analgesic
their doctor has prescribed for them. Compounded
presciptions often are used for pain management in
hospice care.
What kinds of
prescriptions can be compounded?
Almost any kind.
Compounded prescriptions are ideal for any patient
requiring unique dosages and/or delivery devices, which
can take the form of solutions, suppositories, sprays,
oral rinses, lollipops and even as transdermal sticks.
Compounding applications can include: Bio-identical
Hormone Replacement Therapy, Veterinary, Hospice,
Pediatric, Ophthalmic, Dental, Otic, Dermatology,
Medication Flavorings, Chronic Pain Management,
Neuropathies, Sports Medicine, Infertility, Wound
Therapy, Podiatry and
Gastroenterology.
Will my insurance cover
compounded medications?
Because compounded
medications are exempt by law from having the National
Drug Code ID numbers that manufactured products carry,
some insurance companies will not direclty reimburse the
compounding pharmacy. However, almost every insurance
plan allows for the patient to be reimbursed by sending
in claims forms. While you may be apying a pharmacy
directly for a compounded prescription, most insurance
plans should cover the final cost.
Is compounding
expensive?
Compounding may or may
not cost more than a conventional medication. Its cost
depends on the type of dosage form and equipment
required, plus the time spent researching and preparing
the medication. Fortunately, compounding pharmacists
have access to pure-grade quality chemicals which
dramatically lower overall costs and allow them to be
very competitive with commercially manufactured
products.
Is compounding legal? Is
it safe?
Compounding has been part
of healthcare since the origins of pharmacy, and is used
widely today in all areas of the industry, from
hospitals to nuclear medicine. Over the last decade,
compounding's resurgence has largely benefitted from
advances in technology, quality control and research
methodology. The Food and Drug Administration has stated
that compounded prescriptions are both ethical and legal
as long as they are prescribed by a licensed
practitioner for a specific patient and compounded by a
licensed pharmacy. In addition, compounding is regulated
by state boards of pharmacy.
Does my doctor know about
compounding?
Prescription compounding
is a rapidly growing component of many physicians'
practices. But in today's world of aggressive marketing
by drug manufacturers, some may not realize the extent
of compounding's resurgence in recent years. Ask your
physician about compounding, then get in touch with a
compounding pharmacy - one that is committed to
providing high-quality compounded medications in the
dosage form and strength prescribed by the physician.
Through the triad relationship of patient, physician and
pharmacist, all three can work together to solve unique
medical problems.
Is custom compounding
right for you? Ask your
physician or
pharmacist today about the
benefits
of personalized
prescription
compounding.
