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, though, compounding 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 prescription 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 prescriptions 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.
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 directly 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 paying 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 benefited 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.
