Compounding Questions & Answers:

Pharmacy compounding is the art and science of preparing customized medications for patients. Its practice dates back to the origins of pharmacy, although compounding’s presence in the pharmacy profession has changed over the years. In the 1930s and ’40s, the majority of prescriptions were compounded. With the advent of mass drug manufacturing in the 1950s and ‘60s, compounding declined as the pharmacist’s role as a preparer of medications quickly changed to that of a dispenser of manufactured dosage forms. However, this “one-size-fits-all” approach to medication meant that some patients’ needs were not being met.

Within the last few decades, however, compounding has experienced a renaissance as modern technology and innovative techniques and research have allowed more pharmacists to customize medications to meet a patient’s unique needs.

There are several reasons why prescribers and pharmacists provide compounded medications for patients. The primary reason for compounding is to avoid patient non-compliance, which means the patient is either unable or unwilling to use the medication as directed. Many patients are allergic to preservatives or dyes, or require a dosage that is different from the standard drug strengths.

With a physician’s consent, we can:
Adjust the strength of a medication
Avoid unwanted ingredients, such as dyes, preservative, lactose, gluten, or sugar.
Add flavor to make the medication more palatable
Prepare medications using unique delivery systems. For patients who find it difficult to swallow a capsule, a compounding pharmacist may prepare the drug as a flavored liquid suspension instead. Other medication forms include topical gels or creams that can be absorbed through the skin, suppositories, sublingual troches, or even lollipops.

Yes! Children and the elderly are often the types of patients who benefit most from compounding. It is common for parents to have a tough time getting their children to take medicine because of the taste. At Siena’s Pharmacy, we can work directly with the physician and the patient to select a flavoring agent, such as bubblegum, grape, tutti frutti, or vanilla butternut, which provides both an appropriate match for the medication’s properties and the patient’s taste preferences.

We can also can help patients who experience chronic pain. For example, some arthritic patients cannot take certain medications due to gastrointestinal side effects. With a healthcare practitioner’s prescription, we may be able to provide these patients’ anti-inflammatory or pain-relieving medications with topical preparations that can be absorbed through the skin. Compounded prescriptions frequently are used to ease pain, nausea, and other symptoms for hospice patients as well.

Compounding has been part of healthcare since the origins of pharmacy, and is widely used today in all areas of the industry, from hospitals to nuclear medicine. Over the last few decades, compounding’s resurgence has benefited largely 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.

Some insurance plans allow the patient to be reimbursed by sending in claim forms. While you may be paying a pharmacy directly for a compounded prescription, many insurance plans may cover the final cost.

Compounding may or may not cost more than conventional medication. Its cost depends on factors such as the type of ingredients and equipment required, plus the time the pharmacist spends 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.