|
In every field of medicine, there are some patients who don’t respond to traditional
methods of treatment. Sometimes they need medicine at strengths that are not manufactured
by drug companies, or perhaps they simply need a different method of ingesting a
medication.
Pharmacy compounding meets these needs. It provides a way for physicians and compounding
pharmacists to customize an individualized prescription for the specific need of
their patient. Compounding provides solutions which are not met by commercial products.
Q: What is compounding and what are its benefits?
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 in 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.
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 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 cream that can be absorbed through
the skin. For those patients who are having a hard time swallowing a capsule, a
compounding pharmacist can make a liquid suspension instead.
Compounding pharmacists have the opportunity to work with a variety of practice
specialties, such as hospice, pediatrics, pain management, and OB/GYN, which in
turn broadens the scope of their practices and creates other opportunities to provide
other pharmacist care services. Your pharmacy can become a compounding pharmacy
– one that is committed to providing high-quality compounded medications in the
dosage form and strength prescribed by the physician. This triad relationship between
the patient, the physician, and the pharmacist is vital to the process of compounding
so all three can work together to solve unique medical problems.
Q: What is PCCA’s role in this?
PCCA now has become the nation’s complete resource for compounding pharmacies. The
company’s members are more than 3,500 independent community pharmacists in the United
States, Canada, Australia, Europe and New Zealand. PCCA provides high-quality fine
chemicals and pharmacy equipment to members, and maintains a sourcing department
to locate those hard-to-find chemicals and devices. We also host a variety of ACPE-accredited
training and continuing education classes for pharmacists and prescribing physicians.
(Click here for more information on PCCA’s CE Programs.)
PCCA also maintains close, working relationships with several universities. In fact,
PCCA is a dedicated rotation site for the University of Houston’s College of Pharmacy.
When pharmacists join PCCA, they gain access to a staff of more than 20 consultant
pharmacists, pharmaceutical chemists, and training personnel ready to serve their
technical support needs. On average, PCCA’s Pharmacy Consulting Department answers
more than 600 consulting calls a day from member pharmacists who have technical
questions about preparing medications for patients. Our members and consultants
have access to a formulary database of more than 8,000 proprietary formulas that
have been pre-tested with PCCA’s chemicals.
PCCA offers comprehensive marketing consultation and support to help member pharmacies
develop their business strategies and inform patients and physicians in their community
about the benefits compounding can offer them.
Click here for more information about PCCA.
Q: Can children or the elderly use 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, which 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’s prescription, 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.
Q: 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 (for the ear), Dermatology, Medication Flavoring, Chronic
Pain Management, Neuropathies, Sports Medicine, Infertility, Wound Therapy, Podiatry
and Gastroenterology.
Q: Is compounding legal? Is it safe?
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 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.
PCCA’s Quality Control department is exhaustively devoted to assuring the quality
of the chemicals received, repackaged, and sold to our members. Steps include obtaining
a Certificate of Analysis for all chemicals received, verifying the identity of
every bulk chemical received both before repackaging and completing a second identity
test after repackaging, conducting regular tests of all chemicals in inventory,
and verifying all unique identifier numbers prior to shipping.
As a repackager of unformulated chemicals for pharmacy compounding, PCCA is registered
and inspected by the FDA and DEA. The company is also licensed in the state of Texas
and other states where licensure is required.
Q: Are doctors aware of 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.
PCCA member pharmacists are encouraged to invite physicians to our seminars and
symposiums, where they can learn about compounding while earning CME Continuing
Education credit. (Click here for more information on PCCA’s
CE Programs.) Through the triad relationship of patient, physician and pharmacist,
all three can work together to solve unique medical problems.
Want to learn more about compounding and how it can expand your practice? Call PCCA’s
Pharmacy Services Department at (800) 331-2498.
|