Alexandria, Va. (Nov. 13, 2012) - Most independent community pharmacies offer patients traditional compounding services and, while it accounts for a small portion of their business, the health-enhancing effect for patients can be dramatic, according a new survey released today by the National Community Pharmacists Association (NCPA).
“This survey offers fresh evidence that traditional compounding services are a saving grace for patients when mass-produced drugs aren’t available or are not appropriate for the patient,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “Traditional compounding may just be one of many health services offered by independent community pharmacists, but it is vital to better health for many Americans. Pharmacists will continue to work constructively with Congress and other policymakers to not only help prevent another crisis like the meningitis outbreak, but to also preserve patients’ access to customized and safe compounded medications. ”
Pharmacists and other experts consider the cornerstone of traditional pharmacy compounding to be the preparing of customized medications on a patient-by-patient basis in response to the request of a doctor or other prescriber. The practice is most commonly employed when manufactured drugs are not appropriate for a particular patient (such as children or those with allergies) or when mass-produced medicines are not available.
In November 2012, over 400 independent community pharmacists responded to an NCPA survey about traditional pharmacy compounding. According to the survey:
- 85.5 percent of respondents offer traditional compounding services.
- Of those pharmacists who compound medications, nearly two-thirds (62 percent) say these medications make up a very small portion of their pharmacy practice (five percent or less).
- Almost three out of four compounding pharmacists (72 percent) only provide non-sterile medications.
- Despite the fact that traditional compounding only represents a fraction of their business, 70 percent of pharmacists report participating in ongoing training/educational courses related to compounding techniques. This training is in addition to any continuing education that may be required to sustain one’s license as a pharmacist.
“Pharmacists are appalled by the reported actions of the rogue drug manufacturer at the center of the tragic, nationwide meningitis outbreak,” Hoey added. “It purported to be a pharmacy, but its actions told another story. It’s disappointing that regulators did not act sooner to prevent patient suffering.”
The survey also recorded the following accounts of pharmacists to address patient needs through traditional pharmacy compounding:
- We had a pediatric hospice patient with pulmonary hypertension. We compounded a sildenafil prescription that saved hospice thousands of dollars per month and made the suspension palatable for the child.
- A local Veterans Affairs hospital was completely out of potassium chloride and morphine injections. Neither of these was available commercially. We saved them with emergency supplies until the manufacturer had them back in stock.
- We had a pediatric patient with Menkes Syndrome which is 100% fatal. We supplied Copper injection which lengthened the baby’s life and reduced discomfort. It also allowed the mother and father time to bond and ultimately say goodbye in their own spiritual way. They could not thank us enough.
- We have a cystic fibrosis patient who would not be alive today without the compound we make for him.
- We have a patient who cannot swallow properly so all his medications must be made into liquids. Tablets/Capsules get lodged in his esophagus causing damage. He was suffering prior to us compounding his medications into liquids.
- We compound medications that are not commercially available that patients often cannot do without. An example is child coming out of a children’s hospital in need of heart medications that must be reformulated from an adult’s dose to a child’s dose.
- We compound medications for hospice patients who are near death. We provide dosage forms, other than oral, so people can live their last days with less pain and anxiety.
- I have a patient who is allergic to all dyes, preservatives, corn and gluten. She cannot take most conventional medications due to the fact that they have most of these ingredients in them. I have been able to formulate her medicines into a capsule formulation and ensure that there is nothing she is allergic to in the capsules.
- We have quite a few patients who are able to be seizure-free because we can compound their medications into age-appropriate doses that are not commercially available.
- We provide pain relief to paralyzed patients who require special administration of medication not available anywhere on the market.
A copy of the survey is available here.