Why Compounding?
Compounding is integral to any pharmacy or pharmacist
In modern times, the roles and responsibilities of pharmacists have coincided with the industrial revolution and the changes in health care. In the 1930’s and 1940’s, approximately 60 percent of all medications dispensed were compounded. During the 1950’s and 1960’s, with the advent of manufacturing, compounded weaned. Pharmacists were thankful for the opportunity to fill prescriptions pre-made from the manufacturers. It was during this time that the role of the pharmacists went from that of a compounder, preparing medications from scratch, to that of a dispenser of the manufactured dosage form.
Since the early 1980’s physicians and patients are again realising the benefits of individualised or unique dosage forms for specific patient needs. No other health care professional has studied chemical compatibilities and can prepare dosage forms. Even when modern scientific technologies have produced new chemical entities, the ability of the pharmacist to combine one or more chemicals into a new preparation or process the existing dosage form into one that is better suited to the patient’s needs, has remained the domain of the pharmacist.
Because every patient differs and has different needs, a compounding pharmacy will always have an essential practice of the profession.
Meeting the Patient Needs:
The basis of the profession of pharmacy has always been the patient-physician-pharmacist relationship. Through this relationship, patient needs are determined and decisions are made about treatment regimen that may include a compounded medication. There are a number of reasons to compound medications, including but not limited to:
1. Medications That Are Not Commercially Available
Manufacturers must be assured that there will be a return on their investment when entering the market place with a drug product. Therefore, there are limited chemical forms, dosage forms, strengths, flavors and packaging that are available for the physician to prescribe and the pharmacist to dispense. Compounding allows the physician to prescribe a custom-tailored medication that is not available commercially.
2. Medications that Are Not Stable
Pharmacists prepare small quantities of the prescription more frequently to ensure stability of the product for its intended use.
3. Altered Commercially Available Medications
Physicians prescribe a commercially available medication in a different dosage form to meet a specific patient need and ensure patient compliance. For example, a patient may be allergic to a preservative or dye in a manufactured product, the compounding pharmacist can prepare a dye-free or preservative-free dosage form. Some patients have difficulty swallowing a capsule and require a troche or lozenge. Many pediatric patients are non-compliant because their medications are bitter, but become compliant when the medication is flavored to their liking.