Compounding: Are You There Yet?

Eugene Medleyby Eugene Medley, PharmD, MS; Owner, Sea View Pharmacy; Regional Leader, WSPC

We have all heard it before: “Compounding can help recover lost revenue from decreased reimbursement from the monopolistic terrorists.” Yet what does it take to really perform and get into that revenue stream? Hopefully the information provided here will help you increase efficiencies, improve performance, and capitalize on a potential opportunity. Your success will depend on having the right equipment and facility, offering proper training for complete patient consultations, and utilizing active direct marketing to promote your services.

I personally have been compounding for over a dozen years and our facility has been in business for over 40 years. Our staff has a combined total of over 120 years of personal experience. The continuous innovation in equipment is vital to generating pharmaceutically elegant formulations. The machines that are available today help us prepare consistent formulations that patients and practitioners can rely on to obtain consistent therapeutic results. The formulations must be made efficiently and uniformly each and every time with no exceptions. Thankfully, this is not as difficult as it sounds. It’s meeting the regulatory requirements where the true difficulty lies.

Like many industries, the pharmaceutical industry depends on technology to improve performance. This technology includes:

  • a computer terminal with a bar code scanner,
  • printers,
  • analytical balances,
  • an electronic mortar and pestle,
  • an ointment mill,
  • a hot plate/stirrer,
  • a homogenizer,
  • a resonance acoustic mixer,
  • a planetary mixer,
  • and a centrifuge, among other things.

These pieces of equipment might seem like extravagances, but they actually free up the compounder’s time to comply with all of the rules and regulations that accompany each prescription. Being able to make a suppository in less than 20 minutes is an amazing thing that can only be achieved if one embraces the tools of the trade.

We have positioned ourselves as an indispensable part of the community, providing care that no one else can offer.
The facility has its own standards that also must be met. The compounder must have access to proper personal protective equipment and engineering controls that are required by each individual State Board of Pharmacy.

It’s fine and dandy to have wonderful equipment and a beautiful facility, but it’s useless without the know-how to use it. That is where training and education come into play. Thankfully, there are multiple organizations that provide continuing education, including certification and training.

The ongoing education is ultimately what provides the diversification of the revenue stream.

PCCA, Medisca, Letco, Humco, Spectrum, Encore Scientific, American Pharmaceutical Ingredients, Fagron, and others also provide quality bulk Active Pharmaceutical Ingredients (APIs) to purchase. So, relationships with each organization become a win-win partnership. It is up to you to determine which relationships to pursue, based on your unique needs and preferences.

Now, what kind of product mix do you offer? That would depend on the demographics of your patient population. Do you have men and women who come into your store? Well, perhaps some bioidentical therapies for andropause and menopause. Do your patients have pets? Well, perhaps a veterinary offering. Do your patients have children with sensitivities? Well, perhaps pediatric formulations. Maybe you have a dermatologist nearby that sees patient with dermatological issues. Maybe you have an otolaryngologist nearby who needs head and neck remedies (nasal sinus rinses). The key here is to provide a service that it is not found in a large chain operation for a reasonable price to promote wellness. I have treated entire families, from the newborn baby to the great grandparent to the family dog.

We have positioned ourselves as an indispensable part of the community, providing care that no one else can offer.

Being able to make a suppository in less than 20 minutes is an amazing thing that can only be achieved if one embraces the tools of the trade.
After compounders are able to prepare formulations and meet regulatory compliance, they need to promote their newfound skill set. You do not want to hire an advertising agency for this. The rules for contracting with an outside advertising agency to promote the business does come with risk; therefore, direct-to-practitioner marketing by the compounder is the tried-and-true method. A Yelp ad campaign gets you to the end user, but they need someone to write the prescription. It is the doctor who has to have confidence in your facility’s ability to provide optimal care to his or her patients.

Ultimately, it comes down to what makes you happy. If you’re not of the right mindset, then this isn’t for you. We are all professional chemists. We thrive on science and innovation. Our profession is based on developing patient-specific treatment modalities. If you are creative and able to understand the science, then compounding is a great fit.

You are able to directly impact a person’s life and help them overcome what ails them. Making money becomes a byproduct rather than a core objective. Passion drives innovation, which leads to the accumulation of the almighty Dollar.