Do we still need compounding pharmacies in today’s modern world?

Compounding pharmacies are often referred to as ‘old-fashioned’ pharmacies; sometimes with reverence, and sometimes with a sigh. The term comes up because there was a time when all pharmacies were compounding pharmacies. Medications were made on site in the dispensary using the raw ingredients stipulated on a doctor’s script. With the advent of mass- manufacturing in the 1950s and 1960s, this made-from-scratch model of pharmacy began to die off. Consumers preferred the pills in the shiny packets and regulators preferred the uniform consistency of mass-produced drugs.

But is ‘old-fashioned’ necessarily irrelevant?

There was a time, around the 1970 and 80s, when our cupboards and freezers were full of highly-processed foods, crammed with sugars and preservatives. Remember Spam and cheese in a can? It was a thoroughly modern way of eating. Fast forward 30 or 40 years, and highly processed food of this kind is in the minority in most people’s kitchens. We’ve remembered the health benefits of the ‘old-fashioned’ way of eating – one that is high in whole vegetables, fruits and grains and quality proteins.

We’ll never go back to the ‘old fashioned’ way of compounded medication – mass produced drugs are here to stay – however that doesn’t mean that compounding is finished. Quite the opposite. Compounding still, and will probably always, have an important role to play in producing medicine for people whose health condition doesn’t fit the one-size-fits-all mould of modern pharmaceuticals.

Just as no two people are the same, neither are their health care needs.

Following are some examples of where compounding is critical in treating the unique health care requirements of the individual:

Helping people with allergies

Many mass-produced medicines include preservatives that help them remain stable for the long periods it takes for them to be shipped overseas where they could sit on pharmacy shelves and in warehouses for long periods of time. They are necessary. However some people are allergic to these preservatives. Some people may also be allergic to the colours, fillers and other excipients regularly used in modern medications.

A compounding pharmacist can make up medications, locally, from scratch, that are free of all preservatives, colours and other additives. The patient can continue taking their medication without side-effect.

Hard pills to swallow

Many people have trouble swallowing large pills and tablets. Newborn babies are one obvious example. And in some adults, their gag-reflex is sensitive, making the act of swallowing a large hard object next to impossible. Tablets and pills can be crushed however this is a messy business and studies have shown that nearly a quarter of the medication can be lost in this method.

A compounding pharmacist can make up medications as liquids, creams or troches making administration much easier, especially in the case of babies, and compliance with treatment plans much more likely.

Combining multiple medications

For people with a number of health conditions that require medication, particularly the elderly, the chore of taking numerous pills every day can become problematic.

In many cases compounding pharmacists can combine multiple medications in one tablet, troche or liquid. This makes ‘pill time’ a much less stressful time for the patient and for those responsible for administration of medication.

If it tastes bad it must be good for you

Not when you work with a compounding pharmacist. A compounder can make up medication in flavours such as vanilla, chocolate, butterscotch, raspberry and bubble gum – a great solution for children (and some stubborn adults!) who refuse to take their medicine.

When medications are discontinued or become unavailable

Increasingly drug manufacturers are finding themselves unable to keep up with demand for some common medications and they become unavailable for a period. Stockpiles run out in countries across the world, including Australia, causing real concern to patients and doctors alike. In addition some perfectly safe and effective medications are taken off the market and discontinued as they’re no longer profitable to manufacture.

In these cases a compounding pharmacist can make up the unavailable or discontinued medication, safely in their local laboratory. This is a god-send to many patients, allowing them to continue their treatment plans with no disruption and no switching to alternatives that may not be as effective or suitable.