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Originally Posted by johnep  It is really good to have colleagues from the USA on this forum. During a visit to Naples Fl, I called in on an independent pharmacy to see how they survive.
The pharmacist told me that at that time they were fighting to retain compounding. I thought this would be mainly ointments, but a later conversation with a Prof from Gainesville elicited a heated response. he was dead against it as he told me pharmacies were preparing capsules and injections with little controls. In the UK compounding of 'specials' has been taken over by 'specials' laboratories and a charge of 100gbpnds is not unusual for 500g of 1% menthol in aqueous cream (actually this one now dead as a company has launched branded version, but still expensive).
I am sure others can give examples of the costs of non standard prescribing.
johnep |
Johnep,
Typically here, "compounding pharmacies" are the ones who do most of the compounding. Most of your retail/chain pharmacies simply don't have the time, but may do basic compounding (for example ours makes an omeprazole suspension for kids which is quite easy or a lidocaine topical gel for neuropathy). The problem in the US is that it really isn't regulated and is just based off of recipes. There is no standard whereby pharmacies are held accountable to ensure what they are preparing is indeed accurate. This may be changing though (I'm not sure as I don't keep up on this aspect of pharmacy). The other problem here is that physicians are taught to practice evidence-based medicine, and with compounded products, the evidence lacks and most of it is anecdotal. The other issue here is the whole liability of prescribing a compounded product that ends up causing someone harm and results in a lawsuit. I think many steer clear for these reasons. In terms of pharmacy though, I think it is a great niche if you owned one of these pharmacies.