The Compounding Business

At compounding pharmacies, we can’t copy or duplicate a commercially available product. We can make something different than what is on the market, or we can make an alternative product if someone is allergic to something already on the market. Compounders can make things that are commercially available only when a drug is on shortage; then, we can step in and compound something like magnesium sulfate, which is always on backorder.

Some medications we make are found only at compounding pharmacies; they are not available elsewhere at retail pharmacies. Some medications are combinations of different drugs that may only be commercially available individually. We make some drugs that have four or five active ingredients in them. This can be beneficial because, instead of a patient getting two medications, they can get a combination cream that might be less expensive and keeps them more compliant by just using one product.

Something like an estrogen cream may cost a patient $300, but it only costs us $10 to make, then we can sell it for $20. It’s how big pharma and huge manufacturers take advantage of patients every single day.

I don’t think there are enough people out there that know that. People usually get to us through a doctor that reaches out asking if we can make a medication because the patient can’t afford it at the pharmacy. The doctor wants to know if we can make it cheaper.

We may not be able to make the exact drug, but we can make a derivative or use a different base or ingredient and it will cost less than a co-pay. I don’t think a lot of doctors know that, because they are so used to writing a script and patients go to a pharmacy. Sometimes they are able to just pay a $10 co-pay, and that’s great for the patients who can do that.

We have a sales team, and they are responsible for talking to doctors about what products we make and give pricing and provide education and teaching and training. It’s the efforts of our sales team that gets most doctors saying, “I’d rather use you than a pharmacy.”

We also do marketing in social media, but it’s hard to go directly to patients, because then they have to go to their doctors to ask and some doctors may not use compounding pharmacies. We also don’t work with employers, because it is the doctor that has to end up writing the script. Sometimes we work with telemedicine companies. We have partnerships where telemedicine doctors will prescribe patients compounded products and it goes directly to us.

IV nutrition is a big one; we work in intravenous and intramuscular nutrition like vitamins B, C and D. We work in women’s health in areas like hormone replacement therapy, pelvic pain and sexual health. Men’s health is another big one. Erectile dysfunction is huge in compounding because there are so many different products that we can make for ED and for other sexual health for men.

We work in allergy with sublingual and subcutaneous testing. In pain management there are topical creams for athletes and for people who have arthritis and osteoarthritis. There is also a lot of compounding in weight loss, and, of course, dermatology is also a really big one.