Compounding Pharmacies / FWA

• Compound Requirements

• Must be for medications for specific patients, for a specific condition, for a specific prescription

• Compounding in bulk for multiple patients before prescriptions are received is manufacturing!

• Limits

• Patients will probably not know

• Prescriber will not know unless they have a commercial arrangement with the pharmacy

• Health Plans will only know when doing analysis of medication utilization

• PBMs will only know when doing analysis of medication utilization

• What are compounds?

• Injectables with custom ingredients and dosing

• Oral tabs/caps with non-manufactured ingredients

• Oral liquids for custom dosing

• Topical medications in different bases for better absorption or non-allergic

• What are compounding pharmacies?

• Regulated by State laws

• Rationale:

• Children’s medications

• Allergic modifications

• Dosing modifications

• Mixing injectables

• Animal treatments

• Misc.

• Limits on compounding

• PBM restrictions on medications currently manufactured

• State oversight

• Lack of absorption or effectiveness

• FWA

• Small % of total dispensing

• Physician prescribing for custom medications with a commercial motive

• Pharmacists dispensing/manufacturing for multiple patients for custom medications with a commercial motive

• Sterility problems

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