Medicines can be classified in several ways, one of which is the way in which they are produced. In this case, there are:
- Medicines of industrial origin, i.e. prepared, packaged and marketed by the manufacturing company. On this type of medicine, the pharmacist cannot make any changes.
- Compounded drugs, i.e. prepared directly by the pharmacist in the laboratory of the pharmacy, parapharmacy or hospital.
Compounded drugs (i.e. made in a pharmacy on prescription) are prepared according to the quality and quantity of each component as expressly indicated by the prescribing doctor.
The benefits of drug compounding
Most people rely on common industrial medicines that usually manage to meet the most common needs of the population. This does not mean that compounded drugs do not have their own utility and that “preparatory” pharmacists are not still important today.
They can make up for drug shortages
The global supply chain of almost all traded goods has suffered a major setback following the Covid-19 pandemic, and although there are signs of recovery, some sectors are struggling to return to the same import and export levels achieved before 2019.
In addition to supply problems, the pandemic has exposed the market’s difficulty in coping with such drastic changes in demand for certain products. In the pharmaceutical sector, a case in point is pediatric ibuprofen, which was almost unavailable on the market for a while following the increase in cases of Covid-19 and other respiratory viruses in the child population.
In these cases, where industrial production fails to meet market needs, compounded drugs can be used to make up for it. Especially in the case of children’s medicines, the possibility of having the medicines produced in pharmacies prevents parents from trying to give children adult medicines in lower doses, without knowing the risks and contraindications.
Responding to a patient’s particular needs
Among the reasons why a doctor might choose to use compounded drugs is the need to use particular preparations that are not available in current industrial production.
Sometimes, these ad-hoc preparations are deemed necessary to meet therapy protocols for diseases that involve customized treatments, developed according to numerous parameters that generally vary greatly from case to case. The patient’s diet, for instance, might make it necessary to remove or replace certain components of an industrial drug to comply with vegan, vegetarian or kosher principles.
They are useful in veterinary medicine
European legislation has provided that certain drugs for human use may also be used in veterinary medicine. In these specific cases, compounded drugs can be useful because pets, even more than humans, differ in weight, assimilation capacity or swallowing ability.
The drug compounding market
The global compounding pharmacy market revenue was approximately USD 10.3 billion in 2022, and the global market is estimated to expand at a CAGR of 8.6% to reach a valuation of USD 25.4 billion by the end of 2033.
The main drivers of market growth are:
- Progressive aging of the population: one of the main requests made to pharmacies is to formulate medicines in liquid form, to meet the difficulties of taking tablets of the infant and, especially, elderly population.
- Greater attention to health: the general spread of medical awareness in the population has led people to be increasingly attentive to their own bodies. Compounded drugs are by nature “customized”, designed to meet the uniqueness of each person and therefore more attentive to the needs of each patient.
- Hormone replacement therapy: given its varied uses, from the treatment of menopausal symptoms to gender transition, HRT must be prescribed following a specific dosage that varies according to the person and the use to be made.
Compounded drugs may seem a relic of the past but the increasing attention to individual differences and the progressive demand for specific solutions for each patient could mark the beginning of a return to the origins of pharmacology.