Are compounded prescriptions covered by insurance?
Some health insurance plans cover compounded medications. Check with your insurance company to see if you have coverage. Many pharmacies are able to bill insurance companies directly for compounded medications. If unable to bill your insurance company, you may submit a claim form to your insurance company to reimburse you directly. Depending on the nature of the product, these medications may be just as affordable as your conventional prescriptions. Pharmacies are also willing to work with patients who wish to pay out-of-pocket on pricing.
How does my medical provider play a role in compounding?
Many medical providers are aware of the practice of compounding, and they may work with your local compounding pharmacy to provide the right medication for you. Talk to your pharmacist or doctor today if you feel that a compounded prescription may be a better way to manage a health condition for you or your family member.
What is “compounding”?
In general, compounding is a practice in which a licensed pharmacist, upon a physicians’ prescription order, combines, mixes, or alters ingredients of a drug to create a medication tailored to the needs of an individual patient. A health care provider will prescribe a compounded drug when commercially available products do not meet your needs. Preparing a paste or suspension from crushed tablets is one example of compounding. Likewise, adding flavoring to a medication is also compounding.
What makes compounded medications different from commercially available medications?
Mass-produced, commercially available drugs are manufactured by drug companies for the general population with no specific patient in mind. Compounded medications are ordered by a physician and individually prepared by a compounding pharmacy in the exact strength, dosage and formulation to meet your unique medical needs. For example:
- Oral liquids can be compounded for those patients who have difficulty swallowing tablets and capsules.
- Ingredients such as dyes, preservatives or gluten are sometimes excluded from medications due to allergies or other sensitivities.
- Custom flavor enhancers or sweetening agents can be added to mask bitter or otherwise unpleasant oral products for human and veterinary patients.
- Multiple medications can often be combined into a single dosage or made into sustained-release capsules.
- Cellulose capsules are available for patients who do not want to take a gelatin capsule.
- Many medications can be formulated into topical preparations (gels, creams, lotions, sprays, and foams) to allow direct absorption through the skin and to avoid certain unwanted side effects.
- Troches (dosage form that dissolves under the tongue), lollipops and suppositories are other medication forms that may be prepared to meet your unique needs.
Does a compounding pharmacist have special training?
All pharmacists are taught in pharmacy school how to properly compound medications, and many compounding pharmacists have advanced training after pharmacy school graduation. Compounding pharmacists utilize their unique pharmacy skills, knowledge, and creativity to work with you and your prescriber to prepare medication in a dosage form that has been customized to your particular needs.
Is a prescription required for a compounded medication?
Yes, a prescription order from a physician is required for the pharmacist to compound your medication to meet your specific needs.
Can a regular pharmacy compound my prescription?
A compounding pharmacy ensures the quality of its products by using specialized equipment, high grade chemicals and advanced techniques. Other pharmacies generally do not have the time, equipment, chemicals, or specialized training and techniques to appropriately prepare your customized medications.