EGG HARBOR TOWNSHIP - Jersey Shore Pharmacy built a new lab last year to make small batches of drugs that patients from around the country rely on every day.
When patients can't find the drug, dosage or the liquid form they need, they turn to compounding pharmacies that offer help to people who have allergies to some fillers or preservatives or have trouble swallowing big pills or tablets.
"We're shipping into 30 states," said Keith Hartman, of Galloway Township, a pharmacist and co-owner of the compounding pharmacy.
"Nobody has the sophistication of the compounding lab we have in South Jersey. We have quality-assurance measures in place to maintain safety and provide access to care," he said.
Most prescriptions can be filled by most any pharmacy, which rely on big manufacturers to supply drugs.
Occasionally, though, there are national shortages of medicines such as the flu vaccine in 2009. Jersey Shore made liquid doses of Tamiflu in South Jersey that year.
But the pharmacy also provides hard-to-find prescription drugs for which national manufacturers stopped mass-production because of the cost or lack of demand. And they can turn any pill or slow-release capsule into a liquid suspension for people who have trouble swallowing.
"A lot of commercially produced tablets and capsules may be produced with wheat or gluten filler. For people with celiac (disease), it tears up their stomach and irritates their gastro-intestinal tract. They need something compounded without gluten," he said.
Compounding pharmacies are expected to face stricter federal oversight soon after a batch of injectable steroids contaminated with mold produced in a Massachusetts compounding lab last year killed 36 people and sickened 500, many from meningitis.
Congress is considering stricter inspection rules and quality controls.
"We're seeing a lot of insurance companies that don't want to cover compounding in the wake of the meningitis outbreak," Jersey Shore Pharmacy co-owner and pharmacist Mark Taylor said. "Patients don't think that's fair. We don't think that's fair."
Taylor, of Galloway Township, said his company sees a steady demand for compounding products. His pharmacy is licensed in states across half the country.
"Big Pharma has a one-size-fits-all approach. But if you need a different strength or maybe the medication only comes in a large capsule, you need a compounding pharmacy," he said.
His pharmacy creates medicines for lions, tigers and other animals at the Cape May County Park & Zoo.
"We can incorporate that into a food. It's easy for the zookeepers to administer," he said.
In New Jersey, lawmakers want compounding pharmacies to maintain best practices through accreditation, which Jersey Shore Pharmacy is pursuing voluntarily this year.
"We want to put the best product out there," Taylor said. "The only way you can do that is to have everyone focused on every step of the process. It makes us a better pharmacy. Ultimately, it will be a stronger industry."
But bill sponsor and state Sen. Jeff Van Drew, D-Cape May, Cumberland, Atlantic, said pharmacy oversight is best handled at the federal level.
"Then you would have uniformity and consistency in the whole country," he said.
Van Drew said lawmakers will pursue statewide changes until they are superseded by federal oversight.
"It's shameful. It shows how stagnant our federal system is when this life-and-death situation that everyone should agree on goes unaddressed," he said. "You should rest assured that when you get an injectable (medicine) that it is sterile and contains the appropriate dose of medicine and it's dated."
Already it appears that compounding labs are taking greater precautions. In 2012, just one compounding lab issued a drug recall, according to the U.S. Food and Drug Administration.
Compounding pharmacies have issued at least 18 recalls so far this year, according to the agency.
At Woodruff's Drugs in Bridgeton, pharmacist Meredith Swank specially prepares medicines for a handful of customers each week.This represents a tiny fraction of her customers each week.
"But for the people who need it, it's essential," said Swank, of Bridgeton. "For example, we have hospice patients who can't swallow."
She uses a small glass mortar and a heavy pestle to grind up tablets or pills. To turn the powder into a liquid medicine, she adds it to a suspending agent to keep the medicine from settling to the bottom of the bottle and flavoring syrup since a little bit of sugar still helps the medicine go down.
She can make preparations of creams or ointments as well.
She gets nearly as much business from pet owners as patients. She can turn pet medications into treats that dogs or cats will swallow without fuss, she said.
"It's a lot harder to give medicine to animals than people. Plus, it's an all-cash business so you don't have insurance companies telling you how much they'll pay," she said.
Swank said all pharmacists learn in school how to make pharmaceutical compounds. It's part of her job she enjoys, she said.
"It makes me feel like I'm doing something - not just counting and pouring and dealing with insurance companies all day," she said.