Michael Stringer mixed powders in a bowl Friday, grinding and stirring with mortar and pestle like a druggist from an earlier time.
Stringer, who owns Doctors Center Pharmacy on West Main Street, is one of a growing number of pharmacists practicing the old-school craft of compounding drugs.
Compounding is used when ready-made pharmaceuticals won’t work. Whether a patient is unable to swallow pills or needs a nausea medication made into a cream, compounding pharmacists can usually tailor the product to the patient.
“It can be as simple as flavoring (a drug for a child),” said Stringer, who has been compounding drugs since he started practicing pharmacy 22 years ago.
While the bulk of Stringer’s business continues to be in ready-made drugs, his compounding work has boomed in recent years.
Since 2005, he’s seen an increase in the number of people seeking individualized drugs for everything from hormone replacement therapy to topical pain creams to a cat’s behind-the-ear thyroid medication gel.
So, what’s changed?
“Patients are more informed,” he said. “If I have to come up with one thing, that would probably be it. Patients are more informed about what they want and need as far as their healthcare.”
On average, Stringer said he fills about 500 to 600 compounding prescriptions a month. While it doesn’t sound like much compared to the 7,000 to 8,000 regular prescriptions filled, the compounding work is far more time-consuming and meticulous.
Regular prescriptions are often filled in a matter of minutes, but compounded drugs are specially-made on site. Because of that, they usually have at least a 24-hour turnaround, Stringer said.
Compounded drugs can be slightly pricier, as well, he said. That’s partly because of the time it takes to mix them and partly because of the expensive equipment involved. The price of the drug also is important, he said.
Stringer’s compounding lab cost about $50,000, but other labs can be more or less depending on the needs of a pharmacist’s patients.
While most of the news on compounding drugs has been positive, the Food and Drug Administration recently got involved after several people died from drugs that were made in a compounding pharmacy, then shipped all over the country.
The result was a federal act requiring all compounding pharmacists to submit to FDA inspections, as well as other regulations.