The Role of Compounding Pharmacies in Meeting Patient Needs

In a video interview with Pharma Commerce, Donald Prentiss, founder and CEO of Qualthera, describes how compounding pharmacies play a critical role in addressing unique and unmet medication needs that cannot be met by commercially available drugs. Their role in the pharmaceutical supply chain varies depending on the type of compounding facility: 503A or 503B.

A 503B facility, also known as an outsourcing facility, primarily supplies office-use medications to healthcare providers, who then administer them to patients. These facilities must adhere to current Good Manufacturing Practice (cGMP) standards, as they are FDA-registered and subject to inspections. In contrast, a 503A facility focuses on compounding medications based on individual prescriptions, typically in smaller, patient-specific batches. This allows for customization, such as removing allergens or adjusting dosage forms to better suit a patient's needs.

Both types of compounding pharmacies are particularly useful in cases of drug shortages or when commercially available drugs are insufficient. For example, if a patient requires a medication that is in short supply, a compounding pharmacy can step in to provide a tailored solution. This flexibility makes compounding pharmacies essential for meeting the unique needs of patients, whether by modifying an existing medication or creating entirely new formulations to address specific medical conditions.

Ultimately, the primary function of compounding pharmacies is to bridge gaps in the pharmaceutical market by providing personalized, alternative treatments that meet the diverse needs of patients.

Prentiss also comments on the tirzepatide shortage, the notion that commercialized and compounded drugs are competing with one another, what needs to be done amid the various legal battles pertaining to GLP-1s that are currently taking place, and much more.

A transcript of his conversation with PC can be found below.

PC: Generally speaking, what role do compounding pharmacies play in the pharmaceutical supply chain?

Prentiss: I think the primary role for compounding pharmacies is to fulfill unique unmet needs when it comes to the medication needs of patients across the country. How those needs are met are dependent on the dosage form. Who is administering the medication will then decide whether or not it's coming from what's called a 503B, an outsourcing facility, or a 503A, which is a your traditional compounding pharmacy. Typically, on the 503B side, you're going to have them primarily focused on supplying office-use medications to doctors, who then administer to patients in the office. You're going to have some of them that do have the ability to dispense pursuant to prescription.

But the tricky part there is, on the 503 B side, they have to follow what's called current Good Manufacturing Practice, or cGMP, because they are registered with the FDA, and succumb to those inspections. On the 503A side, you're going to have them focused on the just for Nico, or just for Don; your prescription only. They're not making these large batches of medication, and that's going to be a certain adjustment, just like on the B side, to what's commercially available. Whether Nico is allergic to something in a medication, we can make it without that excipient. For example, we can put in a different dosage form that's more amenable to his specific needs, unique unmet needs, either through the 503B or through the 503A, and then also what's called just in general shortages, which we'll get into a little bit later, when there's just limited or no supply of these commercially available drugs. That's where both of these types of compounding facilities can step in and help fill that gap, which is very important.