Transcript Innovations in Compounding Panel

NCPA Future Pharmacist Programming
Cheri Garvin, R.Ph., Leesburg Pharmacy
Chris Simmons, R.Ph., PCCA
Lea Wolsoncroft, R.Ph., KidsMeds
Pharmacy
INNOVATIONS IN PHARMACY PANEL
INNOVATIONS IN COMPOUNDING PHARMACY
Cheri Garvin, RPh
Owner/CEO
Leesburg Pharmacy
[email protected]
LEESBURG PHARMACY, INC.
Opened in 1976
 Located in Leesburg, Virginia which is 45 miles
NW of Washington, DC
 Leesburg is the county seat of Loudoun County,
the fastest growing county in the US
 Age categories: <19 = 13%, 20-44 = 44%, 4564 = 19% and >65 = 6%
 Average household income is $115,000/yr

TOUR OF LEESBURG PHARMACY
Wellness Center
Medical Equipment and
Home Health Care
Medication
Receiving
Management
Pharmacy
OTC / Sundry
Cards and Gifts
Compounding Center
MIX OF BUSINESS
Regular Rx
The Compounding
Center
Gifts
DME
% of Sales
49
20
3
6
NP %
-0.2
21
2
12
WHAT IS COMPOUNDING?
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Compounding is the method of preparing
customized medications to help meet unique
prescriber and patient needs.
THE COMPOUNDING CENTER
CONSIDERING COMPOUNDING?
Potential for greater net profits than
traditional prescriptions
 Sets you apart from your competition
 It is professionally rewarding (and fun!)
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CONSIDERING COMPOUNDING
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More labor intensive than traditional Rx
CONSIDERING COMPOUNDING
Requires specialized equipment and training
 Liability concerns and insurance billing
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CONSULTATIONS
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Fee and appointment based consultations
are offered in our Wellness Center
MEN’S AND WOMEN’S HEALTH
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Bio-Identical Hormone Replacement Therapy
 Estriol,
Estradiol, Progesterone, Testosterone,
DHEA, Pregnenolone
 Customized dosage forms and combinations
NUTRITIONALS

Supplements for patients with Lyme Disease
 Vitamin/mineral
replacement
 Herbal protocols and Probiotic support

Sugar free and Dye free preparations for
Autistic patients
 Intestinal
support:
 Probiotics,
 Specialized
 Liquid,
yeast protocols, chelation
vitamin/mineral formulations
capsule, powder-mix
THYROID AND ADRENAL FATIGUE
Supplements and lifestyle/dietary changes
 Customized thyroid preparation

 T4,
T3, SR and IR and combinations
MARKETING
Your target audience might be the patient OR it
might be the prescriber
 Direct marketing to consumers
 Direct marketing to physicians – offer to solve a
problem
 Host seminars (HRT), attend local events (horse
and dog shows)
 Word of mouth
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QUALITY AND SAFETY
Policies and Procedures
 Process validation and consistency
 Sterility and Potency Testing
 Protection for staff
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REGULATIONS AND ACCREDITATION
State Boards of Pharmacy regulate
compounding pharmacies
 Compounding pharmacists should be
compliant with the USP chapters 795 and 797
on non-sterile and sterile compounding
(process validation, sterility and potency
testing, P&P in place and followed)
 PCAB accreditation – the best thing we ever
did!
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RESOURCES
Professional Compounding Center of America
 International Journal of Pharmaceutical
Compounding
 International Academy of Compounding
Pharmacists
 National Community Pharmacists Association
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INNOVATIONS IN VETERINARY COMPOUNDING
Chris Simmons, RPh
VP Creative Development
PCCA
FLAVORING NEWS
Steve Irwin.wmv
PEDIATRIC PHARMACY PRACTICE
Lea Wolsoncroft, R.Ph.
KidsMeds Pharmacy
.
Why choose pediatrics?
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Children 6 and under are the 2nd largest group that uses
medications
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Nearly 80% of medicines marketed in the United States do not
carry recommendations for use in children
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Seniors use the most medications
60 million (20%) of the US population are children under 14
Pharmacists that specialize in pediatrics are needed
Out of 250,000 pharmacists in US, about 1000 specialize in
Pediatrics and 99% of those work in hospitals.
CLINICAL SERVICES
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OTC Selection and
Counseling
Pulmonary
 Asthma, COPD, CF
Influenza, H1N1
Immunization
Compounding
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Nutrition Counseling
Diabetes
Obesity (weight
management)
IV services
Specialty Meds (biotech
& oncology
Flavoring
OTCS

Critical need for pharmacists counseling to prevent harm
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Most common health issues in pediatric population
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DDD (Drug, Dosage, Duration) - varies by age and weight of child
When to refer to physician?
Cough, Cold, Fever
Pain
Itching, Rashes
Constipation, Diarrhea, GI issues
Allergies
Business Opportunity: High profit margins (35-50%) And NO
third party billing
PULMONARY
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Disease states that can be managed
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Asthma
COPD
Cystic Fibrosis
Help manage disease therapeutically and through
lifestyle changes
Opportunity to mange patients with Collaborative
Practice Agreements (CPA)
Business Opportunity: Service fee for education,
disease management, and sale of supplies
IMMUNIZATIONS
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Opportunity for educating patients regarding
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Disease prevention
Distinguishing seasonal influenza from novel H1N1
Treatment options
Administer Influenza AND H1N1 Vaccines
Business Opportunity: Administer vaccines (cash
payment, can work with schools and day care
centers), disease education (H1N1 FAQ), and sale of
supplies (masks, hand sanitizers, and thermometers)1
1http://www.cnn.com/2009/HEALTH/07/25/uk.swine.flu.pharmacies/index.html
IMMUNIZATIONS
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Currently all 50 states allow pharmacists to provide
immunizations
Pharmacist administer immunizations check your State Regs
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Age limitations: can you vaccinate children of all ages?
Does state require RPh to finish certification course? (these often cover
CDC guidelines and give CPR certification)
Are interns allowed to immunize while working under trained preceptor?
Do you need to work under protocol and obtain patient consent?
Pre-notify PCP if contraindication (good practice to notify/document)
Business Opportunity: Cash payment & third party billing. Can
partner with local pediatricians, day care center, and schools
COMPOUNDING
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One of the highest profit margin services
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Huge opportunity in pediatrics as children
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May not like taste of medication
May not like taking pills
Cannot take medication by mouth
Commercial products may have inappropriate doses
Rx needed that is alcohol, sugar, or dye free (allergies)
Require medication in an alternative formulation: rinse, gel, pastes,
cream, suppository, etc
NUTRITION
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One of the newer services offered in pharmacies
Provide nutrition information to parents and children to address
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Obesity
Diabetes
Poor growth
Hyperlipidemia
Eating Disorders
Food allergies
Chronic diseases (COPD, CF)
Provide various weight management programs
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Offer parent and children fun cooking classes
DIABETES
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High demand for management of diabetes in children
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186,300 children OR 1 in every 400-600 have Type 1 diabetes
2 million overweight adolescents have pre-diabetes
Type 2 diabetes is on the rise among age 20 and under population
Help manage disease therapeutically and through lifestyle
changes
Business Opportunity: Sale of diabetic supplies, education, and
disease management
OBESITY
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Number of obese children under 11 years have doubled since
1980
Need for pharmacists to inform parents and children about
long term effects of obesity
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Increased prevalence of CV diseases in adolescence and adulthood
Business Opportunity: Obesity prevention/treatment education,
weight management (could work with a nutritionist), offer fun
physical fitness program utilizing Wii fitness gaming system
CONCLUSION
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Pharmacists specializing in pediatrics are needed
in community pharmacy setting
Many clinical services can be implemented
Opportunity exists for implementing profitable
business services
Greater earning potential as pharmacy owner
Pediatric Specialty pharmacy presents a model of
innovative clinical practice and a profitable
independent pharmacy niche
RESOURCES
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NCPA – National Community Pharmacy
Association
http://www.ncpanet.org
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Lea Wolsoncroft, KidsMeds Pharmacy
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PPAG – Pediatrics Pharmacy Advocacy Group
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http://www.kidsmedspharmacy.com/km_web/index.ht
ml
http://www.ppag.org/
Kids Meds
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http://www.kidsmeds.info/
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QUESTIONS?