- Describe your practice at the Professional Compounding Center of Iowa.
PCCI is a compounding-only pharmacy. We are currently located inside a busy, independently owned community pharmacy. The majority of the products we do are non-sterile compounds, but we also compound a handful of low risk compounds by renting hood space from a local hospital. My partner, Lindy, has a chemistry degree and does the majority of the compounding while I focus more on patient consultation and management activities. I have a passion
for women’s health and work closely with women on hormone balance with bioidentical hormone replacement. We also do a lot of work with adrenal, thyroid, and insulin products. My interest in adrenal and thyroid pathophysiology and therapies has really encouraged me to development my knowledge of nutrition and nutritional supplements, which has become a big portion of our business in addition to compounds.
- What is your background and how did that lead to your desire to pursue this opportunity/bring this product to market?
During pharmacy school, two things happened that fueled my passion for women’s health. First, I completed a rotation at a compounding pharmacy where I read several books on hormone replacement and thyroid health. What I was reading really clicked and made sense. The second experience that fueled my passion was a side effect that I developed when using a synthetic progestin.
- Why do you focus on nutritional supplements?
Nutritional supplements provide the body with the elements that it is either unable to produce on its own or to supplement what is not being ingested through diet. The typical American diet does not provide the nutrients needed for optimal health. It always seemed logical to me that a multiple vitamin should make people feel better since they are supposed to provide the lacking nutrients. The fact that the “one-a-day” type vitamins weren’t causing the desired benefit for people made me question the quality of these products. To answer my questions, I sought out resources including other pharmacists and nutritionists. As I began to learn more through my adrenal studies and networking, I began to understand the differences in quality amongst supplements. I have so much to say about the value of nutritional supplements, but the most important message is that when you put someone on a good product that provides the necessary nutrients in the proper amounts, they will feel better.
- Why do you compound hormone replacement therapy when there are
replacement options commercially manufactured?
We use the commercially manufactured hormone replacement options when they are best for our patients. The problem is that women often need doses that are not available in the commercially manufactured products. The hormones available are also limited; estradiol and progesterone are the only bioidentical hormones available commercially. Given my education and knowledge of hormone replacement therapy and the importance of hormone balance, the options available commercially are often not best suited for women.
- What challenges have you had to overcome in the compounding pharmacy?
The biggest challenge has to be marketing. When you have a pharmacist and a chemist on staff—two very left-brained individuals—simply letting people know you are here can be a monumental challenge. Thankfully, our reputation has gotten us a long way; when you help women feel better, they can’t help but tell their friends.
Another obstacle is working against “the establishment”. Drug companies work hard to sustain their profitability in the hormone replacement market, and they have unlimited funds to do so. When I am given the time to talk with someone, whether it be practitioner or patient, the feedback is always positive and any negative views they had on what we do here have been
eliminated. Unfortunately, the aggressiveness or persuasiveness it sometimes takes to get in the door to be able to educate is not my strength and is a barrier that we are in the process of overcoming.
- How are you promoting change in the pharmacy profession?
My focus has been very much on developing and growing a new business, but there is more that I could do. I would love to participate in Compounders on Capitol Hill which is organized by IACP every year for compounding pharmacists to talk with government representatives about what we do and to discuss the issues affecting pharmacy. I also would love to be more involved with NCPA in the future. I have a great amount of pride working with women in this community, but without the pharmacists who are advocating on the behalf of the profession that could change.
- What advice do you have for other pharmacists who want to implement
compounding at their pharmacy?
The best advice I can offer is to know what you are getting into. To be a good compounding pharmacist and to be a profitable compounding pharmacy, you must have specialized knowledge, as well as the time to network and learn continuously. The pharmacists with the largest compounding pharmacies are spending more time outside of their practices learning and
networking than they are doing hands on compounding.
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