Compounding pharmacy

Certified Pharmacy Technician Jackie Diamond (right) is being trained in compounding by Pharmacist Craig Mathews. Unlike filling a regular prescription which comes from a manufacturer, compounding takes extra time because is customized for the patients needs.

SPRINGERVILLE – The World Famous Small Town Store, Western Drug & General Store is open 365 days a year in Springerville. Not only does it have everything but the kitchen sink – which is why it is called a general store — but it was the first compounding pharmacy in the White Mountains. In spite of a rumor going around saying they no longer offer this service, they continue compounding daily and even mail it out for free.

Fred Harper, a pharmacist himself, and his wife, Deb own and run the18,000 square foot store and provide jobs for around 40 people in the area. Twenty one of those people are employed in the pharmacy – four pharmacists, not counting Fred, 16 pharmacy technicians and pharmacy manager Sam Powers who manages to motivate and inspire everyone in her department in unconventional and special ways.

Powers, who has been at Western Drug for 13 years said, “We are one big family. We spend 40 hours a week with the people we work with. It’s nice that we love each other. I fell into the job in high school. I started as a cashier. I am the fixer – whatever it is. I love making sure the customers are taken care of.”

Lead pharmacist Val Crane has been at Western Drug 13 years or more. Coming from a chain pharmacy, he loves the family atmosphere and epitomizes the Harpers’ hiring philosophy. “They hire Western Drug type of people and then train them to do their job. It’s attitude,” said Crane. “I love the small town atmosphere.”

“Fred takes this seriously – customer service. He may come to a manager and say ‘This person was really connecting with the customer – give them a raise.’”

“Sam does team building with us. It starts the day. Sometimes we dance and the two best dancers lead and the rest of us follow and mimic them. It’s fun.”

Western employees work and play hard for the goal – serving the community. “We may not always succeed, but we always try,” said Crane.

That started with Fred’s dad, Merle, who bought the store in 1958, later moved it to its current location and then expanded the store to serve the community with – again, everything but the kitchen sink. Crane said that it was Merle who came up with the idea to be open every day of the year for the people.

Craig Matthews, a doctor of pharmacy, who oversees compounding, also trains the certified pharmacy technicians. A person must have achieved certification before they can train for compounding. Mathews said, “It takes about two weeks to train a tech the basics in compounding. Then we add on more over time.”

Compounding is a gift for many patients who may not be able to tolerate a regular manufactured drug. Mathews explained that a person could have an allergy to some ingredient in the drug they have been prescribed, may not be able to swallow pills, or in the case of hormones, may have better results with a bio-identical. Compounding allows for the allergic ingredient to be taken out, or there can be something added if needed. Pills can be converted to liquid and even flavored. Bio-identicals, which are man-made hormones derived from plant estrogens chemically identical to those the human body produces, can be adjusted to fit the needs of the patient. Compounded formulas are often better adsorbed by the person.

“Compounding is solving a problem,” said Mathews. “Most hormones we use, for example, are not commercially available; typically not in the strength needed. Sometimes it takes more than once to find the right formula for the patient and usually by the second time, we have it. Compounding is highly regulated and inspected by the State Pharmacy Board and the FDA.”

Simply put, “Compounding a prescription is like going to a tailor to get a suit made,” said Mathews. To get what you want, you do not buy it off the rack.”

Insurance companies do not pay for compounding. Mathews said there was a time when they did, but preparing a compounded formula takes a lot more time with preparation and equipment than preparing a manufactured prescription in a bottle.

To show Western’s commitment to compounding, they will be upgrading their facility for what is known as the USP Compliance. It is a new law that will safeguard the pharmacists and technicians in 2020 with personal protective equipment for safe drug preparation. Techs and pharmacists already “gown up” and wear hats and gloves and work in a hooded area. Micronized powders increase absorption rate and is a great hazard for people working with it. Adapting the work area will afford the greater safety required by the new law.

“The USP is like the FDA filtered through the State Board of Pharmacy,” said Mathews.

Most doctors today work with the pharmacies on compounding. Western even has a Certified Menopause Educator who can act with the physician, patient and pharmacy to ensure the patient is getting the right compounded formula. Western is a proponent of the patient working with their physician first, and then they with follow up the patient and the team will work together to obtain the best results for the patient.

Compounded formulations can be in the form of capsules, creams, gels, ointments, solutions, sub lingual tablets/drops, suppositories, suspensions, syrups and troches.

Illnesses compounded medications can help include, but are not limited to, chronic pain management endocrine disorders, hormone replacement therapy, veterinary conditions and dermatological conditions.

Mathews said the cost for the compounded prescription is about supply and demand. Sometimes they are not able to get the bulk items and they have to use commercial – a difference in cost.

“Fred does his best to keep the cost down for people” said Mathews. “The protective upgrade will be expensive but he will spread out that cost over a couple of years.”

Compounding is an answer for many. “We prefer people to get with their doctor first,” said Mathews, “and the we can get involved from there.”

Mathews pulled down a card from the several displayed on the window sill. The card was from a patient who wrote to thank them for the formula they made for her. In her note she described how it had changed her life. “We don’t just do this for the money,” said Mathews. “It’s about the people. It’s things like this that keep you going.”

Western Drug & General Store is located at 106 East Main St., Springerville. Their pharmacy is open Monday through Friday from 9 a.m. to 7 p.m., Saturday from 9 a.m. to 6 p.m. and Sunday from 10:30 a.m. to 2 p.m.

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