FAQ

Frequently Asked Questions

What is a 'compound'?

A ‘compound’ is a medication that is prepared specifically for a patient off of a medical provider’s order.

There are many reasons a compounded perscription might be ordered. The medical provider may choose a compounded medication due to –

  1. Drug discontinuations
  2. Shortages
  3. Patient allergies / sensitivities to gluten, dairy, corn, or dyes
  4. Clinical need for specialized doses
  5. Clinical need for medications in an alternate form than how it’s manufactured

Compounding requires advanced knowledge and skill to prepare medication according to a doctor’s order and made specifically for a patient.

What is a 'compound' in medicine?

Some medications are not commercially available. If a doctor or other medical provider wants a patient to take this medication, they will send the prescription to a compounding pharmacy. In that pharmacy, a state-licensed pharmacist combines ingredients to create the medication. This service is most often used by patients who have unique medical concerns that commercially available medications do not address.

What is the difference between a compounding pharmacy and a regular pharmacy?

A: The only real difference is that compounding pharmacies combine the ingredients in-house to meet the individual patient’s needs. Patients require a prescription for all compounded medications, just as they do for retail pharmaceutical prescriptions.  Malley’s is both a compounding pharmacy and traditional retail pharmacy.  

When is a compounding pharmacy necessary?

A: A health care provider will prescribe a compounded drug only when commercially available drug products do not meet your needs. If you do not understand why you have been prescribed a special formulation, ask your prescriber. If you are concerned about taking a compounded drug and you and your prescriber agree that you can tolerate the commercially available drug, a compounded medication may not be right for you.  

How does a compounding pharmacy work?

A: Compounding pharmacists can put drugs into specially flavored liquids, topical creams, transdermal gels, suppositories, or other dosage forms suitable for patients’ unique needs. Compounding does not include making copies of commercially available drug products. 

How is pharmaceutical compounding different from drug manufacturing?

A: Traditional compounding is the preparation of a medication to meet the prescriber’s exact specifications and to be dispensed directly to the patient, pursuant to a valid prescription for that patient. Pharmaceutical compounding is performed or supervised by a pharmacist licensed by a state board of pharmacy (see question below on legal oversight of compounding versus manufacturing). Manufacturing is the mass production of drug products that have been approved by the Food and Drug Administration (FDA). These products are sold to pharmacies, health care practitioners, or others who are authorized under state and federal law to resell them.

Are compounded prescriptions safe?

A: The Food and Drug Administration recognizes that the practice of pharmacy compounding is an important public health alternative for patients who require medication that is not commercially available, or not available due to drug shortages.

What is the difference between commercially available medications and compounded medications?

A: Compounding is a specific process by which a pharmacist prepares customized medications to treat unique healthcare needs when no commercially available medication can address those needs adequately.

Does a compounding pharmacist have special training?

A: Compounding is a central activity to the practice of pharmacy. Pharmacists are taught in pharmacy school how to properly compound medications, and many states test pharmacists’ compounding knowledge and skills before issuing them a license. Pharmacists who practice in the 7,500 pharmacies that specialize in compounding services have generally had advanced training in compounding after they graduated from pharmacy school. No state currently requires a particular type of training, and no nationally recognized specialty exists for pharmaceutical compounding. Specialized training in pharmacy compounding processes is available through several of the active pharmaceutical ingredient (API) suppliers serving the needs of the compounding pharmacy community.  Malley’s is a proud member of PCCA- the Professional Compounding Centers of America.

How long does it take to compound medicine?

A: Compounded medicines are a little different. Because we formulate and prepare each prescription to the patient’s individual needs at the time of order, the process to fill/make each individual prescription varies. It typically takes one to two business days for us to prepare a compounded medicine.

Are compounded medications covered by insurance?

A: Depending on your insurance plan, compounded medications may be covered by insurance. We will always try to bill insurance for compounded medications.  If a compounded medication is not covered by an insurance plan, we will review pricing options with you before the compounded medication is prepared.  Many insurance companies will reimburse compounded prescriptions; however, we suggest that you consult with your insurance provider for eligible benefits.

Does Medicare cover compounded medications?

A: Medicare D does not cover compounded medications prepared from raw chemical ingredients.  Some plans will pay for compounds prepared from commercially available ingredients.  Our insurance billing technicians will always attempt to bill your plan for any compounded medication communicate pricing options with you before a compound is prepared.

Who can perform compounding?

A: Compounding is generally a practice in which a licensed pharmacist or a licensed pharmacy technician combines, mixes, or alters ingredients of a drug to create a medication tailored to the needs of an individual patient.

Why would I need a compounded medication?

A: Doctors prescribe compounded medications for many reasons. For example, some patients have difficulty swallowing large capsules or pills. The doctor may request the pharmacist to create a liquid or transdermal form of the medication. Some medications can contain ingredients that a patient is allergic or sensitive to. The physician can request the pharmacist to create the medication without those ingredients.  

Which types of prescriptions can be compounded?

Almost any medication can be compounded. Compounded prescriptions are intended for patients that require customized medication for any number of reasons.

Delivery vehicles that are often used for compounding include – 

  • Creams, gels & ointments
  • Oral solutions & suspensions
  • Tablets & capsules
  • Lollipops & lozenges
  • Sprays
  • Suppositories
  • Balms
  • Powders
  • Pet medications

New delivery methods are developed periodically. Stay in contact with us to find out more.

 

What medications can be compounded?

A: Compounding pharmacists can put drugs into specially flavored liquids, topical creams, transdermal gels, suppositories, or other dosage forms suitable for patients’ unique needs. Compounding does not include making copies of commercially available drug products, as this is not allowed by law.

How would a patient know if his or her medication is compounded?

A: A patient can receive compounded drugs from a typical community pharmacy or a specialty compounding pharmacy, or compounded drugs can be administered by doctors or other health professionals in clinics or medical offices. Patients should ask the person administering a medication or the pharmacist dispensing a prescription whether it was prepared in a compounding pharmacy or manufactured by a drug company. A widely accepted standard of practice is to label all compounded preparations with information stating the medication has been “compounded.”  All medications compounded at Malley’s start with a “C-” in the drug name.  

Who can write a prescription for compounded medications?

A: Prescriptions can come from Medical Doctors (MD), Doctors of Osteopathic Medicine (DO), Doctor of Dental Surgery (DDS), Naturopathic Doctors (ND), Physician Assistants (PA), and Advanced Practice Registered Nurses (APRN). Some doctors have limitations on what may be prescribed and these limitations may vary from state to state.

Who regulates compounding pharmacies?

A: A compounding pharmacy is licensed by each state and the pharmacist-in-charge must meet certain state licensing requirements. 

How are compounded medications customized?

A: With a physician’s prescription, a compounding pharmacist can adjust dosage for strength or quantity, change the medication’s form (e.g., create a liquid for a child or adult who cannot swallow a pill), formulate the medication to exclude non-essential ingredients (i.e.. dyes, gluten, sugar, lactose, preservatives), or flavor certain medications for adherence to taking the medication.

How much will my compound cost and why?

The cost of a compounded medication varies. We always try to bill insurance first. We will verify either the copay of the cost of the compound before we make it in the lab.

Malley’s is proud to be one of the only compounding pharmacies in the state that bills insurance. Many types of medications are compounded for a variety of reasons from avoiding allergens to making customized doses for medically fragile babies or the family pet. When a compounded medication is deemed medically necessary by a medical provider, Malley views it as our professional responsibility to make every effort to bill the patient’s insurance for the medication.

Many compounding pharmacies choose not to bill insurance. They have even stated that by not billing insurance, they somehow are saving you money. We cannnot vouch for that assertion and feel it misrepresents the situation. At Malley’s we feel that by working with our patients by billing insurance, we are able to participate in the care for our region’s most medically fragile children.

Children with critical heart conditions who need customized doses of heart medications. Every time we bill insurance for these medications, we get paid for the tablets or capsules we put into the compounds. Most insurance companies do not pay for the syrups and suspending agents we use to make them into liquids. We found that we can put in a special override code; we take a little less profit on these ingredients. You get what you need.

We do this because we care for our communities and these children. We believe that in business some things are more important than money. If small pharmacies like ours and other compounding pharmacies who also bill insurance and do the same don’t care for these children, no one will. Large children’s hospitals have fundraisers to offset these losses, small pharmacies simply do not. We will not allow the barriers of the imperfections of our insurance systems keep us from maximizing insurance benefits and providing life saving medications for critically ill children and others. 

Why is the same supplement priced different between manufacturers?

or Why would I buy this more expensive supplement?

Malley’s prides itself in offering premium products, exclusive ingredients, and the best product we can find.

Everybody has a different need and budgets vary. We are confident that our chosen brands are manufactured properly and carries the manufacturers seal of approval for safety.

Why won’t my insurance pay for my compound?

Insurance companies pay for medications based off of their ‘approved’ formulary – which is a list of medications which they offer to pay for. Most compounds are made from bulk powders. Many insurance companies do not have bulk powders on their formularies. Compounded products made from commercially available products (tablets, capsules, syrups, creams) may be covered by insurance companies.

Malley’s always puts our best effort into billing insurance companies for all medications including compounds. When a compounded medication is not covered by insurance, our compounding billing technician will review pricing before the compound is made.

How long will it take to get my compound ready?

Malley’s typically asks for up to one to two business days for compounded medications.

Compounded medications are custom made in our state of the art lab according to a medical provider’s order. We understand that some compounded medications need to be done faster. When these situations arise, we put a priority on these prescriptions and make every effort to have them compounded in an expedited manner.

How will I know when my compound is ready?

We can text you when medications are ready. 

If you have asked for a text and not received a message, please feel free to check back with us.  We love to hear from our customers!

What brand supplements do you carry?

We carry high quality professional grade brands like Pure Encapsulations, Thorne, and Ortho Molecular.  We also carry Nordic Naturals, Now Foods, Methyl Life, Biocidin, Herb Farm, Jarrow, Microbiome, Zeolite, and Seablue Vitamins in store for your convenience. 

Can you mail or deliver to me?

Sometimes we can other times we cannot, click here to find out. Click here to ask more specifics about your needs.

What is MTHFR?

‘MTHFR’ is an acronym for Methylene tetrahydrofolate reductase.  It is an enzyme in the pathway that converts folic acid to the active form methyl folate the body can use.  The Human Genome Project identified these genes for the first time and with that potential therapies were developed. 

The work demonstrates that, for the first time, we understand that for many patients supplementing folic acid wasn’t enough, but the active form of folic acid, methyl folate was necessary.