U.S. Compounding Pharmacies

The Rise of U.S. Compounding Pharmacies: Meeting Specialized Medication Needs


Compounding pharmacies, which customize medications to meet individual patient needs, have seen tremendous growth in the United States over the past few decades. What started as a small niche industry focused on preparing specialized medications is now a multi-billion dollar business serving millions of Americans each year. Here is an in-depth look at the rise of compounding pharmacies across the country.

Growth and Reach of U.S. Compounding Pharmacies

According to industry estimates, there were over 7,500 compounding pharmacies operating in the U.S. as of 2020. This represents significant growth from just a few thousand facilities in the early 1990s. Compounding pharmacies can now be found in every state, with some of the largest concentrations in California, Texas, Florida and New York. A market analysis found that over 500 million prescriptions are filled annually by compounding pharmacies, up from around 100 million in the year 2000.

This rapid expansion has been driven by several key factors. More patients are seeking unique dosage forms, delivery methods or ingredients that are unavailable through traditional drug manufacturers. Conditions like allergies, sensitivities and pediatric needs often require custom medication preparations. Compounding pharmacies are also playing a larger role in specialized fields like oncology, veterinary medicine and aesthetics/skincare. Changing regulations have also opened up opportunities for pharmacists to fill niche demands not met by typical pharmaceutical products.

The Human Side of Custom Compounding

While the business of compounding has grown exponentially, practitioners see their work as more of an art than a mass production operation. At the individual pharmacy level, customizing medications is still very much a personalized process that requires extensive skill, knowledge and precision.

Compounding pharmacists must carefully consider each patient’s unique medical history, current prescriptions, allergies and preferences when developing their individualized treatment plan. This involves utilizing their expertise in pharmaceutical sciences, anatomy, physiology and an understanding of how different substances interact within the human body. Only the highest quality, pure ingredients are utilized to safely craft potent non-standard solutions.

For many patients, customized compounds are truly life-changing by addressing severe, often rare, conditions in a tailored way that approved drugs sometimes cannot. Success stories through compounded remedies have given hope to populations previously left with few options. The human touch that compounding brings to healthcare is a big part of why it resonates so strongly with those it serves.

Regulations and Continued Growth

As the sector has rapidly expanded, lawmakers, licensing bodies and agencies have worked to put appropriate guidelines in place to protect public health while allowing the profession to flourish. The Pharmacy Compounding Accreditation Board (PCAB) was established in 2001 to set quality standards for compounding facilities. State boards of pharmacy also closely monitor licensed compounding pharmacists.

However, high profile incidents in recent years highlighted some deficiencies in the existing framework. The 2012 nationwide fungal meningitis outbreak linked to contaminated injectable steroids from the New England Compounding Center (NECC) resulted in over 100 deaths. This tragedy led to the passage of the Compounding Quality Act in 2013, adding stricter federal oversight of larger-scale compounders through the FDA.

While more regulations aim to curb bad actors, the U.S.Compounding Pharmacies profession is optimistic about continued positive evolution. Advanced technologies now allow for superior sterile technique, environmental monitoring and quality testing compared to decades past. Enhanced requirements around bulk purchasing, production volumes and ingredient sourcing seek to find the right balance of access and assurance.

With the passage of the new legislation, industry leaders see opportunities for greater accountability and understanding from regulators. It also opens pathways for compliant operators to grow responsibly and reach more patients nationwide under a federal quality framework. Overall, the sector remains poised for prudent, patient-centered progress in the years to come.

1.  Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it