Compounded medications are a tool that doctors and pharmacists use to give patients access to customized prescriptions to meet their exact needs. Read on to learn more about compounded prescriptions, including what they are, why they’re prescribed, whether your health insurance will cover them, and more.
The American Pharmacist’s Association (APhA) defines compounding as “the creation of a pharmaceutical preparation—a drug—by a licensed pharmacist to meet the unique needs of an individual patient (either human or animal) when a commercially available drug does not meet those needs.”
Most pharmacies offer some level of compounding within their facilities. There are also specialized pharmacies with the additional equipment needed to formulate a large assortment of different prescriptions. These compounding pharmacies generally employ pharmacists with additional training on the ins-and-outs of compounding medications safely.
Doctors prescribe compounded medications for a wide variety of reasons, including:
For example, young children and older adults may not be able to swallow a pill. In this case, liquid medication can be ordered from a compounding pharmacy. As another example, preterm infants often require customized doses of medications used to treat common ailments such as acid reflux.
Absolutely! Compounded medications are subject to the same strict standards as commercially available medications. When you fill a prescription for a compounded medication, you can trust that it is safe to take.
The main downside of compounded prescriptions is the cost — they tend to be more expensive than their commercially available counterparts.
Like many aspects of healthcare, the answer to this question depends on your personal prescription coverage. Some plans cover 100% of the cost of compounded medications, others pay a portion, and some plans do not cover this type of prescription at all.
To determine whether your health insurance will cover compounded medications, check your plan’s drug formulary. Every health insurance provider has formularies that outline what exact prescriptions are covered. Oftentimes, this documentation can be found online.
Rocky Mountain Health Plans (RMHP) members can visit our About Your Prescription Drug Coverage page to view formularies for every plan we offer. Members can also call 970-243-7050 (800-346-4643) to speak with someone from our friendly and knowledgeable Customer Service team. We’d be happy to help you determine whether a compounded prescription will be covered under your plan.