What happens if a pharmacy decides not to compound any non-sterile preparations?

Refer to Sections 3 and 5 of the NAPRA Guidance Document for Pharmacy Compounding of Non-sterile Preparations.

Compounding is within the scope of practice and authorized acts for pharmacy professionals defined in the Pharmacy Act, and compounding non-sterile preparations according to recognized guidelines and standards is an entry-to-practice competency for both pharmacists and pharmacy technicians. Therefore, it is reasonable that the public and other health practitioners expect any pharmacy to provide some compounding services.

The requirements for “all levels of compounding” (Section 5), corresponding to Level A, should be attainable for all pharmacies already engaged in compounding. Moreover, the College‘s Code of Ethics expects that “registrants make every reasonable effort to provide quality cost-effective pharmacy care and services to patients and society.”

As explained in Section 3 of NAPRA’s Guidance Document, “given that pharmacists and pharmacy technicians are expected to maintain competency in basic compounding skills, they are also expected to provide compounded preparations within their level of expertise and within the limitations of available and appropriate facilities and equipment.”

As for all prescriptions, it is expected that a pharmacist will assess the prescription for a non-sterile preparation to determine whether it is the most appropriate therapy for the particular patient or if there is a suitable, safer alternative. If a compounded preparation is the best option, the Designated Manager/department head must ensure that the pharmacy has the resources necessary to safely and accurately prepare a quality preparation. If not, they have an ethical obligation to “assume responsibility for making reasonable efforts to ensure continuity of patient care when they are unable to provide requested pharmacy services.”