“If you provide the service and take care of the people, the profit takes care of itself.”
— Eric Juergens, Madison Avenue Pharmacy
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The designer drugs that usually make the news are illegal and profitable.
The custom pharmaceuticals Joe Jordan concocts in the compounding lab at Eric Juergens’ Madison Avenue Pharmacy are strictly above-board — and profitable.
Five years after he invested $50,000 the get into the niche business, Juergens is getting ready to spend more just to keep up with the demand.
“It’s a great problem to have,” said Juergens.
“Successful compounders have been in the business the last 10-12 years,” he explained.
When he entered it, one market segment was obvious: Custom dosing of hormones for men and women.
Although standard dosages are available in varied strengths, “we can tweak the formula, and it’s a whole lot more effective,” Juergens said.
With hormone therapy and other treatments, “usually what happens is people have tried the traditional approach,” he said. “It works somewhat, but they want better results.”
Juergens sees patients’ assertiveness to be a response to their seeing public figures like Oprah Winfrey and Suzanne Somers being more assertive about managing their own care.
Entering the business required a $50,000 investment to build a lab equipped with a safety hood and a $4,000 machine that makes smoother compounds than anyone could make by hand.
The investment included sending Juergens and Jordan to Houston, Texas, for classes at Professional Compounding Centers of America, the organization that also advised them on setting up their lab.
The two then returned to spread the word about the benefits of compounding to doctors, physicians assistants, nurse practitioners and others.
In addition to hormone therapy, which makes up about a third of the business, “we do a lot of stuff for kids that can’t take regular medicines,” Jordan said. “And we do some compounding for animals, too.”
“If you’ve ever tried to give a cat a pill, you can do it once,” said Juergens.
That means for those cats with common thyroid problems, owners can use a cream-based compound absorbed through the skin much more easily.
Said Juergens, “The cat’s happy and you’re happy.”
The threat of addiction to prescription pain killers has led to a second area of demand that’s about to overtake hormone therapy: topical pain relievers.
With physicians and patients aware and wary of the dangers of addiction, “people are not looking for narcotics,” Juergens said. “We can put many things in a topical cream.”
“We’ve been real successful working with some of the local podiatrists to make up some effective compounds” for diabetic neuropathy that often is described as “burning feet syndrome,” Juergens said.
“We have not done a whole lot as far as educating the public yet,” he added, but the efforts to reach out to prescribers has led to many “aha” moments in which they begin to see tailor-made drug therapy as a way to help patients who fall between the cracks of packaged pharmaceuticals.
Still, “one of our biggest market things is word-of-mouth from patients,” said Jordan. “It has helped us more than anything else.”
Jordan has enjoyed the move because it has taken him back to the roots of pharmacy and reconnected him with much of what he learned in pharmacy school.
“Especially with compounding, you can put it all together.”
Two Cedarville University pharmacy technician students work in the lab with him, a lab likely to be expanded before the year is out.
“All those things probably this year are going to get a retooling,” Juergens said. “We’re going to have to expand the space and work on staffing.”
Juergens said the compounding lab has brought in more direct business, then had additional benefits when those same people transfer other prescriptions to the pharmacy for convenience sake.
It also has brought some challenges, including third-party payers.
“We’re attempting to bill insurance where we can,” Juergens said. “We are getting some push back” from one major company, he said.
For those whose insurance doesn’t cover tailor made hormone therapy “we try to be price sensitive,” he said, and keep the cost under $100 a month.
“If you’re paying something, we want you to feel that you’re getting something reasonable,” he said, or give people interested “an opportunity to make that call.”
He also said that “although some of the things we buy are really expensive,” in most instances the cost is driven more by labor and time than materials.
He added that, for quality control, he sends the compounds out for independent testing at a laboratory in Texas to make sure they have what the labels say they have.
“It’s not required that you do so,” he said, “but every time I try to do something new, I feel like I’m staking my reputation on it.”
In offering the potential for a closer match of patient need and prescribed drug, for those willing to pay for it, “this is a way to get premium health care,” Juergens said. “This is designer therapy. It certainly can be thought of that way.”
And if more people think that way, compounding would be the business to be in.
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