Apothecary mixes drugs from scratch.

Byline: Tim Christie The Register-Guard

At a time when the pharmaceutical industry has seemingly invented a drug for every ache and ailment, the work that goes on in the lab of Broadway Apothecary seems almost quaint.

On a recent afternoon, one pharmacy technician was using a mortar and pestle to mix powdered sugar and milk sugar with active ingredients for a prescription for hormone replacement therapy. Another technician was filling a prescription by carefully weighing each dry ingredient on a precision scale, then mixing them into an anti-inflammatory gel.

It's time-consuming, painstaking work, but it helps explain why Broadway Apothecary is able to survive, even thrive, at a time when many independent pharmacies are struggling to stay afloat. At least three independent pharmacies in Lane County have gone out of business in the past year, and 10 to 20 have closed in Oregon in each of the past three years.

The small drugstore at 1712 Willamette St. (it was on Broadway when it started) doesn't fill conventional prescriptions and doesn't even try to compete with the Walgreens and the Rite Aids. Rather, Broadway Apothecary is a compounding pharmacy, which means its pharmacists and pharmacy technicians custom-make each prescription for each patient.

Most pharmacies practice a small amount of compounding, but that's all Broadway Apothecary does.

"We don't take anything off a shelf and put it in a bottle," said owner and pharmacist Kate James. "It's all made from scratch.

"Rather than match a patient to a drug, we're trying to match a prescription solution to the patient," she said.

Pharmacists Sheri Cannell and Heather Wilson started the business in 1997. Both were veteran pharmacists who had tired of working at conventional pharmacies, so they decided to start a compounding pharmacy.

"We wanted something more interesting," Cannell said. "You get to use your brain a little more."

James, who earned her pharmacy degree at Oregon State University, had been working for a small pharmacy chain in Roseburg in 2006 when she heard Broadway Apothecary might be for sale. In 2006, she bought the business, and Cannell and Wilson stayed on. They wanted to keep working, but wanted more time to travel and visit with grandchildren, James said.

At many big pharmacies, a mortar and pestle is a prop, a symbol of how pharmacists used to mix drugs. At Broadway Apothecary, it's a tool put into daily use. Some prescriptions can be prepared in 15 minutes; others take days.

"You actually get to play," said pharmacy technician Marian Parsons said. "You're cooking 10 hours a day, following recipes."

In the middle of the 20th century, about half of all prescriptions dispensed by pharmacists were mixed by hand. Today, only about 5 percent of prescriptions are compounded, James said.

Pharmacists compound prescriptions for patients who, for one reason or another, can't take off-the-shelf medications. Most off-the-shelf drugs today are intended to be taken orally, and are available in a limited number of dosages. A compounding pharmacy can make drugs in smaller doses for children, for example, or find other ways to deliver a drug in case a patient can't take it orally - as an ointment applied to the skin, a tablet placed under the tongue, or a solution injected under the skin.

As much as 40 percent of Broadway Apothecary's business involves hormone replacement therapy for women. Some off-the-shelf drugs are too strong or in the wrong combination for some women, James said.

"What we're able to do is come up with a dose that is more individualized," James said.

When the Olympic Trials were in Eugene in late June and early July, Broadway Apothecary prepared anti- inflammatory ointments for several athletes, James said.

If a patient can't tolerate an inactive ingredient in a drug, such as gluten or sugar, a compound pharmacy can mix up a prescription without the offending ingredient.

About 30 percent of Broadway Apothecary's business involves filling prescriptions written by veterinarians. Because dogs come in such a broad range of sizes, dosing varies widely as well. And because some cats are finicky, James and her staff are able to mix up prescriptions that will appeal to a picky feline palate. In the lab's freezer are plastic bags filled with frozen cubes of different flavored solutions to be mixed with pet medicine: tuna, triple fish (tuna, salmon and sardine), and chicken.

Broadway Apothecary recently became the first compounding pharmacy in Oregon to be accredited by the Pharmacy Compounding Accreditation Board, signifying that it meets the highest quality and safety standards in its profession. To earn the accreditation, James had to complete a detailed written application and open her pharmacy to a comprehensive on-site inspection.

James said she finds the work of compounding prescriptions to be "a lot more fun" than working in a conventional pharmacy. James said she enjoys the hands-on nature of compounding drugs, and working with patients and doctors to find a solutions to prescription problems.

"It's art and it's science," James said. "It's really a neat mixture."

BROADWAY APOTHECARY

Founded: 1997 by pharmacists Sheri Cannell and Heather Wilson

Employees: 10

What it does: Custom mixes prescriptions for children, women, athletes, animals

Annual sales: Not disclosed