Pharmacy owners John Waclawski R.Ph., CDE, and daughter Monica Zatarski, Pharm.D., R.Ph. discuss the therapeutics of a topical delivery while removing a preparation from an Electronic Mortar and Pestle (EMP). The EMP helps to ensure uniform and thorough mixing of each preparation
From cell phone apps and e-Readers to the Global Position System in your car, the notion of customized and made-to-order is the way we live. Preparing individual remedies for illness has progressed from special elixirs created from medicinal garden harvests to high tech in the corner drug store and specialized medication dispensing units in the health care setting. Think of the perfect combination of individualized service and high-tech—and think compounding.
MD Custom Rx is a compounding only pharmacy. Instead of using drugs that come from pharmaceutical companies in predetermined strengths, dosages, and packaging, the compounding pharmacist prepares the individualized prescription on site. Compounding pharmacists become medication problem solvers using a combination of creativity and science to create individual medicines for each patient.
Clients often arrive at MD Custom Rx with a prescription in hand. For example, an individual discontinuing a medication may need to taper a dosage in an amount that is not typically available. MD Custom Rx can make the needed dose. “It’s ultimately very rewarding because many people end up here because nothing else has helped,” said Monica Zatarski, (Pharm.D. ’04) (see below), business partner and daughter of John Waclawski (B.S. ‘72). “We offer hope and see results.” Compounded prescriptions generally cost between $30 and $40, and, as at any pharmacy, customers pay cash or file an insurance claim. In addition to prescriptions, MD Custom Rx also provides consultation services for current medications, nutritional supplements, pain management, and bio-identical hormone therapy—Zatarski’s area of expertise.
Waclawski opened Ye Olde Pharmacy, the parent company of MD Custom Rx, in Glendale, WI, a Milwaukee suburb, 30 years ago. He began compounding medicines in the early 1980s. Today, MD Custom Rx is the only full-service compounding pharmacy in Southeast Wisconsin and one of two accredited Pharmacy owners John Waclawski R.Ph., CDE, and daughter Monica Zatarski, Pharm.D., R.Ph. discuss the therapeutics of a topical delivery while removing a preparation from an Electronic Mortar and Pestle (EMP). The EMP helps to ensure uniform and thorough mixing of each preparation, compounding pharmacies in the state.
Walking into MD Custom Rx is not like walking into the usual pharmacy. An inviting reception area and storefront gives way to large windows looking into the lab area. Behind glass, a la Wisconsin State Fair cream puff viewing, pharmacists and lab techs scurry among the state-of-the art equipment, and customers can watch their made-to-order meds being prepared. “Oh, I never knew anything like this existed,” is commonly overheard, Zatarski noted.
Since MD Custom Rx uses raw materials, it follows a stringent set of safety standards. The company completes routine environmental monitoring through surface and air sampling. Many hospitals have not yet met that standard because the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the regulatory and accrediting agency for hospitals, has extended the deadline for compliance.
The Pharmacy Compounding Accreditation Board (PCAB) parallels the JCAHO process for accrediting compounding pharmacies. In just four years, the PCAB has been recognized for its thorough, one and a half year, stringent compliance process. About 65 of the several thousand compounding pharmacies in the United States have received accreditation, including MD Custom Rx. Zatarski is passionate about the regulatory process, has been active in this area of the profession, and hopes to see the status of PCAB accreditation equal that from JCAHO. Her bottom line is that customers would only receive compounded drugs from accredited companies.
While accreditation brings industry respect, challenges still exist for compounding pharmacies. These often small companies must compete with large pharmaceutical companies that have set standards of how drugs will be delivered to consumers. The smaller pharmacies have formed the International Academy of Compounding Pharmacists (IACP), a lobbying group, to represent their interests on Capitol Hill.
As pharmacy practitioners increase their role in the delivery of healthcare, compounding pharmacists are dedicated to serving clients with safe, customized medicines.
Two generations of Badger pharmacists
For as long as Monica Zatarski (Pharm.D. ’04) can remember, she’s been interested in pharmacy. During high school she worked in Ye Olde Pharmacy, her dad’s pharmacy in Glendale, WI as shelf cleaner, delivery driver, fill technician, and, eventually, compounding lab helper.
The natural progression continued as she followed in her father’s footsteps to attend the University of Wisconsin-Madison to earn a Pharm.D. degree. She continued to explore her early interest in compounding during school and returned to the compounding lab at Ye Olde Pharmacy when she graduated, focusing on bioidentical hormones. At about the same time, the United States Pharmacopeia (USP), a non–governmental, official public standards–setting authority for prescription and over–the–counter medicines and other healthcare products manufactured or sold in the United States, was developing stricter compounding regulations. Ye Olde Pharmacy built the new regulations into a new business, MD Custom Rx, which opened in November 2005.
Today, Zatarski balances her roles of owner, business partner, and pharmacist with those of family member, UW alumnae, and mom. In addition to her dad, the pharmacy ties include her husband, Dan Zatarski (Pharm.D. ’03), who operates Ye Olde Pharmacy, and her mom, Faye Waclawski, who manages the billing and payroll. Until 2007 and before Dan Zatarski bought Ye Olde Pharmacy, Monica Zatarski, her husband, and, her dad worked together.