CIO Bulletin

Valor Compounding Pharmacy – Providing High-Quality Custom Compounded Medications

While most pharmacies produce medicines that work for the masses, they may not be suitable for everyone. There are several scenarios when patients need customized medicines. That's where compounding pharmacists come in. They can create a drug that will achieve similar benefits but specifically tailored to the patient.

Valor Compounding Pharmacy is a specialized compounding pharmacy that customizes medications to fit each patient's unique needs. Its mission is to reinvent compounding pharmacy. They work with a network of providers, patients, health systems, institutions, and research scientists throughout the United States. We interviewed Christine Stephanos, the Vice President & Chief Pharmacy Officer of Valor Compounding Pharmacy, to get more details about the company and the purpose it serves. Here are a few excerpts of the interview:

Q. What is a compounding pharmacy, and how is Valor different than Walgreen's or Rite Aid?

Walgreens, Rite Aid, and other retail pharmacies dispense commercial drugs that are manufactured by Big Pharma. Compounding pharmacies prepare medicine, based on a doctor's prescription, for patients with unique needs where a commercial drug isn't available to obtain the desired therapeutic outcome. Active ingredients are weighed and incorporated in bases resulting in a custom medication in the desired dosage form for treatment administration. One of the many factors in determining whether or not a prescription can be compounded includes the consideration of chemical compatibilities of ingredients with each other and with the bases in which they are compounded. Valor pharmacists have comprehensive training and unique expertise in preparing, handling, and dispensing compounded medications.

Q. In what situations do doctors write for or prefer compounded medications for their patients?

Pharmaceutical compounding dates back to the very origins of pharmacy, and, ever since, it has been an integral part of pharmacy practice worldwide. Compounding medicine plays a major role in closing therapeutic gaps by providing unique medicines to patients.

Patients diagnosed with specific medical conditions, such as having a hormone imbalance, chronic pain, infertility, or erectile dysfunction, may be good candidates for compounded prescriptions. Doctors may also choose to recommend prescribing a compounded medication for patients who are allergic to certain ingredients in commercially available medications, have difficulty taking certain medications in the available dosage forms they come in, usually take a medication that is facing a drug shortage or has been discontinued, or have an issue with compliance when taking multiple medications. Compounded medications are preferred to encourage compliance, improve treatment outcomes, and, subsequently, patient's well-being.Patients may need compounded medicines due to drug shortages or discontinued medications. Sugar, commonly used to improve the flavor of medicines, may also be problematic for some patients.

Compliance with drug therapy can be problematic, especially in two populations of patients- pediatric and geriatric. Both groups of patients have swallowing difficulties and prefer liquid or topical dosage forms that are not always available on the market. Drug strength can also be a problem for these two populations.

Another area where compounding is necessary is a veterinary pharmacy. Compounding for animals provides professional challenges and requires a thorough knowledge of animal physiology and pharmacology.

Q. Who are your customers and patients, what is your geographical service area, and how does someone get started with Valor?

We consider patients, physicians, healthcare institutions, telehealth platforms, and research organizations to be our customers. Each has a unique need that we can help address. Our patients are our largest customer base by far, presenting a vast spectrum of compounding needs. Valor makes it easy for all customers, whether a patient, a doctor, administrator of a research organization, telehealth platform, or healthcare institution, to get their compounding needs addressed. We are currently licensed in 22 states and hoping to be approved in all 50 by the end of 2021.

Q. Since COVID arrived, it seems like telemedicine and telehealth are more prominent today. What is your value proposition for telemedicine companies, and why should they choose Valor?

Valor's core values revolve around service and quality. This is embodied in how Valor pharmacists personalize their relationship with patients as they choose therapy plans, provide in-depth patient education and assist with implementation. We help design and create a therapeutic product for an individual patient. With telemedicine on the rise, we pivoted and leveraged legal and business talent to help design and create a streamlined process for platforms to follow while ensuring our continued compliance with the practice of pharmacy, the prescriber's compliance with the practice of medicine, and compliance with all of our accreditations, such as PCAB and LegitScripts. We also make the journey for telehealth platforms just as easy as we do for patients.

Q. I can imagine that quality controls and assurance must be very important for Valor. Tell me how you tackle this and what you've put in place to ensure medications are made safely and accurately?

At Valor, the function of quality is to develop and implement processes that test and verify product quality against predefined standards. These standards include inspection of raw material, validation of process, release or rejection of batch, stability testing, and product shelf-life evaluation. In addition, our processes also include analytical investigation of complaints or product recalls, out-of-spec and deviation investigations, and analysis for non-conforming products. We have established guidelines and procedures to evaluate and implement change control suggestions and maintain consistent personnel training and environmental monitoring documentation. All quality-related documentation is maintained in a robust quality management system, Propel, which has enabled us to streamline our quality control and quality assurance responsibilities.

Q. What are Valor's core values, and why are they important to you and the company?

Valor's core values are trust, quality, curiosity, accountability, communication, and critical thinking. Patients and doctors trust us with the prescription journey. We listen to needs, research problems, communicate solutions, and always hold ourselves accountable while striving for excellence. We incorporate our core values into everything we do – from recruiting new team members and performance reviews to considering the vendors and customers we work with and partnering together.

Meet the Vice President

Christine Stephanos is the Vice President & Chief Pharmacy Officer of Valor Compounding Pharmacy. Her leadership starts with her passion for problem solving and efficiency. Continuous performance improvement is the objective behind all projects Christine leads. She mentors her team through problem-solving and critical thinking while always considering the myriad possibilities and scenarios for improvement. Equally important, Christine can integrate diverse perspectives from those around her in refining Valor's compliance strategy by building and supporting the best leadership team, instilling the courage to explore new methods which challenge the current norm while aggregating different schools of thought-driven by a common goal of best-serving patients.