The Pharmaceutical Journal
Vol 270 No 7236 p227
15 February 2003

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Letters to the Editor

Dispensing

Extemporaneous dispensing may not be cost-effective

From Ms F. Cruickshank, MRPharmS

In response to the letter from Christopher Wragg (PJ, 8 February, p188) regarding preparation of simple formulae, I do not believe it is beyond the current generation of pharmacists to carry out extemporaneous dispensing.

It is a skill still taught during the undergraduate degree course. However what has to be evaluated is whether such an activity is cost-effective and safe in general practice today.

In the case of copper and zinc sulphates lotion BPC, the process of making the preparation is straightforward but the following points should be considered:

• Do procedures for extemporaneous dispensing comply with Health and Safety legislation, eg, COSHH Regulations?

• Is the equipment used dedicated to products for external use to avoid cross contamination?

• The concentrated camphor water BP must be made separately because it is no longer available

• Are the balances used to weigh the ingredients calibrated and accurate?

• How much time will be involved in sourcing the materials, preparing the product and recording details of dispensing?

• The four principal ingredients cost approximately £100

• Pharmacists will only be reimbursed basic costs if they choose to prepare a product such as the lotion and this does not remunerate them adequately for the time involved

• The last edition of Martindale to carry the formula was the 28th, published in 1982. How many dispensaries have a copy of this?

There are pharmacists engaged in extemporaneous dispensing and manufacturing in licensed units both in hospitals and industry and they build on the skills taught as undergraduates.

I do not believe that extemporaneous dispensing is a dying skill and those of us actively engaged in this area continue to develop this branch of pharmacy, and thoroughly enjoy it.

Fiona Cruickshank
Prudhoe, Northumberland

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