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Keystone Pharmacy is mixing drug combos to combat the nationwide shortage of Ritilin & Adderal

December 2nd, 2011 - GRAND RAPIDS TOWNSHIP - In the laboratory at Keystone Pharmacy, white-clad technicians carefully weighed, measured and mixed to the whirring sound of an electronic mortar-and-pestle blender.

This is where medications are compounded, and it is an especially busy place these days. A record number of drug shortages is prompting customers to seek pharmacies that can make their medications or alternatives that will do the job.

"One of the unique niches we fill as compounders is helping out with drug shortages," said David Miller, a pharmacist and the owner of Keystone, 4021 Cascade Road SE. Adderall, a stimulant often prescribed for attention deficit disorder, is one of the most recognized examples.

In many cases, doctors have switched patients to Ritalin or Dexedrine. Manufacturers have been unable to keep up with the increased demand, so shortages have developed for those drugs. That's where the compounding pharmacists come in: They mix the medications for customers with Ritalin or Dexedrine prescription. They are unable to provide Adderall, however, because the ingredients are in scarce supply. Federal limits on the controlled substances are blamed by some for the shortage. Tetracycline, an antibiotic commonly prescribed for skin, urinary tract and respiratory tract infections, is another drug that is in scarce supply. So is methylprednisolone, an anti-inflammatory. In both cases, medications can be compounded at a pharmacy.

More than 200 prescription drugs are listed on the Food and Drug Association shortage list. President Barack Obama has urged the FDA to work with drug companies on increasing medication supply and has asked the Justice Department to intensify its investigation into price-gouging claims. In the meantime, customers are turning to pharmacists who can create the pills, capsules, liquids or creams they need by hand.

"It's very labor intensive," Miller said. "It takes an average of 45 minutes to fill a compound versus three to four minutes for a traditional prescription." The pharmacy employs eight technicians to make medications. The equipment they use includes built-in safeguards. The bar code of each ingredient must be scanned by computer to ensure it is the right one. And the scale is connected to a computer to double-check that the correct amount is measured. But not every tool is high-tech. Miller picked up an old-fashioned glass mortar and pestle, long a symbol of pharmacists. It is still used to mix some compounds, particularly suspensions, such as creams and ointments and liquid versions of medications given to children.

"You can get a lot of energy into the particles. There's nothing really better than this," he said. "You can get things to mix a lot better." A mortar and pestle are used to create many of the medications created for pets. Miller uncapped a bottle of a foul-smelling liquid and offered a whiff.

"That's our fish-suspension base we make for kitties," he said. "It's real salmon, sardines and tuna." Medication is added to the fishy liquid goes down much easier with cats than pills, he said.

The cost for compounded medications is usually not much higher for customers, Miller said. In some cases, prior authorization is needed from the insurance company, or the higher, brand-name co-pay charge instead of the generic co-pay. And sometimes, the compounded medication costs less than an expensive brand name drug. Miller advised patients unable to find a prescribed medication to talk to their doctor and pharmacist.

"If they call four or five pharmacists and can't find it, it's time the doctor, the patient and the pharmacist come together to find an alternative," he said.

Megan Meyering, a certified technician at Keystone Pharmacy, does capsulating of powder medications as part of compound medications. As shortages develop for Adderal, Ritalin, tetracycline and other drugs, pharmacies are seeing an increased demand for them to compound those medications.

Nicolle Holzgen, left, and Lynn Berry, certified technicians at Keystone Pharmacy, dose capsulating of powder medications as part of compound medications.

Certified Technicians at Keystone Pharmacy (front to back) Lynne Spiller, Debbie Martinson, Nicolle Holzgen (left) and Lynn Berry work at different stations for preparing a variety of compound medications.

Nicolle Holzgen, a certified technician at Keystone Pharmacy, does capsulating of powder medications as part of compound medications.

Compounds are heated up and melted to make troche sublingual tablets as part of compound medications.

Keystone Pharmacy expands on Cascade Road

GRAND RAPIDS TOWNSHIP – While other independent drug stores keep dropping off the scene, Keystone Pharmacy is completing a building expansion and taking on a new venture. The pharmacy took over another 1,600 square feet in the plaza at 4021 Cascade Road SE, creating 40 percent more space, with a seminar room, expanded lab and two consultation rooms. The $130,000 expansion also includes a sterile lab that few other pharmacies outside of hospitals ever add.

Keystone Pharmacy Expands, Celebrates 10th Anniversary

Grand Rapids, Michigan, October 5, 2011 – Fueled by strong demand for its compounded medications, Keystone Pharmacy is putting the finishing touches on a significant expansion of its Grand Rapids store – just in time for its 10th anniversary.

The locally owned, full-service pharmacy will celebrate its anniversary and the grand “re-opening” of its store at 4201 Cascade Road SE on Wednesday, Nov 2. The new store, which has increased square footage by 62 percent, will feature:

• A new, state-of-the-art sterile compounding laboratory for the preparation of customized sterile medications, including injectibles, surgical preparations, fertility treatments, eye drops and ointments, and inhalations
• An expanded lab – nearly tripled in size – for compounded medications for people and their pets
• A new seminar room that will allow Keystone to host lunch-and-learn programs for patients and educational seminars for physicians
• Two new private consultation rooms where patients can meet with a registered pharmacist to discuss pain management, functional medicine and hormone therapy
• A new, dedicated immunization room that provides a discreet and comfortable environment to enhance the patient experience, particularly for overseas travelers who need hard-to-find immunizations and medications

“Keystone is extremely pleased to be celebrating our 10th anniversary in West Michigan by unveiling our expanded store,” said David J. Miller, chief formulation scientist and co-owner. “We opened our doors a decade ago with a strong commitment to providing individualized medication solutions, and this formula continues to resonate with our patients. We have grown nine-fold over that time and are continuing to grow.

Linking Cortisol Production to Stress By Mary PreFontaine, R.Ph, FAAFM

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Andropause: Male “Menopause” By Mary PreFontaine, R.Ph, FAAFM

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Testosterone: Prescription for Passion By Mary PreFontaine, R.Ph, FAAFM

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West Michigan doctors offer tips to improve your sex life

An article written by Paul R. Kopenkoskey and published in The Grand Rapids Press. View the article here

Congratulations to our winners of our Christmas Angel Coloring Contest!

Keystone Pharmacy would like to congratulate our two winners of our Christmas Angel Coloring Contest, Emily Beidler & Brett Holzgen. They both will receive a webkinz of their choice.

A Letter of Thanks!

We recently received these kind words wanted to share them with you.

Dear Dr. David Miller,
I wanted to thank you for supporting the mission trip to Haiti with your generous donations. With the assistance of the medications donated from Keystone Pharmacy, we were able to provide medical care for 1200 patients in the course of the trip. We traveled from Port-Au-Prince to several tent cities, the largest which has grown in size to 5500 families, since the earthquake of January 12, 2010. Our group was able to serve patients who were severely malnourished and medically ill, spreading the love of Jesus Christ to many desperate for help. Most lived in boxes and tarps wrapped around sticks for homes, and were starving without adequate food and clean water, sickness all around. We shared food and water available, clothing, and provided medical care to those in need, bringing donated medicines in suitcases to dispense. I have truly been blessed to have seen the power of healing and hope that can occur through sharing the blessings we have received with others less fortunate, and Keystone Pharmacy has helped provide the bridge for us to share.
Thanks again,
Christopher Van Ryn, PA-C

Keystone Pharmacy Donates Children's Items to Metro Health Child Life Program

Wyoming, Michigan, April 7, 2011 - Keystone Pharmacy has donated more than 400 stuffed animals and accessories to the Metro Health Hospital Foundation for use in the Metro Health's Child Life Services program.

After reading an article describing Child Life Services in The Grand Rapids Press, pharmacy employees wanted to contribute to this important service. Marie Woodard, director of marketing at Keystone Pharmacy, worked with the team to gather the items and deliver them to the hospital.

Child life specialists at Metro Health are experts in child development who provide support and help children cope with the emotional stresses of healthcare and the hospital. Working with children who are patients or family members, child life specialists try to take the unknown out of the hospital experience for many young patients or family members.

As a compounding pharmacy Keystone also provides special services to children by formatting medications into flavored liquids or gummies, which make the medications easier for kids to take, according to Woodard.

"It's exciting to see that our community supports the important work of our child life specialists," said Metro Health Hospital executive vice president of foundation and community outreach Laura Staskiewicz. "Donors make this program possible. Metro's Child Life Services program is fully funded through generous gifts from our community."

Keystone Pharmacy Team CPR Training Class

On September 14th, the entire team participated in the optional CPR training, obtaining CPR certification as well as valuable life-saving skills!

Congratulations to our pharmacist, Dave Miller for being elected to another 3 year term after completing a 4 year term!

July 19, 2010 PIPCo NEWS
BOARD OF DIRECTOR ELECTION

The Annual Meeting of Shareholders was held on July 19, 2010 in Milwaukee, WI. At the meeting the Board of Directors election took place. Steve Felkey, Dave Miller, and Gregg Russell were all elected to serve a three-year term on the board. Matt Mallinson will fill the role as the alternate board member. The next board meeting will be Saturday September 18 in Milwaukee WI. Congratulations to Steve, Dave, Gregg and Matt.

Keystone Meets with Senator Stabenow

Keystone Pharmacy Working for your rights to continue to have compounded medications as prescribed by your healthcare professional. Dr. Dave Miller and Senator Debbie Stabenow recently met to discuss her support for compounded medication legislation. We are working diligently to protect your rights in this area of healthcare as some would like to limit, or altogether end, your doctors ability to prescribe compounds.

Pharmacists Head to Washington, D.C. to Protect Your Access to Compounded Meds!

More than 250 community pharmacists, including Keystone Pharmacy owner, David J. Miller, RPh, PhD, and pharmacy technicians from across the United States traveled to Washington, D.C., to meet with their federal House and Senate delegations as part of the International Academy of Compounding Pharmacists (IACP) 2011 Compounders on Capitol Hill 17th annual conference and legislative event held, June 11-14, 2011.

Pharmacy Compounding Accreditation Board Teams Up With the Society for Maternal-Fetal Medicine

Pharmacy Compounding Accreditation Board was recently asked to prepare a question and answer document for the Society For Maternal-Fetal Medicine. SMFM has been very active in advocating the use of 17-hydroxyprogesterone for prevention of preterm labor, and compounding the drug for patient convenience. You will note that it alerts physicians to use PCAB accreditation as a way to identify quality compounding pharmacies. Keystone Pharmacy is proud to be West Michigan's first and only PCAB Accreditated pharmacy! How can we help you today?

PCAB's Q&A has been posted on the SMFM homepage

Team Keystone ran in the West Michigan Urgent Care 5K

”For being a first time race I am really impressed with how they had it organized. From a real race timer to race bibs, to a great spread of food, and medals for the top 3 in different age groups. Lily and I even scored some cool swag from Keystone Pharmacy, Xenergy, and Quiznos Subs. If you are looking for a inexpensive $25/$15 race day 5K for next spring to stretch your muscles out after the Fifth Third River Bank run, this would be it."

Medical Mission

These are pictures from the medical mission trip of Christopher Van Ryn PA-C to Haiti in January 2010. Keystone Pharmacy once again was able to help out by donating $5500 in medications to Chris that helped him see over 1000 patients! Best wishes to Chris on his upcoming trip back to Haiti along with fellow Doctors from Riverwood Family Medicine. Check our more photos and the store on our Facebook page.