HN Summary
• Compounding pharmacists and technicians ensure safe, customized medications for patients when standard treatments aren’t suitable or available.
• They play a critical role in high-risk medication safety, using strict quality systems to prevent errors and harm.
• Compounding teams help maintain care continuity during drug shortages, supporting system resilience and patient access to essential therapies.
From chemotherapy and parenteral nutrition to pediatric, ophthalmic, and investigational therapies, compounded medications are essential to modern health care. Across Canada, pharmacists and pharmacy technicians working in compounding ensure that patients receive medications that are safe, effective, and tailored to unique clinical needs—especially when commercial products are unavailable or inappropriate. In an era of increasing medication complexity, supply disruptions, and heightened safety expectations, compounding professionals play a critical role in safeguarding patient care and system resilience.
Meeting complex patient needs
Many patients require customized medications due to allergies, swallowing difficulties, dose requirements, or formulation needs that cannot be met by manufactured products. Compounding enables this personalization. National data from the Hospital Pharmacy in Canada Survey confirm that the vast majority of Canadian hospital pharmacies provide sterile and/or non sterile compounding services as core functions of patient care.
Demand for compounding has continued to grow alongside rising pharmaceutical complexity. Prescription drug expenditures in Canada have increased steadily over the past two decades—particularly in hospitals, where growth has averaged more than seven per cent annually—driven by high cost, specialized therapies that often require customized preparation. Compounding pharmacists and technicians ensure these therapies are prepared accurately, aseptically, and in accordance with evidence-based standards.
Ensuring safety in a high-risk practice area risk practice area
Compounding—particularly sterile compounding—is among the highest risk activities in pharmacy practice. Canadian and international safety analyses demonstrate why robust systems and trained teams are essential. Surveys of hospital pharmacies have shown that nearly three-quarters of respondents were aware of at least one sterile compounding error in the previous year, underscoring the importance of specialized training, independent verification, and technology enabled safeguards.
Organizations such as ISMP Canada emphasize that errors in compounded sterile preparations can result in severe patient harm, including infection, dosing errors, and treatment delays. This has led to the widespread adoption of best practices such as standardized master formulation records, barcode verification, gravimetric checks, and environmental monitoring. Pharmacy technicians are central to this work, performing compounding tasks under strict quality systems, while pharmacists provide clinical oversight, verification, and accountability.
Supporting care during drug shortages
Compounding plays a crucial role in maintaining care continuity during drug shortages, which remain a persistent challenge in Canada. In 2024–2025, 2,588 new drug shortage reports were submitted to Health Canada, with 1,772 shortages still active at year end. Shortages disproportionately affect injectable, oncology, anesthetic, and pediatric medications—areas that frequently rely on compounded preparations.
When suitable alternatives are unavailable, hospital pharmacies often compound medications from available ingredients, adjust concentrations, or prepare interim solutions to prevent treatment delays. Evidence shows that pharmacist led mitigation strategies during shortages reduce patient harm and support system stability. Without skilled compounding teams, many patients would face significant disruptions in care.
Leadership in practice: Vivian Lee, B.Sc.Phm., RPh. & Dana Lyons, RPhT
National leadership continues to advance compounding quality and collaboration in Canada, led in part by Vivian Lee and Dana Lyons through CSHP’s Compounding Community of Practice.
Vivian, Clinical Director of Pharmacy Services at Mohawk Medbuy, supports hospitals nationwide through drug shortage management and national sourcing initiatives. Dana, Manager in Provincial Operations at Alberta Health Services, focuses on building reliable systems to ensure safe, consistent medication distribution across the province.
“Pharmacy professionals who engage in compounding often find their roles at an important intersection between chemistry, microbiology, medication safety, operational standards, systems integration, and workflow & infrastructure design, all to ensure patient care needs are met,” says Vivian.
As co-chairs, they connect pharmacy professionals across Canada to share best practices, address complex challenges, and advance education in sterile and nonsterile compounding. Their leadership has strengthened peer learning, supported practice alignment, and elevated the multidisciplinary expertise essential to high-quality compounding.
“Being part of this community of practice has meant connection and shared responsibility. It’s a space that reminds me that improvement work isn’t just technical, it’s human. Learning alongside others who are equally committed to safer, more consistent systems has strengthened my perspective,” adds Dana, “we don’t improve systems in isolation, we strengthen them by learning and building together.”
A foundation of safe, high-quality care quality care
As medication therapies become more advanced and individualized, the importance of pharmacy compounding will continue to grow. Pharmacists and pharmacy technicians working in this space deliver a vital public good: ensuring access to medications that are not otherwise available, prepared to the highest standards of quality and safety.
By investing in compounding infrastructure, training, and leadership—and by recognizing the contributions of national leaders such as Vivian Lee—Canadian health care organizations strengthen patient safety, resilience during shortages, and confidence in medication use systems. Compounding excellence is not a niche service; it is a cornerstone of safe and effective hospital care.