Ad augusta per angusta! To the heights through narrow paths!

The holiday is over… A demanding working period now awaits us. In the coming period, there are problems—particularly concerning pharmacy economics—that are difficult to solve, but not impossible. Of course, the challenges we face while practicing our profession will be present today just as they were yesterday; however, rather than falling into despair, I am among those who believe our problems will be overcome through unity and knowledge. For this reason, the title of my article consists of a Latin motto emphasizing reaching the summits through arduous, narrow paths.

Dear Colleagues, I had highlighted the importance of knowledge in overcoming professional challenges. The significance of acting upon knowledge when providing pharmaceutical care services to our patients in our pharmacies is indisputable. To solve economic problems, rather than merely waiting for profit margins on SSI (Social Security Institution) prescriptions to be revised, pharmacists must refresh and advance their knowledge to correctly recommend non-prescription products—namely dietary supplements and cosmetic-dermocosmetic products—to patients. Furthermore, instead of simply saying ‘unavailable’ for medications that cannot be found day by day in our country due to various reasons, it is our essential duty to remind physicians that many medicines can be prepared in pharmacy laboratories. To achieve this, we must also review our laboratories and our knowledge of magistral compounding accordingly.

In this sense, on June 2–5, in Mardin, we successfully held our congress titled “Magistral Pharmacy Summit 2022” in collaboration with Eczacının Sesi, with broad participation. For our members who could not attend the congress for various reasons, the presentations delivered at our congress by esteemed speakers on invaluable topics have been published in the password-protected section of our association’s website. In the upcoming period, our association will continue to bring magistral-themed congresses to life.

Also in October, members of our association will attend and contribute to the event titled “7th Aegean Cosmetics Days”, organized by the Department of Pharmaceutical Technology at Ege University, where innovations in the field of cosmetics will be discussed alongside practical laboratory studies and presentations, allowing them to refresh their knowledge in cosmetics. The congress will conclude with an excursion to Bergama (Pergamon), the birthplace of Galen—the Emperor of Physicians, one of the most prominent physicians of Ancient Rome, considered the father of pharmacy, the founder of experimental physiology, and the Roman world’s first sports physician.

On October 20-21-22, 2022, at the Istanbul Congress Center (ICC), we will collectively envision the pharmacies of the future at the traditional “Future of Pharmacy” (Geleceğin E Hali) congress, one of the largest pharmacy gatherings of our time, organized by the Pharmetic Entrepreneur Pharmacists Association. I will also be delivering a presentation titled “Magistral Pharmacies in the Future” at the congress as an invited speaker.

As is known, on January 28, 2022, following the applications and negotiations carried out by our Professional Organization with the R.T. Ministry of Health and the Turkish Medicines and Medical Devices Agency for updating the Magistral Tariff used in determining the prices of magistral medicines prepared in our pharmacies; it was updated by applying the revaluation rates for 2017, 2018, 2019, 2020, and 2021 published by the Ministry of Treasury and Finance and specified in the General Communiqué on the Tax Procedure Law. The fact that the magistral tariff, which should be updated annually in January, was updated after a delay of a full 6 years—even if insufficient—was welcomed positively. However, the decision taken 7 months after this date, on September 3, 2022, to increase the prices in the “Tariff for Medicines Produced in Pharmacies” (Magistral Tariff) registered in the MEDULA system by 36.20%, and to have the necessary regulations made by the General Directorate of General Health Insurance, remains quite inadequate in our country where inflation figures stand around 115%. Moreover, the communiqué published on July 25, 2014 stated that “By decision of the Health Services Pricing Commission, magistral medication fees exceeding 500 TL will not be reimbursed as of July 25, 2014.” Therefore, necessary arrangements must be made in the Medula Pharmacy Provision system promptly, the 500 TL upper payment limit set in 2014 must be updated, and patient grievances must be addressed without delay.

Dear Colleagues; “Magistral Compounding”, which observes public interest in economic terms and represents the art of the pharmacist by elevating the patient’s quality of care, is gaining more significance worldwide every day. When magistral compounding is evaluated in terms of drug cost, efficacy, and as a national project; we believe it possesses an aspect that can prevent unnecessary healthcare spending in our country and enhance patients’ treatment quality.

Today, as the number of orphan drugs increases with each passing day, redesigning pharmacy compounding laboratories and addressing magistral preparation within this framework is undoubtedly of paramount importance.

Unquestionably, magistral drugs must be at least as effective, safe, and high-quality as commercially manufactured pharmaceuticals, and must be produced in appropriate premises and under suitable conditions. The preparation and delivery of magistral drugs to patients in a safe, effective, and high-quality manner falls within the duty and responsibility of pharmacists.

Our association—which contributes to improving the quality of magistral compounding activities in Turkey to an internationally competitive level, thereby aiming to bring together qualified pharmacists who grasp current and emerging technologies, are equipped with research-based knowledge and skills, adhere to ethical principles and attitudes, and embrace lifelong learning—aims to ensure that pharmacy laboratories receive the necessary diligence in our country, just as in the rest of the world.

Within the framework of all these justifications; in the compounding of magistral prescriptions written by physicians within pharmacy laboratories, in enhancing the safety and quality of formulations, and when necessary, preparing them under aseptic conditions using technological infrastructure in line with the standards specified in international formulation and stability compendia, we believe the time has come to discuss and implement cleanroom standards—which are among the methods used in pharmaceutical manufacturing facilities to protect human health—in pharmacy laboratories as well. In the upcoming period, which we refer to as the new era, we will witness the compounding of magistral prescriptions inside HEPA-filtered cleanrooms within pharmacy laboratories.