How Skycare Pharmacy has excelled in providing a personalized approach to patient care.
By Inna Levchuk and Irina Lytchak
Photography by Eric Forget
For such a young pharmacy, it’s impressive to see how much Skycare has grown since its inception. Founded in June 2013 and licensed as Skycare Compounding Labs in 2014, the company is the brainchild of two brothers, pharmacists and huge believers in the concept of individualized patient therapy, Mina and John Bashta.
“We’re both pharmacists,” says Mina. “We came to a point where we realized that as pharmacists, we can only help patients with what’s on our shelves. If it goes on backorder or it’s not working for my patients, I’m no longer useful as a healthcare provider. We thought there has to be a way around that, so we started researching and we realized that compounding could be a great solution for these patients, and that’s really what got us into it.”
Compounding pharmacies prepare personalized medications based on the exact dosage of ingredients required by the patient. Running this type of business requires a different level of accreditation— much higher than for a regular pharmacy.
“The reason being is that it allows us to supply hospitals with compounded medications,” explains Mina. “ There are only five pharmacies in Ontario that have that level of accreditation at this point.”
Skycare has two labs, which take up almost more than half of the pharmacy’s space. In the first lab, compounds, such as capsules, troches, lollipops, transdermal creams, specialty creams and suppositories are prepared. The second lab is where injections and sterilized drugs are built. To standardize the outcome, Skycare uses specific equipment, such as an electronic mortar and a pestle.
“We use things like an ointment well—a special piece of equipment that would crush the drug powders, and they create something called ‘mysol formation.’ What that means is the goblet of cream or transdermal base has the micronized drug locked inside it. So as the cream is crossing the skin, it’s actually pulling all of the drug with it.”
When you apply a cream that wasn’t produced in an ointment well, the product will have grit, which is the actual drug that will sit on the skin, providing no medical benefit—something many people experience when having ointments compounded at their local pharmacies, says Mina. At the same time, he believes the reason why typical pharmacies can’t prepare compounds goes beyond the lack of proper equipment.
“There’s more than one angle to it. It isn’t just the labs that require you to come up with that product, it’s also the training, which is also just as critical.”
Mina says a team of experts is needed in order for a compounding pharmacy to function properly, starting with pharmacists and technicians who work hand-in-hand to ensure that a product is created in the most stable and therapeutically active fashion.
“Then, there’s the other side, which is the research side,” says Mina. “Doctors will call us when they run out of options and we’ll start digging into research and come back with a plan for them. This is another part of the training that’s really important—it is the knowledge base that you’re researching into.”
Currently, Skycare works with over 460 prescribers across the GTA, including everyone from urologists, pain management clinics, fertility clinics, integrative practitioners, pediatricians, ophthalmologists, obstetricians and gynecologits to family doctors, naturopathic doctors, podiatrists and veterinarians. Mina believes another important factor that sets Skycare apart from other pharmacies is the way its pharmacists work with the patients.
“A lot of the times you see big-box stores where patients are pretty much prescription numbers to the staff that are working inside,” says Mina. “Everybody is a number and everybody who is in queue waiting to get their prescription hears, ‘Here are three tablets today, take that every eight hours.’ We want to make sure that we personalize the experience for our patients; this is really what they deserve.”
One example of personalized medication provided at Skycare is bio-identical hormone replacement therapy, where saliva testing is done under the doctor’s order to supplement the patient with the exact amount of hormones they need.
“If one size fits all, we’d all be wearing one jacket, so I can only imagine that statement goes even further when we’re talking about hormones,” says Mina. “Hormones are very specific to every patient; my deficiencies may be very different from my next patient’s deficiencies. That’s why it’s very important that we supplement the right amount of hormones, because with 100-milligram segments, we’re either overdosing or underdosing the patient. In that sense, bio-identicals are made to be the perfect fit for everyone.”
One of the policies Skycare has in place to guarantee the pharmacy is working against the trends that are currently in the market is that all of its labs are kept behind glass.
“First of all, it creates that sense of transparency between us, our patients and the physicians that we’re working with,” says Mina. “But at the same time, my staff has a face for every prescription that they’re working on. They know that their patients are standing outside.”
One of Skycare’s priorities is educating their patients on the medications they are getting as well as taking a holistic approach to solve their health problems.
“These are small things, but they do end up going a much further way when they are combined with the traditional medical or pharmaceutical approach.”
Skycare also creates compound medications for animals, which often requires extra research.
“A patient is a patient,” says Mina. “Flavouring is huge when it comes to animals – knowing which flavours are going to which animal. We do a lot of research before compounding something for a patient—whether human or not—so safety is another key thing. Even in the veterinary world sometimes, a horse will need something a bit more specific than what’s commercially available, and this is when veterinarians will contact compounders.”
Aside from providing a personalized approach to each patient’s case, the bottom line is that Skycare is presenting doctors with ways around their patients’ health concerns by providing them with more tools to work with.
“At the end of the day, we make sure we’re gearing up every effort to have the best and the safest therapeutic outcome for the patient.”