Second Question of the Day July 1, 2014 How many times does an animal or human take a compounded medication based on preference of the patient or the doctor? Is this a valid, legal reason?

How many times does a doctor prescribe a compound simply because he or she prefers a compounded preparation nor because their is a legitimate basis for the compounded preparation?   How many times does the doctor provide false documentation for the compounded preparation?  Shouldn't the justification be patient-specific rather than a general theory such as all kids have trouble taking pills so the medication needs to be made into a sucker.  This general statement is false:  some kids can take pills; some can't.  Likewise, a general statement that animals are hard to give pills should not be a valid basis.  For example, I have been successful giving most of the cats I have owned pills and in fact sometimes the pills are easier to give to a cat than a liquid preparation in a dropper.  Should it be a valid basis simple because a doctor thinks the compounded preparation works a little better than the commercially available even though the commercially available still works?  For example assume there is a commercially available drug to treat infertility in females.  In studies, it works 90 percent of the time and the female ends up having a baby.  Assume also compounding pharmacies make a very similar if not identical commercially available drug to treat infertility in females.  Studies by compounding groups suggest this preparation works 95 percent of the time but of course the studies required by the FDA for the drug to be approved and commercially available have not been done.   The patient has never tried the commercially available or the compounded preparation. The doctor prefers the compounded preparation because he likes to help the pharmacist stay in business so he or she always prescribes it.  Problems?  Legal?  Illegal?  Should the doctor be prosecuted?  Fined?  Should the pharmacist who clearly knows what is happening be prosecuted?  Fined?  How can it be patient-specific and valid when the patient has no idea if the commercially available will work?  What if the patient tries the commercially available for six months with no success and then the doctor prescribes the compounded medication?  Doesn't this change the legality of the prescription, but again how many times is this being done in actual practice?