I thought this would be a good topic to discuss on Doc's Desk. I am increasingly being asked by patients about these alternatives to hormone replacement therapy that I consider "non-brand" prescriptions for hormones. These alternatives are mostly referred to as bioidentical hormones that are plant-derived hormones and usually compounded by a pharmacist. Compounded bioidentical hormones are custom made by a pharmacist according to a physicians specifications. They are considered "alternatives" to the hormones manufactured, approved by the FDA, packaged, and sold in standardized dosages by drug companies. These compounded hormones have the same safety issues as the FDA approved hormones and may have additional risks related to the compounding. I am also concerned about cost. Are these compounded hormones a covered benefit? Are they on the HMO's and PPO's drug formulary? Bottom line, I do not encourage use of these agents, but it is always open to discussion. Doc
