As a practicing pharmacist in Arizona, my job is simple: make sure patients get medications that are appropriate for their individual needs. My wife and I opened our first pharmacy location in 2014 with the goal of supporting the communities where we grew up and helping our patients achieve the best possible outcomes by working closely with their physicians. The mission we started with remains true today. Every day, I work with physicians and patients who rely on compounded medications because commercially available, one-size-fits-all products don’t work for them.

That’s why I’m concerned about HB4036, a bill moving through the Arizona Legislature that would impose sweeping new restrictions on pharmacy compounding. While supporters frame it as a safety measure, the reality is that it risks limiting access to care without meaningfully improving patient protection.

Compounding is not some loophole or shortcut. It’s a long-standing, carefully regulated practice that allows pharmacists to tailor medications when patients can’t use mass-manufactured drugs. In the last year alone, I have had countless face-to-face interactions with patients—from high schoolers to retired veterans—who heave a sigh of relief in my pharmacy when we dispense custom medications without certain dyes or preservatives that they are allergic to. Many of my patients need their medication in doses that simply aren’t manufactured. Pediatric and geriatric patients often require customized formulations that allow them to swallow pills larger than the size of a raisin. We give them the medicine they need. For them, compounding is not optional — it’s essential.

In addition, we work with veterinarians to develop compounded medications at our Tucson location for pets that offer a number of benefits, ranging from customization through ease of administration. 

Arizona already regulates compounding pharmacies through the State Board of Pharmacy, and pharmacists operate under strict professional standards. We are trained to verify ingredient quality, maintain sterile environments when required, and document our processes. We take our responsibility seriously.

HB4036 would layer on additional requirements that, while sounding technical and prudent, create rigid barriers that don’t reflect how pharmacy practice or supply chains actually work. The bill would make it unlawful to compound certain medications unless pharmacies meet a long list of criteria related to bulk ingredients, documentation, supplier inspections and testing protocols.

On paper, that may sound like a reasonable tightening of standards. In practice, it risks cutting off access to medications because of bureaucratic hurdles beyond a pharmacist’s control. For example, pharmacies could be required to verify that ingredient suppliers were inspected by the FDA within a specific timeframe — something pharmacies cannot dictate or schedule. If an inspection is delayed, even when the supplier remains compliant and safe, patients could lose access to their medication.

When compliance becomes too complex and resource-intensive there is a very real risk that smaller pharmacies could step away from compounding altogether, and if that happens patients lose options.

When access shrinks, patients don’t just face inconvenience. They face treatment interruptions. They face higher costs. They face delays while searching for alternatives that may not meet their medical needs.

Good policy should target actual risks, not create broad restrictions that treat responsible, licensed professionals as though they are operating outside the system. We already work within a framework of state oversight, federal standards and professional accountability.

There is also a larger principle at stake. Health care decisions should be made by patients, their physicians and the licensed professionals entrusted with their care — not dictated through rigid statutory checklists that cannot adapt to clinical realities. Legislating new restrictions into state law may sound decisive, but it leaves little room for flexibility when circumstances change.

If lawmakers believe improvements are needed, pharmacists should be at the table. We support thoughtful policies that strengthen safety without undermining access. But HB4036, as written, tilts the balance to big global drug manufacturers and away from patients and those who directly provide care.

Arizona patients deserve both safety and access. We can have both — but only if we avoid policies that make it harder for trusted health professionals to meet individualized medical needs.

For the sake of the patients I serve every day, I urge lawmakers to reconsider HB4036.

By Justin Brock, Pharm D, Compounding Pharmacist and President and Owner of Acacia Apothecary and Wellness with a staff of over 15 serving Tucson and Southern Arizona.