SYSTEMIC REFORMS IN SOCIAL PHARMACEUTICAL SERVICES: AN ANALYTICAL ASSESSMENT OF REFORM OUTCOMES IN UZBEKISTAN

SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 135 SYSTEMIC REFORMS IN SOCIAL PHARMACEUTICAL SERVICES: AN ANALYTICAL ASSESSMENT OF REFORM OUTCOMES IN UZBEKISTAN M. Izbosarov Academic Degree: PhD in Chemistry, Professional Qualification: Licensed Pharmacist (Provisor), Affiliation: PhD on Chemistry, Research and production center for cultivation and processing of medicinal plants, Tashkent, Uzbekistan https://doi.org/10.5281/zenodo.18045589 Abstract. This article provides a comprehensive scientific analysis of the institutional, economic, and professional effectiveness of ongoing reforms in pharmaceutical services in Uzbekistan. The study demonstrates that under conditions where commercial logic dominates pharmaceutical service provision, the social functions of pharmacy services are institutionally constrained. Based on a comparative analysis of international social welfare state experiences, the article argues that ensuring the social function of pharmaceutical services cannot be achieved through administrative restrictions alone, but requires service-based remuneration, reimbursement, and economic compensation mechanisms. The study substantiates the necessity of functional differentiation between social pharmacy services and commercial pharmacies, the introduction of public–private partnerships in social pharmacy services, reform of centralized procurement and socially mandated wholesale distribution, and the development of in-pharmacy compounding systems. The research explains why current reforms have not resulted in the expected social outcomes in access to medicines and proposes practical, system-oriented institutional and economic solutions adapted to the conditions of Uzbekistan. Keywords: social pharmacy; pharmaceutical services; social pharmacy services; public– private partnership; access to medicines; centralized procurement; wholesale distribution; inpharmacy compounding; professional role of pharmacists; reform effectiveness. 1. Introduction Pharmaceutical services constitute an integral component of the healthcare system, ensuring the continuity of the treatment chain through the provision of medicines to the population. According to the World Health Organization (WHO), physical and economic access to essential medicines is one of the decisive determinants of population health outcomes [1]. Consequently, pharmaceutical services cannot be regarded solely as a commercial activity; rather, they represent a core element of the state’s social responsibility within the healthcare system. In recent years, the Government of Uzbekistan has undertaken a number of initiatives aimed at improving access to medicines and strengthening pharmaceutical regulation. These initiatives include regulatory reforms, digitalization of prescriptions, the introduction of price registries, and attempts to align national practices with selected international standards. The existence of these efforts indicates that the state is not passive with respect to pharmaceutical policy and recognizes the importance of medicine supply for public health. However, despite the presence of reform initiatives, the expected comprehensive social effect in terms of equitable and sustainable access to medicines has not been fully achieved. The SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 136 primary reason lies not in the absence of reforms, but in their fragmented nature. Current measures are often implemented in isolation, lack logical sequencing, and are not embedded within a coherent institutional and economic framework. As a result, individual regulatory or technological instruments fail to transform the pharmaceutical services system as a whole. This article proceeds from the assumption that improving pharmaceutical services requires more than administrative regulation or market liberalization. It requires a systemic reconsideration of the institutional status of pharmaceutical services, their economic mechanisms, and the professional role of pharmacists. In particular, the article argues that without recognizing pharmaceutical services as part of the social healthcare infrastructure, reforms will remain limited in their impact, regardless of progress in pharmaceutical manufacturing or digital control mechanisms. The objective of this study is to provide a comprehensive scientific analysis of the reasons behind the limited effectiveness of current pharmaceutical service reforms in Uzbekistan and to substantiate institutional and economic solutions adapted to national conditions. Drawing on international experience from social welfare states and health economics theory, the article proposes a model based on functional differentiation of pharmacies, the development of social pharmacy services, the introduction of public–private partnership mechanisms, the reform of centralized procurement and socially mandated wholesale distribution, and the revitalization of inpharmacy compounding practices. By situating pharmaceutical services within a broader social and institutional context, this study seeks to contribute to evidence-based policy discussions and to offer a practical framework for strengthening access to medicines as a public good rather than a purely market-driven commodity. 2. Theoretical Framework: The Distinction Between the Pharmaceutical Industry and Pharmaceutical Services. In both academic discourse and policy practice, the terms pharmaceutical industry and pharmaceutical services are frequently used interchangeably or treated as components of a single system. However, from scientific, economic, and institutional perspectives, these concepts represent fundamentally different domains. Failure to clearly distinguish between them leads to conceptual ambiguity, distorts reform priorities, and ultimately results in ineffective policy decisions in the pharmaceutical sector. The pharmaceutical industry primarily encompasses activities related to research and development, manufacturing, clinical trials, registration, and market entry of medicinal products. Its economic logic is grounded in industrial production, investment, innovation, competitiveness, and export potential. Within this domain, market mechanisms, competition, and profit generation are natural and legitimate drivers of development. Policies aimed at strengthening the pharmaceutical industry typically focus on increasing production capacity, promoting domestic manufacturing, reducing import dependency, and fostering technological advancement. Pharmaceutical services, by contrast, possess a fundamentally different institutional nature. They include the operation of pharmacies, the distribution and dispensing of medicines, pharmaceutical counseling, and direct interaction with patients. In this domain, the primary object is not the medicinal product as a commodity, but the patient as a recipient of healthcare services. The core purpose of pharmaceutical services is to ensure rational use of medicines, continuity of treatment, patient safety, and equitable access to essential therapies. Accelerated development of the pharmaceutical industry may increase the availability of medicines on the market; however, without systemic regulation of pharmaceutical services— SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 137 namely pharmacy networks, supply chains, service-based payment mechanisms, and reimbursement systems—real and equitable access to medicines cannot be guaranteed. This structural imbalance is particularly evident in reform agendas that prioritize industrial growth while assuming that improvements in manufacturing will automatically translate into better access for the population. From the perspective of health economics, healthcare services are classified as markets with inherent imperfections [2,3]. Information asymmetry between providers and patients, inelastic demand for essential medicines, ethical obligations toward vulnerable populations, and the social consequences of restricted access all limit the applicability of free-market principles. For these reasons, pharmaceutical services in OECD countries are not left to operate as fully liberalized markets. Instead, they are subject to strict state regulation, perform explicit social functions, and are supported through financial compensation mechanisms such as service fees and reimbursement schemes. Within this framework, it becomes evident that pharmaceutical industry development addresses the question of medicine production, whereas pharmaceutical service reform addresses the question of justice in access to medicines. These two policy objectives are not institutionally equivalent and cannot be pursued through identical regulatory instruments. Accordingly, a clear institutional separation between the pharmaceutical industry and pharmaceutical services constitutes the theoretical foundation for effective reform. Without such differentiation, achievements in pharmaceutical manufacturing will not automatically translate into improved population access to medicines, and pharmaceutical policy risks remaining fragmented and socially inefficient. 3. Reasons for the Ineffectiveness of Current Reforms Despite ongoing reform efforts in the pharmaceutical sector of Uzbekistan, tangible improvements in equitable and sustainable access to medicines remain limited. This section argues that the core problem does not lie in the absence of reforms, but rather in their structural and institutional design. Current measures tend to be fragmented, instrument-oriented, and insufficiently embedded within a coherent socio-economic framework of pharmaceutical services. 3.1. Fragmented and Instrument-Oriented Reform Approach Recent reforms have largely focused on individual regulatory and technological instruments, including simplification of licensing procedures, the introduction of electronic prescriptions, the establishment of price registries, and the implementation of digital monitoring systems. While these measures may enhance administrative transparency and control, they do not alter the underlying economic logic of pharmaceutical services. According to analyses by the World Health Organization, administrative regulation alone cannot ensure access to medicines if financial and institutional mechanisms remain unchanged [4]. Without restructuring service-based payment models, reimbursement schemes, and institutional responsibilities, digital tools and regulatory controls function merely as auxiliary instruments rather than drivers of systemic change. In practice, the reform trajectory can be characterized as a sequence of parallel initiatives implemented without clear prioritization or integration. As a result, improvements in one area— for example, prescription digitalization—do not compensate for deficiencies in others, such as service remuneration or supply chain organization. Table 1. Instrumental Reforms and Missing Systemic Components SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 138 Implemented instruments Systemic components that remain absent Electronic prescriptions Service-based payment mechanisms Price registries Reimbursement and compensation schemes Licensing simplification Institutional differentiation of pharmacy functions Digital monitoring Social mandates for pharmaceutical services This mismatch explains why reforms produce limited social impact despite visible regulatory activity. 3.2. Statistical and Institutional Status of Pharmacies A critical institutional gap concerns the statistical and legal classification of pharmacies within the healthcare system. Hospitals and clinical facilities are formally recognized in state statistics as social healthcare infrastructure and are planned, financed, and monitored accordingly. Pharmacies, despite their essential role in treatment continuity, do not enjoy equivalent institutional status. The absence of formal recognition of pharmacies as part of the “health and social services” sector has direct consequences for policy design. Without such classification, pharmaceutical services are excluded from systematic healthcare planning, long-term financing strategies, and performance evaluation frameworks. Consequently, reforms remain focused on market regulation rather than social service provision. Recognizing pharmacies as social healthcare infrastructure—on par with hospitals—would create institutional preconditions for coherent pharmaceutical policy. It would enable integrated planning, justify public financing mechanisms, and support accountability structures aligned with public health objectives rather than purely commercial performance. 3.3. Regulatory Asymmetry Between Commercial and Social Functions Another source of inefficiency stems from the absence of functional differentiation between commercial and social roles of pharmacies. In the current system, all pharmacies are subject to similar regulatory and fiscal treatment, regardless of whether they primarily serve social healthcare needs or operate as retail outlets for non-prescription medicines. This regulatory symmetry obscures the social mission of pharmaceutical services and incentivizes commercial behavior even in areas where social obligations should prevail. As a result, pharmacies are compelled to prioritize turnover and profitability over professional pharmaceutical care, particularly in underserved regions or among vulnerable populations. Without explicit institutional mechanisms distinguishing social pharmacy services from commercial retail activity, reforms inadvertently reinforce market dominance rather than public health goals. 4. International Experience: How Social Pharmacy Functions in Practice International experience from social welfare states demonstrates that the social function of pharmaceutical services cannot be ensured through administrative price controls or market liberalization alone. Instead, effective systems are built upon institutional recognition of pharmaceutical services as part of healthcare infrastructure, combined with clearly defined financial compensation mechanisms. In such systems, pharmacies are not treated merely as retail entities, but as healthcare service providers performing socially mandated functions. A comparative review of selected national models illustrates that social pharmacy operates through SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 139 a combination of service-based remuneration, reimbursement mechanisms, and regulated pricing frameworks rather than through restrictions on commercial activity alone. 4.1. Germany In Germany, pharmacies are privately owned, yet pharmaceutical services are firmly embedded within the statutory health insurance system. Prescription medicines are dispensed under nationally regulated pricing structures, while the remuneration of pharmacies is largely based on standardized service fees reimbursed by compulsory health insurance funds [5]. This model separates the economic logic of pharmaceutical services from pure retail profit. Pharmacies are compensated not for maximizing sales volume, but for fulfilling defined professional and social functions, including safe dispensing, patient counseling, and continuity of therapy. As a result, access to prescription medicines is largely independent of patients’ income levels, and pharmacies remain financially viable even in less profitable regions. Importantly, the German system illustrates that private ownership of pharmacies is fully compatible with strong social regulation, provided that service remuneration and reimbursement mechanisms are institutionally guaranteed. 4.2. France In France, pharmaceutical services are explicitly integrated into the national healthcare system and supported through comprehensive social insurance coverage [6]. A significant proportion of medicine costs is reimbursed by public health insurance, ensuring broad financial protection for patients. French pharmacies operate within a regulated framework that combines controlled pricing of prescription medicines with professional service obligations. The state recognizes pharmacies as healthcare actors rather than commercial retailers, which justifies the use of public funds to support their social mission. This approach demonstrates that the sustainability of pharmaceutical services depends less on market competition and more on the stability of institutional and financial arrangements that prioritize public health outcomes. 4.3. Japan Japan represents a distinct but equally instructive model. The state establishes uniform national prices and tariffs for prescription medicines, which apply across all regions and healthcare providers. These regulated prices are coupled with a universal health insurance system that ensures reimbursement and financial predictability for pharmacies. Such centralized pricing and reimbursement mechanisms play a critical role in maintaining continuous medicine supply, including in remote and rural areas [7]. By reducing regional disparities and eliminating excessive price competition, the Japanese model reinforces the social function of pharmaceutical services while maintaining system-wide efficiency. 4.4. Lessons for Uzbekistan The examined international models differ in institutional design, yet they share several common principles relevant to Uzbekistan. First, pharmaceutical services are formally recognized as part of healthcare infrastructure. Second, social functions are supported through explicit financial mechanisms rather than informal market cross-subsidization. Third, pharmacies are regulated as professional healthcare providers, not merely as commercial enterprises. These cases confirm that the social role of pharmaceutical services is not achieved by limiting commercial activity per se, but by compensating social obligations through structured payment and reimbursement systems. This insight forms the empirical basis for proposing a social pharmacy model adapted to the institutional and economic conditions of Uzbekistan. 5. Social Pharmacy Services and the Model of Functional Differentiation SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 140 In order to simplify the institutional regulation of pharmaceutical services and to restore their social function, this study proposes a model of functional differentiation between social pharmacy services and commercial pharmacies. Such differentiation is not intended to restrict market activity, but rather to clarify institutional roles, align economic incentives with public health objectives, and reduce structural contradictions within the pharmaceutical services system. Under this model, social pharmacy services assume an explicit obligation to ensure population-wide access to all categories of medicines, including prescription and socially essential drugs. In return, these services are supported through state-backed economic compensation mechanisms, such as service-based payments, reimbursement schemes, and regulated tariffs. Commercial pharmacies, by contrast, operate primarily in the non-prescription medicines market and are allowed to function under more liberal commercial conditions. This functional separation enables the state to move away from blanket regulatory pressure and toward targeted support of socially mandated pharmaceutical services. 5.1. Reduction of the Fiscal Burden on the State Contrary to common assumptions, the establishment of social pharmacy services does not necessarily increase the fiscal burden on the state. On the contrary, it creates opportunities to replace inefficient direct subsidies with transparent, performance-based financing mechanisms. Rather than subsidizing pharmacy operations indiscriminately, the state compensates clearly defined services—dispensing of essential medicines, pharmaceutical counseling, continuity of therapy—through standardized tariffs and reimbursement schemes. This approach improves budget predictability, enhances accountability, and links public expenditure directly to social outcomes. As international experience demonstrates, service-based remuneration is fiscally more sustainable than ad hoc price controls or emergency interventions in medicine markets. Table 2. Comparative analysis of regulatory oversight in commercial pharmacies and social pharmacy services Indicator Commercial Pharmacies Social Pharmacy Services Primary objective Profit generation and market competition Guaranteed access to medicines for the population Economic logic Revenue–profit model Service provision based on approved tariffs and fee schedules Profit as performance indicator Applicable Not applicable Tax authority oversight Primary supervisory body (income tax, VAT, etc.) Commercial tax supervision not applied Taxation Income tax, VAT, other commercial taxes Profit tax not applicable (social service model) Main regulatory bodies Tax authorities, competition authorities Health authorities, insurance funds, financial oversight bodies SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 141 Indicator Commercial Pharmacies Social Pharmacy Services Object of oversight Financial performance, turnover, profitability Service volume, tariff compliance, reimbursement Oversight logic Fiscal Social–financial (targeted expenditure control) Relationship with the state Taxpayer Social service provider Impact on state budget Tax revenue Reduction of excessive expenditures, predictable service-based payments Transparency requirements Tax reporting Service registries, tariff schedules, insurance reporting Note: The comparison illustrates differentiated governance and oversight models rather than legal exclusion from fiscal regulation. Social pharmacy services operate as an integral component of healthcare infrastructure rather than as commercial retail entities. This distinction justifies differentiated regulatory, fiscal, and oversight frameworks aligned with public health objectives rather than market-driven performance indicators. 5.2. Social Pharmacies as Price-Stabilizing Benchmarks An additional systemic function of social pharmacies lies in their role as price-stabilizing benchmarks within the pharmaceutical market. By operating under approved tariffs and regulated pricing frameworks, social pharmacies establish socially anchored reference price levels for essential medicines. This so-called “mirror effect” does not rely on direct price controls over commercial pharmacies. Instead, it indirectly constrains excessive price fluctuations in the nonprescription market segment by providing patients and consumers with a transparent, predictable, and socially regulated alternative. While commercial pharmacies formally retain pricing autonomy, the presence of social pharmacies introduces a competitive discipline grounded in public interest rather than profit maximization. Comparable institutional mechanisms can be observed in Nordic countries and Germany, where publicly supported or socially regulated pharmacy services function as stabilizing reference points within pluralistic pharmaceutical markets. In these systems, price stability is achieved not through intrusive regulation, but through the coexistence of socially mandated pharmacy services and commercially oriented providers within a clearly differentiated regulatory framework. 5.3. Professional Concentration of Pharmacists The social pharmacy services model also contributes to the formation of professional concentration among pharmacists. By offering stable employment conditions, clear professional responsibilities, and recognition as healthcare providers rather than retail staff, social pharmacies attract and retain qualified pharmaceutical specialists. This concentration of professional expertise enhances service quality, strengthens clinical responsibility, and reinforces ethical standards within pharmaceutical practice. In contrast to fragmented retail environments, social pharmacies create institutional settings in which pharmacists can fully exercise their professional competencies. Importantly, this professional concentration serves as a prerequisite for advanced SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 142 pharmaceutical services, including in-pharmacy compounding, patient-oriented counseling, and individualized pharmacotherapy. 5.4. Institutional and Regulatory Implications Functional differentiation between social and commercial pharmacies also allows for differentiated regulatory and fiscal treatment. Social pharmacies, as providers of public healthcare services, may be subject to healthcare-oriented oversight mechanisms rather than standard commercial taxation and retail regulation. Such differentiation enables more effective governance by aligning regulatory instruments with institutional roles. It also clarifies accountability structures and reduces the administrative burden associated with uniform control over heterogeneous pharmacy activities. 6. Public–Private Partnership, Centralized Procurement, and Wholesale Distribution The effectiveness of social pharmacy services cannot be ensured solely at the pharmacy level. It critically depends on the organization of upstream procurement and wholesale distribution systems that carry an explicit social mandate. In the absence of such alignment, reforms at the retail level remain vulnerable to supply disruptions, price volatility, and logistical inefficiencies. This section argues that centralized procurement mechanisms must be complemented by a socially oriented wholesale distribution system based on public–private partnership (PPP) principles. 6.1. Centralized Procurement as a Necessary but Insufficient Condition Centralized procurement has the potential to reduce medicine prices through economies of scale, improve transparency, and strengthen bargaining power vis-à-vis suppliers. However, international experience shows that centralized purchasing alone does not guarantee effective medicine supply if distribution remains fragmented and driven exclusively by commercial incentives [8]. When procurement is centralized but distribution is left to competitive market dynamics without a social mandate, the resulting system often fails to ensure timely delivery, equitable regional coverage, and supply continuity—particularly in rural and low-demand areas. Therefore, centralized procurement should be viewed as a necessary but insufficient condition for achieving social objectives in pharmaceutical services. 6.2. Socially Mandated Wholesale Distribution To support centralized procurement, this study proposes the establishment of a wholesale distribution subsystem endowed with a clear social mandate. Such a system would prioritize public health objectives—availability, continuity, and territorial equity—over short-term profitability. In the context of Uzbekistan, the reactivation and institutional reform of the distribution network historically associated with the “Dori-Darmon” joint-stock company may serve as a viable solution. By redefining its role within a PPP framework, this network could function as a backbone for socially mandated distribution, ensuring efficient storage, logistics, and regional allocation of medicines procured centrally. Importantly, public–private partnership mechanisms would allow the state to leverage private-sector managerial expertise and logistical capacity while retaining strategic control over social objectives. Moreover, PPP arrangements could enable the expansion of working capital through private investment, reducing direct fiscal pressure on the state budget. 6.3. Differentiated Distribution Channels Within this framework, wholesale distribution channels may be functionally differentiated to serve distinct segments of the pharmaceutical market. Social pharmacy services would be supplied through the socially mandated distribution channel, operating under regulated tariffs and service obligations. Commercial pharmacies, by contrast, could continue to source medicines SCIENCE AND INNOVATION INTERNATIONAL SCIENTIFIC JOURNAL VOLUME 4 ISSUE 12 DECEMBER 2025 ISSN: 2181-3337 | SCIENTISTS.UZ 143 through competitive wholesale markets. Such differentiation enhances system resilience by preventing cross-subsidization distortions and ensuring that social objectives are not undermined by purely commercial supply dynamics. 6.4. Governance and Accountability A socially mandated distribution system requires clear governance structures and accountability mechanisms. Performance indicators should focus on service reliability, geographic coverage, and supply continuity rather than profit margins. Regulatory oversight should be aligned with healthcare objectives and integrated into broader public health planning. By embedding wholesale distribution within the institutional architecture of social pharmacy services, the state can transform procurement savings into tangible improvements in medicine access rather than allowing them to dissipate through fragmented logistics and market inefficiencies. 7. The Role of In-Pharmacy Compounding In-pharmacy compounding constitutes one of the fundamental elements of pharmaceutical practice, enabling the preparation of medicines tailored to the individual needs of patients. Standardized industrial medicines do not always provide optimal therapeutic outcomes, particularly for patients with allergies, pediatric and geriatric populations, or individuals with complex clinical conditions. In this context, compounding represents a practical embodiment of a patient-oriented pharmaceutical services model. Scientific literature and professional practice demonstrate that compounded medicines can improve treatment effectiveness, enhance patient adherence, and contribute to more rational use of healthcare resources [9,10,11]. Consequently, compounding should not be regarded as a marginal or obsolete activity, but rather as an integral component of modern, individualized pharmacotherapy. 7.1. Conceptual Clarification: Compounding and Related Terms In both academic literature and professional discourse, the terms compounding, inpharmacy preparation, pharmacies with production units, and extemporaneous medicines are often used interchangeably. However, these concepts differ in scope and institutional meaning, and their clarification is essential for a correct understanding of pharmaceutical services. Compounding refers specifically to the preparation of a medicinal product for an individual patient based on a prescription and a defined therapeutic need. In-pharmacy preparation constitutes a broader category that includes compounding as well as other technological activities performed within a pharmacy’s professional remit. Pharmacies with production units, by contrast, are typically engaged in serial or semi-serial preparation of medicines and operate under regulatory frameworks distinct from individual compounding. The term extemporaneous medicines describe the time-sensitive nature of preparation rather than the institutional or technological process itself. According to definitions used by the United States Pharmacopeia (USP) and the International Pharmaceutical Federation (FIP), extemporaneous preparations are characterized by their prescription-based, patient-specific, and short-term use. Within this framework, extemporaneous medicines may be the result of compounding, but compounding itself represents a broader professional practice rooted in pharmaceutical judgment and responsibility. 7.2. Institutional Decline and Professional Persistence In many post-Soviet countries, in-pharmacy compounding has gradually declined or been almost entirely eliminated. This process has often been justified on economic grounds, with compounding perceived as inefficient in comparison to mass-produced industrial medicines. However, such reasoning reflects a narrow market-oriented perspective that underestimates the institutional and professional value of compounding.