Go Behind the Counter With Town & Country Compounding Pharmacy

Town & Country Compounding Pharmacy started inside the well-known Town & Country Apothecary in Ridgewood, New Jersey. Both were owned by John Herr, RPh. In the early 2000s, the compounding side of the business moved into its own space. By 2011, Herr sold the apothecary, which permanently closed in 2023, to focus solely on compounding. In 2021, the compounding pharmacy moved to its current location in Ramsey, New Jersey, an 8000-sq-ft facility with space to grow and accommodate updated regulations.

Jari Becker, RPh, is a pharmacist and the director of women’s health at Town & Country Compounding Pharmacy. A graduate of the Massachusetts College of Pharmacy and Health Sciences in Boston, Becker worked in retail pharmacy—including the apothecary—for nearly 20 years before joining the Ramsey location.

Town & Country Compounding Pharmacy has a unique setup. There is a small front end with a reception desk. Vitamins and dietary supplements are on display for purchase. A large glass window allows visitors, including health care providers and patients, to watch the pharmacy staff compound various drugs.

“Everything is compounded specific to the patient,” Becker said. “We have almost 7000 unique formulas, and many are patient-specific. There is no mass production. We compound high-quality products and take our accreditations very seriously.” Town & Country Compounding Pharmacy is a 503A pharmacy and is licensed in 23 states, with plans to continue expanding. The most commonly compounded drugs vary by region, as health care providers often learn about Town & Country through word of mouth.

Becker explained that the pharmacy attracts patients and prescribers with its high-quality products, fast shipping, and an internal electronic prescribing portal for health care providers to transmit prescriptions directly to the pharmacy.

A focus of Town & Country Compounding Pharmacy is low-dose naltrexone (LDN). The pharmacy collaborates closely with Asher Goldstein, MD, and the LDN Research Trust, a charity that raises funds for clinical trials and helps individuals access LDN. The pharmacists compound LDN for patients with conditions including autoimmune conditions, cancer, depression, and more. The patient starts with a custom-compounded LDN titration kit, slowly increasing to the optimal dose. LDN is often compounded as capsules, oral liquid, or a topical formulation, and sometimes combined with other ingredients such as a muscle relaxant or anti-inflammatory medication.

“In the world of compounding, there is something new to learn every day. There is always new literature coming out,” Becker said. The pharmacy staff is always preparing new compounds. “With 10 pharmacists on staff, we are always accessible. There are always 6 to 8 of us working at a time,” she said. The pharmacy also prepares compounds for clinical trials, working with hospitals, research centers, and universities. For example, working with the pharmaceutical company Vascarta, Town & Country pharmacists prepare Vasceptor, a compounded, patented, prescription topical curcumin gel.

Town & Country also prepares compounds for pets. Common compounds include methimazole for cats, hydrocodone/homatropine for dogs (used to treat a collapsed trachea), and LDN for various pets. Additionally, pharmacists dedicate significant time to researching and developing formulations tailored to their patients’ needs.

As the director of women’s health, Becker focuses on bioidentical hormones. She counsels women on hormone health and collaborates with health care providers. For patients interested in bioidentical hormones, Becker reviews laboratory results and medical history to understand their needs better. She then works closely with patients’ health care providers to develop an appropriate treatment plan, compounding a personalized combination of hormones—such as estrogen, progesterone, dehydroepiandrosterone, and testosterone—into a topical or oral formulation.

Becker focuses on educating patients, helping them understand their health needs and available options. This collaboration supports health care providers in developing personalized treatment plans using baseline testing. Becker participates in the community by educating patients through various Chambers of Commerce and other community events. “We educate patients on what we do and how we can help them,” she said.

Becker finds it rewarding to see the impact that personalized hormone therapy can have on women’s lives. “Some of these women start out feeling miserable with hot flashes, night sweats, mood swings, and weight gain. After using hormone therapy, they come back and say, ‘My life has changed.’… It is so rewarding to see these women feeling great,” Becker said.

She shared a story of a busy lawyer who was relieved to tell her that, as a result of bioidentical hormone therapy, “I’m finally sleeping, my brain fog is lifting, and I feel like my old self.” Another patient had difficulty for months because she was not using the medication as directed. “When she finally started listening, she came back, gave me a big hug, and said, ‘I should have listened to you a long time ago—I feel fabulous!’”

When she’s not in the pharmacy or in the community working with patients and providers, Becker enjoys spending time with her husband and children. “I’m always working,” Becker joked, “but when I’m not, a good book in front of the fire or on the beach is my favorite thing.” She also loves springtime and planting flowers, as well as taking walks with her silky terrier.