Compounding can be a ‘red flag’ in the industry. This not to say compounding is inherently bad. There are some very legitimate uses for it. However, if the pharmacy does a lot of compounding business (percentage-wise) it could trigger an audit. And you’re right that big pharma trying to crush the little guys is a big part of this, too. Some pharmacies will intentionally under-report the amount of compounding they do, because they know it can draw unwanted attention. Pharmacy is one of those messy complicated things where there are way too many middlemen and rent-seekers, which makes it more expensive for patients and harder for regulators to keep tabs on things. Thank goodness Lina Khan with the FTC is doing her best to throw some sunlight under these dark rocks.