Pharmacy compounding of medicines is an essential part of patient care as it enables pharmacists to provide customized pharmaceutical care when no suitable commercial medicine is available. A distinction is made between individual preparations (on prescription for one patient) and stock preparations (for larger groups). Pharmacy compounded medicines can be of added value when specific pharmaceutical care is required, a commercial medicine is unavailable, or for use in clinical scientific research. A number of preconditions require attention to preserve pharmacy compounding in the future. Pharmacists should share technical knowledge on raw materials and pharmacy compounding more, and it is important that medicine development is retained as a basic skill in the education programme. Rational pharmacy compounded medicines should be eligible for reimbursement, taking room for innovation and research in consideration when determining tariffs. This is essential to ensure responsible implementation of pharmacy compounded medicines to improve healthcare availability and affordability.