7/27/2019 08Feb_Drugstore Chains Rely on Pharmacy Technicians

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Drugstore chains rely on pharmacy technicians

By Erik Brady and Kevin McCoy, USA TODAYWhen Americans bring prescriptions to their neighborhood pharmacies,odds are the person in the white lab coat who greets them and enters theprescription in the computer is not a pharmacist. Neither, most likely,is the person who puts the pills in the medicine vial.

They're probably pharmacy technicians, in some cases teenagers with nomore than high school diplomas. The nation's largest drugstore chainssay technicians don't replace pharmacists. But the companies have cometo rely on technicians because of regional shortages of pharmacists andsteady increases in prescriptions.

*MORE ON OUR EXCLUSIVE SERIES: *Inside a pharmacy where a fatal erroroccurred

Walgreens, the nation's largest drugstore chain by sales and profits,employs about 39,000 technicians, compared with more than 24,000pharmacists. CVS, (CVS)the

largest retail chain in terms of store count, employs about 41,000pharmacy technicians, more than double the 20,000 pharmacists who workfor the firm.

Technicians do much of the administrative work pharmacists used toperform, such as prescription data entry, counting pills, filling vialsand ringing registers. Depending on your point of view, that's goodnews, because it frees pharmacists to do more important clinicalfunctions or bad, because technicians sometimes make mistakes thatpharmacists don't catch, and because pharmacists often have little timeto help teach the technicians.

The hiring practice does make good business sense: Technicians earn an

average of $11 an hour. That translates to about $23,000 a year forthose who work full time. Many pharmacists make more than $100,000 a year.

*Techs aren't required to be certified *

Unlike pharmacists, who are regulated by pharmacy boards in each state,technicians are inconsistently monitored from state to state. ThePharmacy Technician Certification Board guarantees that those who passits examination meet a national standard. But technicians don't needthat certification to work in many states. Just 30 states even mentioncertification in their rules, and most of those don't mandate it.

That comes as a surprise to many Americans, according to the

certification board, which administers the two-hour, 100-question examthat tests technicians' knowledge of pharmacy practices. In December,the board released the results of a survey that found 73% of respondentsbelieved technicians "are required by law to be trained and certifiedbefore they can help prepare prescriptions." Just 9% recognized that asfalse.

The nation's state legislatures should raise standards by requiringtechnicians to pass a standardized certification exam, says PaulDoering, a University of Florida pharmacy professor. He notes that some

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nations, such as Germany, mandate two years of formal training.

Walgreens (WAG)saysnearly 26,000 of its technicians are certified; the chain subsidizestest fees and gives raises to technicians who pass. CVS says about12,000 of its technicians are certified; the chain pays for study guidesand registration fees.

Both chains also have companywide training systems. Walgreens says it isthe only chain whose training has been approved by the American Societyof Health-System Pharmacists. CVS requires technicians to pass internaltraining at three levels as they move up to more difficult duties, saysPapatya Tankut, vice president of pharmacy professional services.

Technicians "focus on the technical functions and (allow) the pharmacisttime to do the professional functions that a technician cannot," such ascounseling patients, Tankut says. "That allows a pharmacist time toreally feel not overworked."

*The technician-to-pharmacist ratio *

Within the industry, there is no consensus on how many technicians asingle pharmacist is capable of supervising while still ensuring

prescription safety. At least 16 states have no limits, according to asurvey by the National Association of Boards of Pharmacy. Six othersallow a 4-to-1 ratio of technicians to pharmacists. The remaining stateshave ratios of 2-to-1, or 3-to-1.

Pharmacy chains and many industry experts say such ratios are safe.Still, a USA TODAY review of pharmacy board records in 10 states foundnumerous cases in which pharmacists did not catch technician errors.

In a typical example, Massachusetts pharmacy board records show anunidentified technician "entered the information incorrectly into thecomputer" in the prescription a CVS pharmacy dispensed to Shaun Taylor.The Kingston man suffered breathing difficulties that required hospital

treatment in 2005 after he was given a Fentanyl painkiller skin patchthree times stronger than prescribed, the records show.

An investigation report by the Massachusetts Division of HealthProfessions Licensure found the prescribing doctor wrote otherinformation in the space where information about drug strength normallygoes, which CVS said was a contributing factor.

But the pharmacist didn't verify the hard copy of the prescription, "andby skipping this step, she missed the opportunity of detecting thetechnician error," the report said.

CVS and Taylor agreed to a confidential settlement.

Philip Burgess, Walgreens' national director of pharmacy affairs, saidin a 2006 deposition that the chain had to rely on technicians and newtechnology to cope with rising prescription volume.

The number of prescriptions "is going to continue to rise as the babyboomers move into the pill-taking age," Burgess said. "And the numbersof pharmacists to fill them is not going to be able to keep pace."