Pharmacy certification to expand

The world of pharmacy certification is getting more crowded. The first and best known certifying body, the Board of Pharmacy Specialties (BPS), was launched by the American Pharmacists Association, then the American Pharmaceutical Association, in 1976.

BPS had the world to itself for more than 20 years. It wasn't until 1997 that the American Society of Consultant Pharmacists launched the Certified Geriatric Pharmacist (CGP) program. The certification is now overseen by the Commission for Certification in Geriatric Pharmacy, which itself was accredited by the National Commission for Certifying Agencies (NCCA) in March of this year.

Defining the new kid

The new kid on the block is the Specialty Pharmacy Certification Board (SPCB), which is developing the Certified Specialty Pharmacist (CSP) credential. SPCB hopes to launch its certification program in early 2013.

"Specialty pharmacy has been a cottage industry until recently," said Gary M. Cohen, BS Pharm, founder and head of the SPCB. "It has been something of a stepchild, because it crosses so many practice and therapeutic categories. Specialty providers, suppliers, and pharmacists have a common interest in validating specialty pharmacy knowledge and skills."

Creating a new certification isn't an easy task, Cohen said. Everyone knows a specialty pharmacy practice when they see it, but there are no uniform definitions that distinguish specialty pharmacy from any other type of practice.

SPCB is launching a role delineation study this month. This job analysis is designed to identify and define the practice of specialty pharmacy. The study also forms the basis for a content map that will be used to create the CSP exam. The SPCB itself must meet criteria set up by the NCCA in order to gain its own accreditation.

Scope it out

One of the problems unique to specialty pharmacy accreditation is the potential scope of practice. Specialty pharmacists practice in almost every setting, including chains, independent retail, hospital, academia, long-term care, research, and more.

Specialty is currently the fastest-growing segment of the pharmacy world, Cohen said, with more than 600 products in the pipeline. Specialty products already treat patients with cancer, cystic fibrosis, immune deficiencies, hemophilia, hepatitis C, HIV, multiple sclerosis, rheumatoid arthritis, and other difficult-to-treat conditions that typically require enhanced levels of pharmaceutical care.

SPCB's solution is a series of "endorsements," or additional assessments in specific therapeutic areas. Cohen likened the system to the endorsements that airplane pilots must earn, in addition to a basic pilot's license, to fly in specific conditions and with specific types of equipment.

Select certifications

Even if the CSP credential is created and accepted, pharmacy won't be overrun with certifications. Nursing has more than 200 certification programs, Cohen said, and medicine has about 50.

BPS currently has six certifications: ambulatory care pharmacy, nuclear pharmacy, nutrition support pharmacy, oncology pharmacy, psychiatric pharmacy, and pharmacotherapy.

The organization is in the process of launching five more specialties: pain and palliative care, pediatric, critical care, infectious disease, and cardiology, said Executive Director William M. Ellis, RPh, MS.

"Much like our colleagues in nursing and medicine, we are starting to see the maturation of pharmacy as a distinct practice with more direct patient care responsibilities," he said. "At the same time, healthcare is becoming more accountable. Purchasers want to know precisely how providers meet standards of care and practice. And pharmacists have been searching for ways to differentiate themselves. Board certification is a universally accepted standard in healthcare."

By the numbers

Just how significant certification has become depends on your point of view. Ellis noted that there were nearly 13,000 pharmacists with BPS certification. That's a 20% jump in the last year and double the number of pharmacists who held BPS certification five years ago.

Cohen sees a universe of some 275,000 pharmacists in the United States and only about 13,000 with any kind of certification.

"We are looking to help payers identify providers who have a specific skill set that enables them to handle specialty pharmaceuticals," he said. "Certification validates their training and their competency."