Pharmacy techs: Many skills, varying responsibilities

Across the country, pharmacy technicians are at work in community and hospital pharmacies. They stock shelves, fill vials, manage inventory, make sure prescriptions are delivered where they are needed, and in retail pharmacies, assist customers. But as their roles and responsibilities evolve, they also now deal with automated dispensing systems in hospitals, help patients obtain financial assistance for medications, and work to develop telepharmacies.

Everett McAllister“Pharmacy technicians are the backbone of the pharmacy,” said Everett B. McAllister, RPh, executive director and CEO of the Pharmacy Technician Certification Board (PTCB).

Hannah PeabodyIn the last few decades, the occupation has changed greatly McAllister said. Years ago, the people doing these jobs might have been called assistants or clerks, but they were not called pharmacy technicians. “Probably only in the last 20 years have we seen the adoption of that term,” he said.

“I think the common thought is that pharmacy technicians just assist the pharmacist in filling prescriptions and cashing out patients through the register,” said Hannah Peabody, CPhT, who was named 2014 PTCB Certified Pharmacy Technician of the Year. “In actuality, pharmacy technicians have huge responsibilities in helping to ensure safe and effective dispensing, inventory management, and so much more, depending on the setting.”

See also: Pharm tech certification: PTCB announces 2015 changes

Changing roles

The roles of pharm techs may be changing and their responsibilities increasing, but the basic job definition is still to assist a pharmacist in distributing medications to patients. However, the tasks that pharm techs can perform vary from state to state in a wide-ranging and complicated patchwork of regulations. Some states require them to be licensed, some require them to be registered, and some require them to be certified. And a state may have different regulations for technicians who work in institutions and those who work in retail settings.

Several state pharmacy boards allow a certified pharmacy technician to check an order filled by another pharmacy technician, a procedure called tech-check-tech (TCT). Some studies of TCT have found accuracy rates comparable to those of pharmacists who do the final check.

Other areas in which the responsibilities of pharm techs are increasing include pharmacy automation, medication coverage/reimbursement assistance for patients, and telepharmacy.

Certification requirements

The number of states that require some form of regulation for pharmacy technicians is growing, and several professional groups have taken up this cause, including the PTCB, the American Society for Health-System Pharmacists (ASHP), the National Association of Boards of Pharmacy (NABP), and the Accreditation Council for Pharmacy Education (ACPE).

Carmen CatizoneWorking to identify the proper roles and responsibilities for pharmacy technicians is a big job, said Carmen Catizone, DPh, RPh, executive director of NABP. “The key to all this is how much the pharmacist is involved in patient-care activities.” Pharmacists are doing more counseling of patients, and they can do this because pharmacy technicians are assuming responsibility for other tasks in the pharmacy, he said.

As state rules and regulations change, there is also a push to make them more uniform across the country.

“ASHP has a policy that says that a pharmacy technician should be trained in an accredited program,” said Douglas J. Scheckelhoff, RPh, vice president of the Office of Practice Advancement for ASHP. Pharmacy technicians should have to prove their competence in a standardized way and be regulated through the state board of pharmacy, he added.

“Over the course of the last 20 years, we have seen a number of states implementing rules and regulations governing the occupation of pharmacy technicians,” said PTCB’s McAllister. “Every state is responsible for providing oversight and rules when it comes to the practice of pharmacy. Right now there is no national standard which provides an umbrella that covers the profession of pharmacy technician.”

Starting in 2020, PTCB will require each new candidate for certification to complete an ASHP/ACPE-accredited education program. This change, now being phased in, will advance pharmacy technician qualifications by elevating the boards’ standards for certification. PTCB’s certification is accepted in all 50 states and the District of Columbia.

See also: PTCB calls for input on pharm tech certification changes

Varying responsibilities

Joni BrownTech-check-tech. Joni D. Brown, CPhT, is director of operations at LTC Pharmacy Solutions in Columbia, S.C. LTC is a long-term-care pharmacy that serves assisted-living facilities, skilled-nursing homes, and hospice programs in the state, and which also has a small retail pharmacy. She started working in a pharmacy at age 15, and has been a certified pharmacy technician since the late 1990s.

At LTC, Brown takes part in a tech-check-tech program, which the company added recently. She researched tech-check-tech process, and found that it saved money and reduced the error rate.

“In South Carolina, a state-certified technician can check the work of another pharmacy technician, as long as the medication is going to be administered by a licensed healthcare professional,” said Brown.

Brown also has worked in a hospital setting and in retail pharmacy chains. She has seen firsthand how the responsibilities of pharmacy technicians vary from state to state. While she was with Walgreens, she helped train pharm techs in Duane Reade stores in New York. “Their technicians there can’t do nearly as much as technicians in South Carolina can do,” she said.

Telepharmacy. Nicole Bernabe, CPhT, is a customer success specialist at TelePharm in Iowa City, Iowa, which has eight community telepharmacies in rural locations. In Iowa, after a year in the job a pharmacy technician must become certified. The company staffs its telepharmacies with certified pharmacy technicians; a pharmacist is always on call through a video link should any questions or issues arise.

“My primary focus is on community telepharmacy development. I am responsible for all steps leading up to the opening of the telepharmacy. So that can cover everything from ordering the vials to domain expertise for the software development team,”
Bernabe said. 

Bernabe, like Joni Brown, also started working in a pharmacy at age 15. Her first job was in her father’s pharmacy, where she implemented a new inventory system. She has been a certified pharmacy technician since 2010 and has worked in many areas of pharmacy.

“I’ve worked independent retail, large-chain retail, hospital, long-term-care, and even veterinary online pharmacy,” Bernabe enumerated. 

Financial assistance. Hannah Peabody works as a pharmacy technician at The Patient Rx Center of Hematology/Oncology Associates of Central New York in East Syracuse, N.Y. There she has been instrumental in helping patients navigate insurance companies and obtain financial assistance.

According to PTCB, her work helped secure more than $1.5 million in assistance for patients at the practice. Her responsibilities include managing drug inventories, completing prior authorizations, responding to compliance audits, training new employees, and processing prescriptions.

“I also spend quite a bit of time on the phone with patients, reminding them of upcoming refills, confirming that they are being compliant with their therapies, and following up with mail-order pharmacies. When we are not able to fill the scripts here at The Patient Rx Center, we will follow the script through to the specialty pharmacy to ensure the patient receives it in a timely manner, with an affordable co-pay,” she told Drug Topics in an e-mail. “I would say that my role in The Patient Rx Center is pretty unique for a pharmacy technician.”

Automated dispensing. Alexander Faulkner, CPhT, is an automation analyst with the inpatient pharmacy at St. Joseph Mercy Hospital in Ann Arbor, Mich. He maintains the automated dispensing cabinets in the hospital. In this position, Faulkner manages more than 130 Pyxis automated dispensing cabinets, which dispense the bulk of medications for the hospital system.

“In this hospital, it has always been a pharmacy tech job - with the oversight of a pharmacist, of course,” he said. At St. Joseph Mercy, he also educates staff members about the use of the cabinets and answers questions from anyone needing assistance.

Faulkner worked as a pharmacy technician for two years before becoming certified in 2006. He was a 2014 finalist for Certified Pharmacy Technician of the Year.