As the field of pharmacy evolves, the role of the pharmacy technician is shifting into areas that require more specialized skills and knowledge. Current pharmacy practices involve the pharmacy technician in prescription dispensing, data input, insurance billing, inventory maintenance, packaging, purchasing, compounding sterile and non-sterile products, and more.
Patients with complex health needs require services and support from a wide variety of health care providers, and technicians are more than ever being called on to fulfill a variety of these needs. The demand for certified pharmacy technicians is expected to increase as job responsibilities become more complex. There is also an increase in the need for technicians within settings that require more specialized training and expertise.
Medication reconciliation regulations have only increased the responsibilities of a technician. Many are now called on to utilize their skills to research, document medication histories, assist with the logistics of patient medical transfer, and provide translation for those who do not speak English. Additionally, technicians help to facilitate medication reconciliation by offering support to the pharmacist, as well as the doctors and nurses.
More than ever, technicians are heavily involved in patient care and playing an active role in the operation of pharmacy work. A career in this field continues to offer many advancement opportunities as the field of pharmacology continues to see advancements. Technicians are being recognized as playing a key role in the healthcare industry. Earning specialized certifications greatly improves opportunities for advancement and employability in certain practice settings for pharmacy technicians motivated to advance in their career path.
With experience and the appropriate amount of training, technicians may seek specialization, or engage in further education and training and earn a nursing degree or a Doctor of Pharmacy degree. Many organizations offer career advancement opportunities for technicians. Technicians have the option to advance in a variety of specializations, including those related to managerial or instructional roles, compounding, sterile products admixture, oncology, IV meds, and nuclear pharmacy.
Choosing to seek specialization in a certain practice field is a big decision. Although you may have concrete ideas about a certain area of study, a more in-depth exposure will provide greater understanding. It’s often best to choose an area where you have a special amount of knowledge and experience. It is also important to consider your interest and future career goals when choosing an area of specialization. Keep in mind the future of the industry of interest and where you will seek employment. Doing your due diligence will help you choose where you want to put additional time and effort into learning.
Choosing an area of emphasis can tremendously affect your career as a technician. Advancements in medicine and technology continue to open more doors of opportunity for pharmacy technicians. Here are a few areas of specialization that are popular among aspiring pharmacy technicians.
One of the first things that I would suggest for any pharmacy technician looking to advance him or herself is to get certified by Pharmacy Technician Certification Board (PTCB). Why PTCB? Because it is the only nationally recognized certification credential. Once a technician passes the exam, he or she can use the CPhT credential after his or her last name (i.e., Elina Pierce, CPhT). Although there is another test available (ExCPT), why spend the money on a test that may or may not be accepted by another state? Who knows? You may not stay in the same state. Be prepared and always have a plan B in place.
To keep a pharmacy’s workflow operating both safely and smoothly, inventory management is critical. Based on the setting, the level of involvement a technician will have in the management of inventory will vary. Many retail pharmacies and hospitals may assign technicians to do basic ordering while others may allocate maintaining the inventory of all medications and supplies as the technician’s sole responsibility.
Inventory management may include tasks such as counting, unpacking, stocking, ordering, and removing and returning outdated or discontinued products. In addition, inventory should be clearly labeled and organized to ensure the wrong medication is not mistaken for another. Performing inventory responsibilities accurately can often prove to be challenging while managing a full shift of other demanding pharmacy tasks. To simplify inventory management, consider the following:
Regular and accurate inventory management is highly important. Inventory should be checked regularly to ensure medications and supplies are available to meet the needs of the patients a pharmacy serves. Most pharmacies use software to help in this area of management. To increase the profitability of a pharmacy, inventory must be managed carefully, accurately, and regularly.
Availability should be taken into consideration when ordering medications and supplies. Sometimes a drug is no longer available due to a recall, shortages, or higher demand. Technicians should be prepared to consider an alternative drug and then communicate the options with the involved healthcare providers.
Recalled drugs should be timely tracked and returned to ensure the pharmacy’s shelves are stocked with products that are safe and practical. Drug manufacturers, outsourcing facilities, drug wholesalers, and other venders notify a pharmacy when a drug has been recalled. The Food and Drug Administration (FDA) also has a website that lists all recalls.
Once a pharmacy has been notified of a recall, all pharmacy staff should be made aware of the information. Additionally, inventory should be checked to see if the recalled product is within the organization’s inventory. Examples of areas to search other than inventory shelves, are medication dispensing machines, storage rooms, purchasing records and medication sample logs.
Most recall notices provide information on the proper action to take in regards to the disposal or return of recalled products. Ideally, it is best to have a designated area for quarantined recalled medications. The area should be clearly marked with a sign indicating the area is for recalls only. In addition, compliance with recall notices should be documented to ensure pharmacy compliance can be proven in the event of an FDA inspection.
Expiration dates are the dates that medications can no longer be used. It is unsafe to dispense medications after the expiration date has passed due to possible chemical changes within the medication, which would likely decrease the potency of the product or change its structure entirely. To ensure patient safety, and to prevent potential loss of profit, pharmacy technicians should be knowledgeable with the shelf life of specific drugs when ordering. It is important to not order more of a drug than can reasonably be used before it expires.
When stocking shelves, remember to place the newest stock items behind older items so that the items with a longer shelf life are used after those that will expire sooner. Always double check labels to be sure the drugs have been placed in the right area, as well.
Turnover rates should be considered when managing inventory. This term refers to how long it will most likely take to use the product up in inventory. Being familiar with the medications that are used more commonly prescribed than others helps to keep needed items in stock while preventing slow-moving medications from being overstocked. Consider the time of year or season when determining a drug’s turnover rate. For example, the flu season is more likely to cause a higher turnover rate for the antiviral medication, Tamiflu, in December during flu season, than in June.
Although this is not available in all states, tech-check-tech is being used by some hospitals around the United States where technicians check the work of other technicians after applying and being approved for such a responsibility by the state’s Board of Pharmacy. Tech-check-tech has been studied off and on since 1978, and after 11 published studies, the results are that pharmacy technicians’ accuracy is very comparable to that of pharmacists (99.3% versus 99.6%) (Adams, Martin, & Stolpe, 2011). Not too shabby for technicians who are thought of not being capable of such responsibility.
Insurance billing is more common in retail pharmacies as hospitals usually rely on the billing department to process claims. A pharmacy technician working in a retail setting can attest to the fact that he or she spends a good portion of his or her day on the phone with insurance companies. Everything from simple claim submission to chargebacks (claims that have been rejected and must be resubmitted for one reason or another) needs to be submitted correctly in order to receive the maximum reimbursement. Another part of this area is to ensure that if reimbursement is not the greatest, other options are investigated.
Earning a certification in compounding greatly enhances your value as a pharmacy technician. With evolving United States Pharmacopoeia (USP) safety standards and heightened inquiry of sterile compounding practices, the healthcare industry looks favorably on technicians who are dedicated and eager enough to seek further training in their career and earn a compounding certificate.
When a commercially available drug does not meet the unique needs of an individual, or the individual cannot tolerate a particular drug, the drug is created by a method referred to as compounding. This includes creams, liquids, pills, transdermal gels, suppositories, and other dosage forms appropriate for the patient’s unique needs. The method may also be chosen when a patient is in need of a drug that is currently discontinued or the drug is in shortage. Compounding refers to the process of mixing, altering, packaging, assembling, and labeling a drug.
Medications are often customized at a compounding pharmacy for a variety of reasons. It is often chosen for the purpose of reformulating the drug to remove unwanted ingredients that a patient may be allergic to, such as lactose, dye, or gluten. For patients who have trouble swallowing or have issues with stomach upset when taking oral medications, compounding allows the drug to be delivered in another form. Compounding is also used to make a drug more palatable for a child or pet by flavoring the medication. Additionally, when a drug is created at a compounding pharmacy, it allows more control in the customization of the strength and dosage of the medication.
Certification in compounding allows technicians to work in a variety of settings. While most pharmacies offer some level of compounding, it is more commonly performed at pharmacies that have invested in special equipment and training. Preparations at such compounding pharmacies usually include both sterile and non-sterile dosage forms. Hospital pharmacies and other health care facilities also provide compounding services.
To further advance in a compounding career, technicians may choose to earn certification in sterile compounding. This type of compounding involves medications administered through injection, IV, or directly into the eyes. Since these methods of delivery involve a high risk of causing infection, special preparation techniques are required during the sterile compounding process to ensure that the medication does not come in contact with any infectious microorganisms. To seek specialization in this area, pharmacy technicians can seek certification as a certified compounded sterile preparation technician (CSPT).
Working with a compounding certificate not only benefits the technician, but it also allows pharmacists to devote more time to safety checks and IV drug preparation. In addition, the certification improves safety for the overall benefit of both the patient and the pharmacy.
Pharmaceutical Representative / Drug Representative
Another area of advancement is being a pharmaceutical representative. These individuals work with a pharmaceutical company. They receive in depth training about a particular medication and are then charged to communicate that knowledge to other members of the healthcare team, including but not limited to doctors, nurses, pharmacists, and pharmacy technicians.
Medication Therapy Management (MTM)
Pharmacy technicians can help pharmacists in the medication therapy management (MTM) process. This process ensures that what the patient thinks he or she is taking is, in fact, what he or she is taking and that there is a communication process in place between the prescriber and the patient with pharmacy personnel as the experts in medication therapy. The MTM process is all about education and ensuring that patients are aware of what they are taking, for what medical condition, and how often they are taking it. Its focus is to allow patients to have an active role in their healthcare as it pertains to their medications. Technicians can help gather information from doctors and patients so that the pharmacist can assess the information for problems, issues, and concerns.
A special area of commitment to dispensing and compounding radioactive materials used in nuclear medicine is referred to as nuclear pharmacy. It necessitates having knowledge in this specific field as it is a specialty pharmacy area. The development of nuclear pharmacy followed nuclear medicine and is recognized by the American Medical Association.
To better understand the field of nuclear pharmacy, it is important to know how radioactivity is used in the medical world to treat patients. In the past, hospitals used trained nuclear pharmacists to handle radioactive material. Smaller hospitals were unable to utilize nuclear medicine procedures in a cost effective manner due to staffing issues. Thus, the idea of centralized nuclear pharmacies was born. It originally served as a drugstore for nuclear medicines where a pharmacist, specifically trained to work with nuclear products, was called on to prepare and dispense the product.
Today, with over 100 nuclear medicine procedures performed, there are a variety of products that can be used in nuclear medicine. The nuclear pharmacist is responsible for getting the necessary radioactive material at a nuclear pharmacy. This is usually from an in house generator system or a manufacturer. Technetium-99m is the most commonly used and readily available isotope in nuclear medicine. Kit formulations are available that contain all of the necessary materials that are nonradioactive. The radioactive isotope is then added and chemical reactions take place in the vial for binding.
Each product must be verified by quality control before being dispensed since the practice involves on-site compounding of just about every dispensed product. Chromatography tests are used to verify the radiochemical purity of the product. Once verified, the product is delivered and ready for dispensing to patients.
An increase in the demand for nuclear pharmacy technicians is expected to increase as nuclear medicine procedures become more widely used. Today, with only a few technicians who are highly specialized in this area, nuclear pharmacy technicians are highly sought. With this powerful and high profile specialty, current nuclear pharmacy technicians are in a very privileged role in this elite field of medicine.
Working as a nuclear pharmacy technician (NPT) requires you to work under the direct supervision of a licensed nuclear pharmacist, which is very much the same setup as other technicians working in other pharmacy settings. Good communications skills are necessary, and like other settings, technicians are often asked to perform clerical and inventory tasks, as well.
Although the set up is strikingly similar, there are inherent differences in the job duties expected of technicians working in a nuclear pharmacy opposed to a traditional pharmacy. The key difference is the fact that the final product is created using a radioactive material and is dispensed to a hospital or clinic instead of the patient. A nuclear pharmacy dispenses medications in mill curie activity units, where a traditional pharmacy will dispense doses in milligram weight units. Additionally, instead of tablets and capsules, as dispensed by traditional pharmacies, nuclear pharmacies dispense radioactive material in liquid or capsule form.
NPTs’ unique roles are what makes specialized training a requirement in this field of medicine. Within the area of nuclear pharmacy are a few different practice areas. These practice areas are only found in nuclear pharmacy settings along with different classes of drugs. Those working as an NPT eventually have to specify a specific practice area.
Technicians often advise or consult medical providers regarding the nature and use of the nuclear drugs that they prepare. Many of the drugs prepared are radiopharmaceuticals, which are used regularly in chemotherapy. A strong knowledge of nuclear drugs is necessary as an NPT must recognize the drug’s benefits and risks as they consult with medical providers.
Following safety procedures, handling instructions, rules, regulations, and laws are essential as NPTs carry out dispensing and compounding nuclear drugs. Since lead is an excellent shielding material, most of the handling is done behind leaded glass using leaded glass syringe shields and lead containers for shielding and protection from the radioactive emissions. Complex situations require excellent problem-solving skills and the ability to coordinate work with other medical providers. Ongoing training is necessary to ensure NPTs are up to date with new medications, advanced procedures, and the latest developments in the field of nuclear pharmacy.
Working in the field of nuclear pharmacy as an NPT can be both a challenging and rewarding career choice. Working closely with other medical experts in nuclear medicine allows technicians to contribute greatly in the care of patients who are undergoing nuclear medicine procedures. Although the career is very similar to traditional pharmacy, it is a very unique area of specialization for those looking to advance in their pharmacy technician career.
Some technicians find themselves fascinated with pharmacy technology. As a result, they can be hired by various manufacturers of such technology to install, maintain, and or fix the technology in various pharmacy settings and provide training to pharmacy personnel.
With the changing employment market for pharmacy technicians, advancing in credentialing through specialization certifications increases opportunities for technicians to be a part of industrial expansion. As in any career, further education and training means more investment of time and learning. Specialization makes pharmacy technicians much more valuable in a pharmacy setting, which means higher pay and increased job security.