Increasing the Pharmacy Technician to Pharmacist Ratio: Is Patient Safety at Risk?

Florida House bill, HB 323, increases the number of pharmacy technicians a single pharmacist can supervise from a maximum of three to six.

This bill, heard by the House Health Quality Subcommittee on February 5th, could significantly impact the profession of pharmacy and the health and safety of the patients in Florida, but other states are also considering similar changes.

Supporters of the bill include large chain drugstores and mail-order facilities. Opponents of the bill include independent, community and hospital pharmacists.

The large chain stores claim that pharmacists spend 40% of their time doing routine administrative-like work that technicians could handle and that pharmacists would likely not be burdened by the additional supervision requirements if the pharmacists delegated most of their current clerical duties. They argue that the delegation of duties in turn would allow pharmacists to concentrate on higher-level work such as medication and chart reviews, patient counseling, immunizations and other patient focused issues.

Opponents of the bill, however, fear the increased technician to pharmacist ratio would negatively affect patient safety based on the following:

1. Time Constraints and Work Load. Pharmacists fear they will not have time to thoroughly counsel and educate all their patients, provide immunizations, review medications and/or to catch potentially harmful or even fatal drug interactions while also accurately checking every prescription.
2. Increased Transcription, Compounding and Prescription Filling Errors. The larger number of technicians, some which may be untrained or unaccredited, could result in an increase in transcription, compounding and/or prescription filling errors – errors that even the most thorough pharmacist may not catch.
3. Non-Verified Prescriptions Reaching the Patient. With up to six technicians and one supervising pharmacist, there is an increased likelihood that non-pharmacist verified prescriptions could reach patients, resulting in significant or even fatal harm.

Therefore, opponents stress that while the extra pharmacy technician assistance is needed and always appreciated, additional pharmacist staffing likely also needs to be discussed to ensure the pharmacist workload is manageable and that patient safety remain the number one priority.

All in all, while it appears the national trend is leaning towards expanding the number of pharmacy technicians a single, licensed pharmacist can supervise, there likely needs to be continued discussion regarding the standardization of technician training, accreditation and licensing if their roles are going to continue to expand.