“Ready to Work” initiatives and The Pharmacy Technician

“Ready to Work” initiatives and The Pharmacy Technician

The practice of pharmacy grows by leaps and bounds each and everyday.

The education of Student Pharmacists to take on both current & emerging roles in providing pharmaceutical care has occurred and continues to evolve. I have a firm belief that this education will satisfactorily meet and exceed the needs of both current and future patients.

While the Pharmacists education is well defined in that Boards of Pharmacy and National Associations have criteria that you must meet prior to entry into the profession. The Pharmacy Technician’s education is not as well defined. Currently technicians are educated by for-profit institutions, some but not all Community Colleges, and there are some online programs.

Question??

How can Pharmacists fully utilize their education and knowledge in both current and emerging markets – if there is not an appropriate and affordable education model to satisfactorily keep pace with pharmacy technician demand in the market?

It’s my opinion that the greatest demand for the Pharmacy Technician will be in the retail sector. There is a high turnover rate in this market and typically this is the space where an organization can take on registered pharmacy technicians that have no pharmacy experience. With an increase in mergers and acquisitions between chain pharmacy, benefit managers, and health insurers – the demand for registered pharmacy technicians will continue to increase.

Current state laws will also need to keep pace with changes in how both Pharmacists and Pharmacy Technicians are utilized in the Pharmacy.

  1. Telemedicine
  2. Pharmacy Technician verification via Barcode technology (http://www.ajhp.org/content/73/2/69?sso-checked=true)
  3. Medication therapy management
  4. Pharmacist Practitioners
  5. Collaborative practice models
  6. The increased market-share of “specialty pharmacy”
  7. Compounding pharmacies regulated by federal guidelines USP 795, 797, and 800

These are all topics to consider when considering the job market and demand for both the practicing Pharmacist and Pharmacy Technician.

What can fill the education gap?

I had never heard of the “Ready to Work” initiatives taking place in Birmingham, AL. But after meeting Ms. Dorothy Henry and leadership at Lawson State Community College — I stumbled upon an institution that is at the forefront of this community based initiative.

Ready to Work programs can offer job seekers foundational knowledge to take on entry level job positions. “Ready to Work” educational healthcare tracks include medical assistant, patient care assistant, and pharmacy technician. These programs help folks learn how to become registered and/or certified to take on entry level positions in the workforce.

Having a job that you care about and enjoy is good for the individual because it increases self-worth. It’s good for the family because it provides a stable source of income. It’s great for both the community and local economy because the money can be recycled into tangible purchases of goods, services, and long term assets.

I’ve had the pleasure of working with folks interested in becoming registered Pharmacy Technicians through this program. And I really believe that this could be an opportunity where more Pharmacists can serve and become involved in helping young people find a career in their local community. Programs like this help to ensure that there are affordable avenues for people to learn and become aware of professions that can be a source for both a rewarding career and steady income. I have posted my lecture materials online at www.samblakemore.com . Feel free to follow along and give back any comments and/or positive feedback.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedInSupport the effort and Purchase Merch

 

 

 

The increasing use of DAW 9 and it’s potential impact on pharmaceutical care…

The Dispense As Written Codes that I use regularly in my practice are:

DAW 0 = NO PRODUCT SELECTION INDICATED

DAW 1 = SUBSTITUTION NOT ALLOWED BY PRESCRIBER

DAW 9 = SUBSTITUTION ALLOWED PLAN REQUESTS BRAND

Why is this important?

Dispense as written codes are important in billing/filing claims correctly to a patient’s insurance plan. Claims must be billed/filed correctly so that patients receive the appropriate drug products at the correct price.

For me… DAW 0 is used most of the time (this holds true for most pharmacists), while DAW 1 is used sparingly; a drug example for those who are not Pharmacists as to when a Pharmacist uses DAW 1 is seen in the case of  prescribing Brand Name Synthroid. Prescribers often write for Brand name Synthroid instead of Levothyroxine because this drug has a Narrow Therapeutic Index (NTI). Due to the NTI, formularies often include both the Brand and Generic products on their formularies so that patients receive appropriate pharmaceutical treatment for their thyroid conditions.

If you’re interested in reading more about NTI, please visit the FDA’s website and review the powerpoint “Quality and Bioequivalence Standards for Narrow Therapeutic Index Drugs.

So…DAW 9?

DAW 9 is increasingly becoming popular and being put into place by Pharmacy Benefit Managers (PBM’s). Typically generics have been dispensed because the generic product is the cheaper alternative when compared to the brand name product. However, increasingly manufacturers have been offering PBM’s rebates for the monies that they pay the pharmacies on the drugs cost.

In short…even when prescribers write a prescription and sign Product Substitution Permitted — the pharmacist must dispense the brand name product for the product to be covered by the patient’s insurance. This is done by changing the computer DAW code from a 0 to a 9.

So you may be asking, “how is it more profitable for the PBM’s to have higher priced drugs on their drug formularies?” I found a great article published by NCPA entitled “PBM Revenue Streams and Lack of Transparency”. The article is a quick read and outlines why Brand Name products continue to be on formulary even when a generic competitor enters the market.

Examples of using DAW 9 in my practice (Generic Drug — Condition Treated)

Dexmethylphenidate ER — ADHD

Diazepam Rectal Gel — Seizures

Methylphenidate ER — ADHD

Budesonide Respules — Asthma

What’s the effect on people and the market?

In my practice this leads to a major consultation point…

  • You and/or your family member is on a drug that insurance is requiring that Brand Name be dispensed (DAW 9). I’m not sure if your local pharmacy carries the Brand Name or Generic product. Thus, it is imperative that you contact your pharmacy days in advance to ensure this product is in stock when you attempt to refill your medication. If you don’t call ahead of time, this could potentially delay when you receive your medication, which could lead you to become non-compliant with your medication(s).

The reason that this is so important…

  • Finding the medication for your patient is important…but ensuring that your patient has access to this medication is just as important. If they can’t obtain or access the medication, then you can’t ensure their compliance on the medicine. And non-compliance ultimately can lead to hospital readmission.
  • When patient’s transition from an inpatient admission to being discharged to the outpatient setting, prescribers are often unaware of what’s on or not on the patient’s drug formularies. This can lead to confusion and delay and/or impede discharge planning which can potentially lengthen their hospital admission.

DAW 0 versus DAW 9 seems like such a trivial issue, but the increased prevalence of this small change can impact our patient’s compliance and can drive up the cost for providing healthcare.

If you have Questions related to this topic? Please feel free to leave a comment.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

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