On the Front Lines

From their position on the front lines of health care, today’s pharmacists serve as trusted providers beyond the prescriptions they fill. Pharmacists advise millions of people on their health care needs and deliver crucial interventions. They assist patients in becoming more adherent to their medication regimens and in closing gaps in care.

Increasingly, pharmacists are moving out from behind the counter to use their clinical skills, offering their expertise to help improve outcomes and manage overall health care costs, by:

• Administering a wide range of immunizations and vaccinations
• Completing drug utilization reviews
• Delivering point-of-care testing for chronic conditions
• Collaborating with other providers through medication therapy management
• Prescribing/administering select drugs (e.g., contraception, nicotine replacement therapy and travel health), based on authority granted by their respective states
• Preventing clinically inappropriate or unnecessary use of prescription drugs, with a growing role in programs that help reinforce opioid dispensing guidelines from the Centers for Disease Control and Prevention

As health care costs continue to rise and demand for primary and specialized care providers outpaces supply, the role of pharmacists is growing. Today, they are part of a move toward improving access to care and providing health care services in a lower-cost setting. Utilizing pharmacists on the primary care team to prevent and manage disease, and provide patient care services, has been one of the most evidence‐based, proven, and time‐tested strategies, according to a U.S. Public Health Service report.

The Lead and the Supporting Cast

In order to enable pharmacists to focus more on providing clinical counseling and health care services, they must have the appropriate level of support from trained pharmacy technicians. These colleagues can take on administrative tasks such as establishing and maintaining patient profiles, processing insurance claims, fielding calls from prescribers, and stocking and taking inventory of prescription drugs. Such duties currently occupy nearly one-third of a pharmacist’s time.

Pharmacy technicians can also prepare prescriptions and label the bottle — with a licensed pharmacist then validating the accuracy of the filled prescription before it is dispensed. Dividing the labor enables pharmacists to be available for more meaningful, face-to-face patient interactions.

Expanding that practice model holds promise in transforming the nation’s health care system to deliver better access to clinical care by leveraging resources in a smarter way while ensuring patient safety and high operating standards, according to the National Association of Chain Drug Stores (NACDS).

Regulations for how pharmacists can use pharmacy technicians vary across the country. And while 32 states currently define pharmacist-to-technician ratios — generally between 1:2 and 1:4 — we at CVS Health endorse the approach taken by the 18 states that currently do not place a limit on the technician ratio. In deferring to the pharmacist’s professional judgment, they allow pharmacies to create a practice setting that best meets the needs of the patients they serve.

What We’re Doing at CVS Health

To help patients access the care they need in clinically appropriate and cost-effective settings, CVS Health works directly with state lawmakers, state boards of pharmacy and retail associations such as NACDS. Our objective is to equip pharmacists with greater flexibility to set technician ratios that work for their stores and assign technician tasks that free up the pharmacist’s time to deliver high-quality, low-cost health care services for their patients.

Proposed legislation we are monitoring includes bills under consideration in California and New York: California Assembly Bill 1589, New York Assembly Bill A4611 and Senate Bill S5584B.

We also support allowing pharmacy technicians to perform additional tasks that don’t require a pharmacist’s professional judgment, such as:

• Basic physical assessments
• Medication reconciliation
• Administration of vaccines and Clinical Laboratory Improvement Amendments of 1988-waived laboratory tests

The pharmacist would always review information collected from the patient and make a clinical recommendation. Pharmacists and the care they deliver are becoming increasingly essential to, and integrated into, the health care system. The support they receive from pharmacy technicians allows them to broaden the scope of their practice and, consistent with our purpose at CVS Health, help people on their path to better health.