Pharmacist-to-pharmacy technician ratio

The pharmacist-to-pharmacy technician ratio is a legal regulation that establishes the maximum number of pharmacy technicians that may be supervised by a licensed pharmacist at one given time. For example, a pharmacist-to-pharmacy technician ratio of 1:3 would mean that three people are allowed to be working as pharmacy technicians at one time for every one pharmacist present.

Characterization

In the United States, the regulation of the pharmacist-to-pharmacy technician ratio is regulated at the individual state level.^[1] Some states vary the ratio by institutional (e.g. hospital) pharmacy practice versus retail (i.e. community) pharmacy practice, while others do not regulate pharmacist-to-pharmacy technician ratios at all.^[1] The ratios vary from a minimum of 1:2 (e.g. in Kansas) to 1:6 (e.g. Idaho).^[1]

Variation by state

State	Pharmacist-to-pharmacy technician ratio
Alabama	1:3
Alaska	None
Arizona	None
Arkansas	1:3
California	1:1, then two more techs for each additional pharmacist
Colorado	1:6, majority must be certified^[2]
Connecticut	1:3 institutional pharmacy, 1:2 community pharmacy
Delaware	None
Florida	1:4
Georgia	1:3, where one technician must be certified and number of technicians may exceed three in hospital settings^[3]
Hawaii	None
Idaho	1:6
Illinois	None
Indiana	1:4
Iowa	1:2^[4]
Kansas	1:4
Kentucky	None
Louisiana	1:3
Maine	None
Maryland	None
Massachusetts	1:4
Michigan	None
Minnesota	1:3 (unless one technician is certified, then 1:4)
Mississippi	1:2
Missouri	None
Montana	1:3
Nebraska	1:3
Nevada	1:3
New Hampshire	None
New Jersey	1:2 (unless one technician is certified, then 1:3)
New Mexico	None
New York	1:4
North Carolina	1:2, more technicians may be allowed upon board approval^[5]
North Dakota	1:4 institutional pharmacy, 1:3 community pharmacy
Ohio	None
Oklahoma	1:4 hospital, 1:2 community pharmacy
Oregon	None
Pennsylvania	None
Rhode Island	None
South Carolina	1:3
South Dakota	None for institutional pharmacy, 1:3 community pharmacy
Tennessee	1:2, may increase to 1:4 (without board approval) if at least 2 are certified technicians. A modification to the amount of technicians may be requested from the Board of Pharmacy. ^[6]
Texas	1:6
Utah	1:3
Vermont	None
Virginia	1:4
Washington	No longer has a ratio as of September 14, 2019.
West Virginia	1:4
Wisconsin	1:4 (unless approved by Board of Pharmacy)
Wyoming	1:3

In some countries, such as in the United Kingdom and in Denmark, technicians can practice without pharmacist supervision at all.^[7] Globally, one survey found that pharmacists are the most frequent source of supervision for pharmacy technicians.^[7]

Rationale and criticism

Pharmacist-to-pharmacy technician ratios are an attempt to find a balance between providing assistance to the practicing pharmacist in operating the pharmacy while maintaining adequate supervision of their pharmacy technicians.^[8] While staffing issues are reported by pharmacy technicians to increase the risk for medication-related medical errors, misconduct by an unsupervised pharmacy technician can result in significant patient harm.^[8] Critics of low pharmacist-to-pharmacy technician ratios have complained that the lack of pharmacy technicians staffing forces pharmacists to devote more time to non-clinical, dispensing-related tasks, as opposed to performing direct patient care services and over-the-counter counseling.^[9]

History

While pharmacist-to-pharmacy technician ratio were initially low with pharmacy technicians engaged in retail tasks (acting as cashiers), the ratios have increased over time as pharmacy technicians have taken on new duties, such as pharmaceutical formulation and intermediating between the pharmacy and insurance companies.^[10]

See also

• Pharmacy (shop)

References

1. Malacos, Kristy. "Pharmacy Technician Regulation". Pharmacy Times. Pharmacy & Healthcare Communications, LLC. Retrieved 1 July 2018.
2. "Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act" (PDF). Colorado Department of Regulatory Agencies. State of Colorado. p. 36. Retrieved 23 May 2022. 12-280-122. Limited authority to delegate activities constituting practice of pharmacy to pharmacy interns or pharmacy technicians. (1) A pharmacist may supervise up to six persons who are either pharmacy interns or pharmacy technicians, of whom no more than two may be pharmacy interns. If three or more pharmacy technicians are on duty, the majority must be certified by the board in accordance with section 12-280-115.5 (2), and any pharmacy technician on duty who is not certified pursuant to section 12-280-115.5 (2) must have a provisional certification issued pursuant to section 12-280-115.5 (3).
3. "Pharmacy Technician FAQs". Georgia Board of Pharmacy. State of Georgia. Retrieved 23 May 2022. A5. The pharmacist to pharmacy technician ratio may not exceed one pharmacist providing direct supervision of three pharmacy technicians, and one of the three technicians must be certified. See O.C.G.A. §26-4-82(d). However, upon application and approval by the Board, the pharmacist to pharmacy technician may exceed one pharmacist providing direct supervision to three pharmacy technicians in a hospital setting. See O.C.G.A. §26-4-82(d).
4. "ARC 4291C - Iowa Administrative Rules". State of Iowa’s Administrative Rules. State of Iowa. Retrieved 23 May 2022. 40.3(6) Pharmacist-to-technician ratio. In any pharmacy which utilizes a TPV program, the ratio of pharmacists to technicians physically present in the pharmacy shall not exceed 1:2 at any time, including when TPV is not in use.
5. "NCBOP -Pharmacist FAQs". North Carolina Board of Pharmacy. Retrieved 23 May 2022. A pharmacist may not supervise more than two pharmacy technicians unless: (1) the pharmacist-manager receives written approval from the Board in advance; and (2) each additional technician is certified. (See G.S. § 90-85.15A.)
6. "Rules of the Tennessee Board of Pharmacy CHAPTER 1140-02 PROFESSIONAL CONDUCT AND RESPONSIBILITIES" (PDF). Tennessee Secretary of State Official Compilation of Rules and Regulations. p. 4. Retrieved 23 May 2022. The pharmacy technician to pharmacist ratio shall not exceed 2:1; however the ratio may be increased up to a maximum of 4:1 by the pharmacist in charge based upon public safety considerations but only if the additional pharmacy technicians are certified pharmacy technicians. However, the pharmacist in charge may request a modification of the ratio from the Board.
7. Koehler, T; Brown, A (2017). "A global picture of pharmacy technician and other pharmacy support workforce cadres". Res Social Adm Pharm. 13 (2): 271–279. doi:10.1016/j.sapharm.2016.12.004. PMC 5317197. PMID 28190479.
8. Lutz, Rachel. "Pharmacist-Technician Ratios Require More Evaluation". Pharmacy Times. Pharmacy & Healthcare Communications, LLC. Retrieved 1 July 2018.
9. Guglielmo, B. Joseph. "Health care: The pharmacist-to-technician ratio". Capitol Weekly. Capitol Weekly. Retrieved 1 July 2018.
10. Marotta, Ryan. "The Evolving Role of Pharmacy Technicians". Pharmacy Times. Pharmacy & Healthcare Communications, LLC. Retrieved 1 July 2018.