Expert Insights: How Pharmacy Technicians Are Closing the Gap in HIV Medication Access and Adherence

In an interview with Pharmacy Times, Samantha Roth, NE-CPhT, senior comprehensive medication management technician at Nebraska Medicine, discusses the critical role pharmacy technicians play in eliminating insurance and financial barriers. This includes prior authorizations and high co-pays that interrupt antiretroviral therapy for patients with HIV, as well as strategies that will be explored at the American Association of Pharmacy Technicians 2026 Annual Pharmacy Technician Convention.

Pharmacy Times: Can you introduce yourself and explain your current role?

Samantha Roth, NE-CPhT: My name is Samantha. I am a senior comprehensive medication management technician working with a team that focuses on specific disease states and comprehensive medication management for people with chronic illnesses.

Pharmacy Times: Beyond the clinical challenges, which systemic or medication-related barriers do you find most frequently interrupt a patient's antiretroviral therapy, and how does your program address them?

Roth: Our biggest hurdle is insurance—whether it comes from prior authorizations or high co-pays, that is usually the biggest issue we run into. Our program is built with that in mind, so we have a team of technicians dedicated to working through prior authorizations and addressing co-pay issues before therapy begins. Likewise, if we run into a co-pay issue in the middle of therapy—because insurance has changed or a prior authorization approval ends midyear—our team has technicians dedicated to making sure those particular barriers are addressed.

Pharmacy Times: Could you highlight one specific technician-led strategy from the Nebraska Medicine model that has been most effective in ensuring long-term medication adherence?

Roth: Our HIV program is really technician-driven. Our biggest asset is refill monitoring. We actually begin the refill process about a week before we anticipate the patient will need the medication, so we can head off any prior authorization needs or unexpected co-pays that we would need to address before the patient actually needs the medication. Hopefully, by the time they need it, everything will be squared away and in order—certainly to the patient's greatest benefit.

Pharmacy Times: How does moving benefits navigation and care coordination to the pharmacy technician role specifically improve speed-to-therapy for patients with newly diagnosed HIV?

Roth: We work very closely with our HIV clinic and are in constant communication with most of the staff there. Often, our work within the pharmacy starts before the prescriber has even written a prescription. Frequently, nurses or coordinators reach out to us to run a benefits investigation before therapy is even initiated, so they know what the coverage for their preferred therapy will look like. We are often able to tell them, for example, that one option requires a prior authorization, but insurance will cover another. The prescriber then uses that information, weighed against what is best for the patient, to make the final determination of what to prescribe. Generally, our work starts before the prescription is even written.

Pharmacy Times: In a high-functioning HIV care team, how does the pharmacy technician's role bridge the gap between the prescribing physician and the patient's daily medication routine?

Roth: I thought this question was perfectly timed. Just yesterday, one of the doctors in the clinic reached out to me directly. She said it would be easier than going back and forth through the nurse. The situation involved a patient who had been on a medication long term but suddenly faced co-pay issues due to a high deductible. He had already exhausted a manufacturer co-pay savings card and a third-party grant, and he still had a co-pay he could not afford. She asked which of her preferred therapies would be best covered by insurance and, in terms of longevity, which medication combination would provide the most value. With her on the phone, I ran test claims in real time and gave her information specific to the patient's insurance coverage, which she then used to change his treatment and write a new prescription.

Pharmacy Times: What is the most critical piece of advice you have for other specialty pharmacies looking to empower their technicians to take a lead role in advocacy for patients with HIV?

Roth: I would say to use technicians in more than just a supportive role. Technicians have the ability to think both clinically and critically. It is about building trust between the pharmacist and the technician—trusting that while the technician can think clinically, they will not exceed the scope of their license and will involve the pharmacist when that additional license is needed. We are the ones in the weeds doing the claims processing. We see the co-pays and the insurance rejections, and know how to navigate those better than almost anyone else in the pharmacy. Utilizing us in that way expedites the process. We are just as much medication access specialists as we are advocates for our patients. Empowering technicians and integrating them into the patient's care team allows patients to get their medication earlier, allows us to monitor adherence more consistently, and allows patients to stay connected to their medication long term.

Pharmacy Times: Is there anything you would like to add?

Roth: Technicians are sometimes overlooked as the heartbeat of the pharmacy. There is so much that technicians do and are able to do that goes either unrecognized or underestimated. I really believe in empowering technicians to practice at the top of their license—and perhaps just at the edge of it—while working with the pharmacist, developing that trust, and knowing where the boundaries lie and what the pharmacist is comfortable with them taking on. That is how you become the best possible advocate for your patients.