Understanding the Growing Impact of Oncology Pharmacy Technicians

In this Q&A with Pharmacy Times, Laura Cannon, PharmD, MPH, BCOP, discusses the evolving role of oncology pharmacy technicians, emphasizing the importance of foundational education, medication safety, and their growing involvement in patient access and support.

Pharmacy Times: When you think about “oncology essentials” for pharmacy technicians, what are the most critical knowledge areas they need to feel confident in supporting cancer care teams?

Laura Cannon, PharmD, MPH, BCOP: Oncology is such a vast field, and so when you think about the oncology essentials, it's really highlighting the basics of cancer treatments. We've seen cancer treatments develop and expand hugely over the last recent years, from chemotherapy to targeted therapy to immunotherapy, and now we're seeing cellular and gene therapy. And so that's a lot for a pharmacy technician to try to grasp.

I think having a basic understanding, or basic conceptual understanding, of how those cancer treatments work is really helpful in helping technicians learn oncology-specific terms and workflows. I think oncology is often seen as more of a scary area, or an area that's intimidating, or can be an area that people don't want to explore because they think they aren't capable, or it's just a completely different world.

And so, when we talk about essentials, it's thinking about explaining some of those terms, the workflows, how the drugs even work, how they're benefiting patients, and explaining the role of the oncology pharmacist in helping these patients and teams take care of their cancer patients. Technicians play a vital role in that.

I think another big area that we think about is medication safety, which is an obvious topic that we think about. We think about that not just in oncology but across the board. But specifically with oncology medications like chemotherapy, there's extra handling, extra policy, and extra protocols in place because they are designated as hazardous drugs. And so again, that can be an area that pharmacy technicians are intimidated by because it's above and beyond what we know as USP 797, but understanding USP 800 and protection for nurses, pharmacy technicians, pharmacists, and patients—anyone really interacting with those medications in the process of preparation, dispensing, and administration.

Pharmacy Times: How is the role of the pharmacy technician evolving within oncology, particularly as treatments become more complex and personalized?

Cannon: I think there is such a special role for pharmacy technicians within oncology. And there's a special role for pharmacy technicians in any area. My bias is toward oncology because that's what my training and my time with pharmacy technicians has been. But I think in this area, it's really being carved out around high-cost medications, medication inventory, and medications specifically made for each patient.

It's not an area where we typically pre-make any medications. Medications are made in real time based off the patient walking in the door; for that patient, they are not to be used for any other patient. And so they have a really specialized role in knowing this and knowing that it's related to the patient-specific treatment plan and being able to say, “Oh wait, with this medication previously, we've maybe given different pre-meds, or we've maybe done something differently before,” and being that extra check in the process for their pharmacist.

So, I think the technician really becomes like a chemotherapy or oncology therapeutic agent expert, knowing the difference in how the chemo works, how the targeted therapy works, how the immunotherapy works, and what supportive care needs the patient may have from those medications. Because they can catch something that's missed just as easily as the pharmacist on the team, there's that vital extra check for medication safety.

The role of the pharmacy technician in the community setting or in the specialty setting is also evolving, because these medications are more high-cost and might have limited distribution. They're serving a vital role for patients as advocates. They're helping with financial assistance, adherence, access, and REMS programming requirements. And so, the pharmacist and the pharmacy technician really are seeing a shift in having to be supportive of patient access and the ability to access these vital medications for their cancer treatment.

Pharmacy Times: Medication safety is such a key concern in oncology—what role do pharmacy technicians play in minimizing risks throughout the medication use process?

Cannon: Pharmacy technicians are really that extra layer of safety and extra check for the pharmacist. I have felt so much more confident in my role as a pharmacist when I've worked with a technician that is also double-checking things like weight-based dosing, the fluid volume, the type of fluid, the concentration of the medication, and the infusion time.

Not only within the pharmacy or working with the pharmacist is the technician playing that vital role; they're also helping transport the medications, helping field nursing questions from the floor, or helping with the disposal process. And so, at each touch point, the pharmacy technician plays such a vital role in medication safety and minimizing risk.

They even have roles related to procedural development and making sure people are updated on policies and procedures for handling. I think that's a clear role that's been established in this field for technicians, and they're a vital member of the team helping to minimize that risk for everyone involved.

Pharmacy Times: What are some common challenges or gaps you see among pharmacy technicians entering the oncology space, and how can those be addressed through training or education?

Cannon: One of the big gaps is that oncology is intimidating, and I think that a lot of people shy away from it because they are scared, or they don't understand, or they think it's too overwhelming, or they're too nervous about their role. And so, I think one of the big gaps is reducing that stigma of oncology and making sure that we're talking about it in a way that feels approachable.

There's a big disconnect between what the healthcare field understands about oncology and what the general population understands about oncology. And so, as pharmacists, I think we can help bridge the gap for our pharmacy technicians by providing more educational opportunities or more chances for pharmacy technicians to learn what it means to be a technician in the field of oncology.

So, the first thing is just to reduce that barrier, try to make it less intimidating and more approachable. We can do so by the way that we talk about it, by educating on roles and the support that is offered throughout these roles.

I think the second area is to help explain the clinical context of oncology and the medications that we use. They are very different and very patient-specific and might be very different from previous roles. And so, helping the pharmacy technician understand the “why” behind certain things can be really helpful to reduce that gap.

The other thing is empowering the pharmacy technician to take more of a role in things like inventory management and patient assistance for these high-cost medications. I think giving technicians more information about what roles are available and what vital skills they bring to the pharmacy team—by helping patients, fielding questions, and helping their pharmacists—they're really supporting in so many ways.

And I think we just have to educate the technicians on those available opportunities, because I don't necessarily think that they realize how vital they are to the oncology team.