In addition to escalating workloads, the COVID-19 pandemic has exposed understaffing in the pharmacy profession.
Any pharmacist will tell you that their technicians are the backbone of
Pharmacists have increasingly been tasked with duties such as disease state management, mass immunization, and medication therapy management. As
the role of the pharmacist has continued to evolve, so has that of the pharmacy technician.
The technician to pharmacist ratio varies depending on the state. It can range from 2 technicians for every 1 pharmacist to 6 technicians for every 1 pharmacist if the technicians are certified.1 This ratio was established because pharmacists are legally responsible for supervising technicians. However, at times pharmacists need additional help. During the COVID-19 pandemic, many states removed the ratio rule so that pharmacists could hire more technicians to help with increased responsibilities and workload.
Like pharmacists, technicians work in a variety of areas, such as community, hospital, long-term care, mail order, and nuclear pharmacy settings.
Historically, the basic duties of a pharmacy technician have included answering phone calls, gathering patient information, managing inventory, performing basic calculations, and processing, preparing, and distributing prescriptions.2,3
Each state has regulations that may allow for different as well as more complex functions to be performed. For example, some states, such as California, allow a duty known as Tech-Check-Tech, which lets a pharmacy technician perform the final check of medications prepared by another technician.4
The pandemic has exposed understaffing in the health care industry, including the pharmacy profession. But many community pharmacies have been operating with unfavorable working conditions since the 1990s.5 Until recently, many pharmacies either did not allow or frowned upon employees taking lunch breaks.
As workloads increase, pharmacy employees have been experiencing higher levels
of stress. Their already heavy workload during the pandemic was exacerbated by an increase in drive-through window services, implementation of COVID-19 testing, and an increase in COVID-19 and flu vaccinations and daily prescription volume.6
In 2013, the American Society of Health System Pharmacists conducted a pharmacy staffing survey that showed the turnover rate for technicians was approximately 14%.7 A company should aim for a turn- over rate no higher than 10%, as a higher rate usually indicates that employees are not happy, according to Joshua Stowers of Business.com.8
Employees may be unhappy with their jobs for a multitude of reasons, but one
of the biggest is compensation. Although technicians are in demand, the median average pay in 2020 was $35,100 per year, or approximately $16.87 per hour.3 It is important to keep in mind that compensation can vary depending in which state a technician is employed, as well additional factors such as advanced certifications and credentials. Not all states require technicians to be certified, but obtaining certification can lead to increased wages and promotion opportunities.
Technicians can gain certification through the ExCPT or the PTCE exams.9,10 In the past, many pharmacy settings accepted results only from the PTCE. However, most employers and states now recognize both exams, especially given the increased demand for technicians.
The employment of technicians is projected to grow only by 4% over the next 10 years, which is slower than the average for other pharmacy occupations, despite there being approximately 32,000 openings for technicians projected each year, according to the Bureau of Labor Statistics.3 Most of those openings will be to replace workers who retire, exit the labor force, or change occupations.3
As the role of pharmacists continues to expand, so will that of technicians. Most states have already seen this trickle-down effect, and job boards are flooded with technician postings, some offering sign-on bonuses ranging from $1000 to $3000.
Prior to COVID-19, many technicians were supporting pharmacists by providing direct patient care and being allowed to dispense without a pharmacist check.11 The US Department of Health & Humans Services helped facilitate the expansion of technicians’ roles when it released guidance on how they could assist during the pandemic, including administering COVID-19 tests and vaccinations.12
The additional duties, responsibilities, and workforce uptick for technicians borne of the COVID-19 pandemic are likely to continue to expand, especially as pharmacists work toward provider status through medication therapy management and proactive direct patient care. Technicians will continue to be an integral part of ever-expanding health care teams.
Roni Bennett-Shye, PharmD, BCACP, CGP, is a pharmacist at OhioHealth in Columbus.
1. Bess DT, Carter J, DeLoach L, White CL. Pharmacy technician-to-pharmacist ratios: a state-driven safety and quality decision. J Am Pharm Assoc (2003). 2014;54(6):648-651. doi:10.1331/JAPhA.2014.14032
2. Pharmacy technician career overview. American Society of Health-System Pharmacists. Accessed October 12, 2021. https://www.ashp.org/pharmacy-technician/about-pharmacy-technicians/pharmacy-technician-career-overview
3. What pharmacy technicians do. US Bureau of Labor Statistics. September 8, 2021. Accessed October 12, 2021. https://www.bls.gov/ooh/healthcare/ pharmacy-technicians.htm#tab-2
4. Tarver SA, Palacios J, Hall R, Franco-Martinez AC. Implementing a Tech-Check-Tech program at a university health system. Hosp Pharm. 2017;52(4):280-285. doi:10.1310/hpj5204-280
5. Lea VM, Corlett SA, Rodgers RM. Workload and its impact on community pharmacists’ job satisfaction and stress: a review of the literature. Intl J Pharm Pract. 2012;20(4):259-271. doi:10.1111/j.2042-7174.2012.00192.x
6. BookwalterCM.ChallengesincommunitypharmacyduringCOVID-19: the perfect storm for personnel burnout. US Pharmacist. May 14,
2021. Accessed October 12, 2021. https://www.uspharmacist.com/ article/challenges-in-community-pharmacy-during-covid19-the-perfect-storm-for-personnel-burnout
7. Pharmacy staffing trends for 2013 examined in ASHP report. American Society of Health-System Pharmacists. May 16, 2014. Accessed October 28, 2021. https://www.ashp.org/news/2014/05/16/pharmacy_staffing_trends_ for_2013_examined_in_ashp_report?loginreturnUrl=SSOCheckOnly
8. Stowers J. Employee retention: what does your turnover rate tell you? Business.com. July 23, 2020. Accessed October 12, 2021. https://www.business. com/articles/employee-turnover-rate/
9. Which is the best certification exam: PTCE (PTCB) or ExCPT (NHA)? Pharmacy Technician Salary 411. September 11, 2020. Accessed October 12, 2021. https://www.pharmacytechniciansalary411.com/what-is-best-certification- exam-ptce-or-excpt/
10. PTCB vs EXCPT. Building Blocks Services. September 16, 2017. Accessed October 12, 2021. http://buildingblocksservices.com/wp/2017/09/16/ptcb-vs-excpt/
11. Newby B. Expanding the role of pharmacy technicians to facilitate a proactive pharmacist practice. Am J Health Syst Pharm. 2019;76(6):398-402. doi:10.1093/ajhp/zxy065
12. Guidance for PREP act coverage for qualified pharmacy technicians and state-authorized pharmacy interns for childhood vaccines, COVID-19 vaccines, and COVID-19 testing. Department of Health and Human Services. October 20, 2020. Accessed October 12, 2021. https://www.hhs.gov/sites/ default/files/prep-act-guidance.pdf