Chapter 6 Retail Pharmacy

1. Chapter 6 Retail Pharmacy

2. Ambulatory Settings • Commonly referred to as community-based pharmacies • Privately owned, chain, or franchise pharmacies • Known as community pharmacies because they serve the local community in which they are located

3. Retail Pharmacy • Face-to-face interactions between the pharmacist, technicians, and patients • Retail pharmacy staff is usually more accessible to the general public

4. Figure 6.1 An independent pharmacy.

5. Independent Pharmacies • Most are privately owned and small in size • Also thought of as neighborhood pharmacy • Can provide more personalized services to its customers • Allows pharmacy staff to become better acquainted with their patients

6. Independent Pharmacies (cont.) • Some independents can provide: • Compounded medications • Home healthcare products • Surgical supplies • Delivery service • Patient charge accounts

7. Figure 6.2 A retail pharmacy.

8. Chain/franchise Pharmacies • Consist of branches, or chains, of more than one store • Generally have a higher volume of prescriptions • Often larger and faster-paced

9. Chain/franchise Pharmacies (cont.) • Can be further categorized: • Mass-merchandise stores (Wal-Mart) • Chain drugstores (CVS and Rite-Aid) • Grocery store pharmacies (Krogers and Albertsons) • May offer other career opportunities to their staff, including retail management and training opportunities

10. Staff Positions • Certified Pharmacy Technician—certified to assist pharmacists in providing pharmaceutical care; however, is not permitted to dispense medication or counsel

11. Staff Positions (cont.) • Pharmacy clerk/cashier—noncertified/nonlicensed individual authorized only to assist with nonpharmacy-related tasks, such as working the cash register • Pharmacy manager—almost always a pharmacist; individual appointed to supervise all aspects of the daily pharmacy operations

12. Staff Positions (cont.) • Pharmacy manager—almost always a pharmacist; individual appointed to supervise all aspects of the daily pharmacy operations • Doctor of Pharmacy (PharmD)—individual who has completed a doctoral degree in pharmacy and is licensed to practice pharmacy in a specific state

13. Staff Positions (cont.) • Pharmacist in charge (PIC)—individual designated on the State Board of Pharmacy Record as the primary, onsite pharmacist; responsible for ensuring that the pharmacy operates in accordance with state laws and regulations

14. Staff Positions (cont.) • Registered pharmacist (RPh)—individual who has completed a bachelor’s degree in pharmacy and is licensed to practice pharmacy in a specific state • Store manager—an individual appointed to supervise all aspects of the daily store operations, including the pharmacy department

15. Figure 6.3 The front-end section of a pharmacy.

16. Eight Areas of a Retail Pharmacy • Over-the-counter/front end—provides customers with various medications, devices, and aids that can be purchased without a prescription • Behind-the-counter OTC—medications and devices that, although available without a prescription, are kept behind the pharmacy counter

17. Eight Areas of a Retail Pharmacy (cont.) • Prescription drop-off—where patients can turn in their prescriptions to be filled • Pharmacy workstations—the area in which new prescriptions and refill requests are entered into the computer system, insurance claims are billed, and prescription labels/monographs are produced

18. Eight Areas of a Retail Pharmacy (cont.) • Pharmacy counter—where pills are counted, liquids are measured, and compounds can be prepared • Storage—Common storage areas include: medication storage, including shelves, cabinets, and a refrigerator/freezer; filled prescriptions; dispensing supplies, such as vials, bottles, labels, and bags; and prescription records

19. Eight Areas of a Retail Pharmacy (cont.) • Pick-up area (drive-thru)—area designated for prescription pick-up • Counseling area—mandatory area designated for patient counseling

20. State Board of Pharmacy (SBOP) • Agency that registers and regulates retail pharmacy facilities, pharmacists, and pharmacy technicians • Pharmacy practice is governed at the state level • The pharmaceutical industry is governed at the national level

21. State Board of Pharmacy (SBOP) (cont.) • Oversees compliance with the state’s pharmacy practice act, and may do the following: • Administer unannounced site inspections • Require operational changes • Suspend or revoke the license of a pharmacy, pharmacist, or pharmacy technician

22. Centers for Medicare and Medicaid Services (CMS) • Formerly known as the Health Care Financing Administration (HCFA)

23. Centers for Medicare and Medicaid Services (CMS) (cont.) • Federal agency that regulates the administration of: • Medicare • Medicaid • State Children’s Health Insurance Program (SCHIP) • Health Insurance Portability and Accountability Act (HIPAA)

24. Centers for Medicare and Medicaid Services (CMS) (cont.) • Federal agency that regulates the administration of: • Clinical Laboratory Improvement Amendments (CLIA) • Several other health-related programs

25. Centers for Medicare and Medicaid Services (CMS) (cont.) • Conducts inspections to ensure compliance with CMS guidelines • CMS approval is necessary to receive reimbursement from Medicare or Medicaid

26. Figure 6.9 An illustration of a prescription.

27. Every prescription has 10 basic elements (Elements 1–5) • Prescriber information—the name, address, telephone number, license number, and DEA number of the prescriber • Patient name and address—the name and address of the individual for whom the prescription was written

28. Every prescription has 10 basic elements (Elements 1–5) (cont.) • Date prescribed—the month, day, and year the prescription was written • Drug name and strength—the name of the medication being prescribed and its strength, or the amount of active ingredient contained in manufactured prescription products

29. Every prescription has 10 basic elements (Elements 1–5) (cont.) • Dose and quantity—the specific dose, or measured amount, of medication being prescribed and a total quantity to be dispensed

30. Every prescription has 10 basic elements (Elements 6–10) • Route of administration—the route by which the medication should be administered to the patient, such as PO (by mouth) • Signa/Directions—commonly referred to as the SIG; specific directions for the patient to follow, such as frequency of dosages, schedule of dosages, and additional instructions

31. Every prescription has 10 basic elements (Elements 6–10) (cont.) • Number of refills—the number of refills authorized by the prescriber, including zero • Product selection permitted—the prescriber’s authorization for the patient to select a less expensive generic equivalent (if available) or the prescriber’s directive to dispense as written (no substitution permitted)

32. Every prescription has 10 basic elements (Elements 6–10) (cont.) • Prescriber’s signature—the prescription is not considered valid unless it is signed by the prescriber

33. Ways Prescriptions Arrive at a Retail Pharmacy • Walk-in • Phone-in • Faxed • Internet delivery

34. Processing a Prescription • Receiving and reviewing the order • Prescription entered into the pharmacy computer system • Prescription label printed • Insurance billed, if applicable • Prescription is filled • Final check • Stored for pick-up

35. Job Duties of Technicians in Retail Pharmacies • Help patients locate OTC medications and prices • Take care of inventory orders, rotations, returns, and billings • Perform counting, measuring, filling, and labeling • Do insurance billing

36. Importance of Confidentiality • Pharmacy technicians have access to sensitive, personal information about: • Patients’ health • Prescription drug information • Payment records • Patients trust that this information will not be distributed or abused • HIPAA regulates the use of patients’ health information