Association Perspective
Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP, Executive vice president and CEO of APhA
Pharmacists simply can’t fulfill our purpose in patient care without a stable workforce of competent pharmacy technicians. The Pharmacy Workforce Center (of which APhA is a partner) reports that during the third quarter of 2024, there were just over 45,000 job postings for pharmacy technician vacancies in the United States. This is up from just over 39,000 job openings for pharmacy technicians for the same period in 2023. APhA’s members want to know what APhA is doing to help address this issue given that staffing shortages, particularly in the community sector, are exacerbating poor working conditions.
Recently, I’ve conducted face-to-face meetings with management leadership of 10 of the largest corporate community pharmacy employers. Based on data we collect in the Pharmacy Workplace and Well-Being Reporting (PWWR) portal, APhA identified three key items to discuss with these employers: 1) consistency in scheduling of pharmacy technicians; 2) career progression and pay for pharmacy technicians, and 3) pharmacy technician retention efforts (i.e., efforts to reduce turnover).
On the issue of consistency of scheduling, I made it clear in my conversations that if we want to stabilize the pharmacy workforce, we must ensure that a technician hired into a full-time position can count on consistently receiving full-time hours with benefits. Technicians need to have a living wage to support their family if they are to see the job as a career. By and large, the national employers I spoke with agreed with this statement. Without exception, every company had either fully implemented a scheduling program to ensure consistency in hours or was rolling out one. Also without exception, the corporations stated this is one of the most difficult challenges facing the pharmacy sector given the difficult PBM reimbursements and thin or negative margins on prescriptions.
Not surprisingly, there is also significant variability across the country by market. For example, high cost of living markets such as Los Angeles, Denver, Boston, and Seattle can be challenging for securing technicians compared with Raleigh, Birmingham, or St. Louis.
I also learned from these conversations that pharmacy employers are discovering that technicians who have completed immunization training have lower job turnover than those who have not. This was a consistent report from every employer. Helping technicians feel like a part of the health care team and not just task-oriented laborers is how one employer manager put it to me—and I think he’s right.
However, getting pharmacy technicians to become comfortable first with the basic tasks of dispensing is where we are losing the battle in addressing the technician shortage. Most of the employers reported to me turnover at a rate of 40% to 60% in the first 60 to 180 days of hire.
Employers recognize that they must address the onboarding processes; insufficient onboarding training leaves the new technician frustrated with their work and unable to fulfill the expectations of the job. With pay often being no better than entry pay in other industries, they choose to leave for less demanding work. APhA will continue to illuminate this issue, yet it largely hinges on a commitment of the corporations to ensure appropriate training and support in the early days of employment coupled with adequate pay to correct this issue.
The greatest frustration of the chain pharmacies themselves is the variability in allowed staffing ratios, dispensing restrictions, and regulation of technology by state boards of pharmacy. This is, not surprisingly, a lightning rod issue when discussing with pharmacists—they need the state boards to support adequate staffing for a safe work environment. Yet those same laws and regulations sometimes limit the innovations and programs for staffing. My guess is that this will be a continued issue for some time to come unless PBM reimbursements for prescriptions change substantially.
Perhaps the one area where the corporations I spoke with are making the greatest strides is in creating more clearly defined career progression ladders for pharmacy technicians: I heard a lot about a commitment to supporting technicians becoming PTCB-certified. There is a shift happening to cover the costs of the training for certification and the certification itself on the front end rather than expecting the technician to pay and then be reimbursed—which has been a barrier to advancing the technician.
A few of the corporate leaders with whom I spoke are developing pharmacist patient-care assistant positions for technicians who have demonstrated advanced skills. Other employers offer career ladders that allow technicians to advance into management over time and are changing how they communicate the career progression opportunities.
Employers vary in their degree of support for technicians to move into pharmacy school. Some have internal tuition support programs, while others work directly with local pharmacy schools to help technicians design pre-pharmacy education plans.
There is much work to do with technicians and strengthening the workforce. While what’s happening in practice is far from perfect, we are moving forward one step at a time. APhA remains committed to supporting our pharmacy technician members, as well as our pharmacists. For every pharmacist. For all of pharmacy. ■