The Alabama Board of Pharmacy (the "Board") has recently taken the position that non-resident pharmacies must comply with the state's 3:1 technician to pharmacist ratio. This position could have serious practical implications for out-of-state pharmacies serving patients in Alabama.
Over the past week, the Board issued multiple letters to non-resident pharmacies that recently submitted renewal applications. If the ratio listed by the pharmacy on the application was greater than 3:1, the Board sent letters stating the following:
In reviewing your most recent renewal, it is represented the pharmacy/technician ratio for your facility is [greater than 3] technicians for each pharmacist. Alabama State Board of Pharmacy Administrative Code Rule 680-X-2.14 provides:
(3) It is ruled by the Board of Pharmacy that three (3) technicians, one of which shall be certified by any credentialing organization approved by the Board, on duty are sufficient in the prescription area of a retail pharmacy or an institutional pharmacy for each full time licensed pharmacist on duty. Nothing in this rule shall prevent a pharmacy from employing technicians to perform supervised tasks not requiring professional judgment.
Please verify in writing, with supporting documentation, within fourteen (14) days from the above date that your facility is in compliance with the required ratio for all prescription medications dispensed into Alabama.
As the Board continues its review, non-resident pharmacies licensed in Alabama should expect a similar letter if they listed a ratio greater than 3:1 on the last non-resident pharmacy permit renewal. Clients utilizing technicians for non-pharmacy tasks (e.g. call center/customer service operations, benefit investigation, etc.) or tasks that do not require professional judgment may wish to recalculate their ratio to exclude such technicians in any response to the Board's inquiry (if they have not done so already).