March 16, 2021

Pharmacy Technician Ratio Requirements

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Many states limit the number of pharmacy technicians permitted to work under the supervision of a licensed pharmacist at any given time. In some states, these regulations have been relaxed in recent years, including as part of the emergency response to the COVID-19 pandemic. In “Pharmacy Technician Ratio Requirements,” James Broughel and Yuliya Yatsyshina argue that this apparent trend toward less restrictive regulation could be an important way to advance public health.

Evolving Roles, Evolving Regulation

Pharmacy technicians assist pharmacists in a variety of roles, from performing administrative duties to providing basic medical care for patients. Technicians’ roles have expanded as pharmacists themselves have taken on greater responsibilities in the management of patient care.

  • The goal of ratio laws is presumably to protect the public and ensure patient safety and a minimum level of quality of service. However, if pharmacists are forced to perform routine tasks that do not need their expertise because they do not have adequate support staff, the overall quality of service could be lower.
  • Relaxing ratio requirements, so that a pharmacist can supervise more technicians, is one way to expand the scope of how these healthcare professionals can serve their patients in a responsible manner. There do not appear to be notable negative downsides to relaxing these requirements or eliminating them altogether, as evidenced by the experiences of states that do not have these requirements.
  • Fears about the risks of relaxing ratios have not materialized. The pandemic has forced new responsibilities on technicians and pharmacists alike, and sharply increased workloads, making burnout an increasingly urgent concern. Maintaining ratios might reduce patient safety by limiting the amount of help available at any given time.

Snapshot of the Current Regulatory Landscape

There is considerable variation in pharmacist-to-pharmacy technician ratio requirements across the states.

  • California, North Carolina, and New York are examples of states that allow one pharmacist to oversee no more than 2 pharmacy technicians under certain conditions.
  • Alaska, Illinois, New Hampshire, and Maryland are examples of states having no state-mandated ratio requirement.
  • Since 2016, 9 states (Colorado, Florida, Georgia, Indiana, Kansas, Mississippi, Montana, North Dakota, and South Dakota) have relaxed their ratio requirements, and 4 (Idaho, Utah, Washington, and Wisconsin) have removed the requirement entirely.
  • Only Tennessee appears to have made the base ratio requirement stricter in recent years (exceptions allow for a ratio of up to 1:4 as the maximum), though other states are considering similar changes.
  • During the COVID-19 pandemic, at least 7 states made changes to their existing pharmacist-to- pharmacy technician ratio requirements, all in the direction of liberalizing restrictions.

Key Takeaway

The evidence suggests that pharmacists and pharmacy technicians are capable of performing more tasks, not fewer. Relaxing ratio requirements and increasing the responsibilities of these healthcare professionals would allow them to better address the growing healthcare needs of Americans.