Competitive Advantages of Accreditation in the Pharmaceutical Industry

How much do you trust your neighborhood pharmacy? Many people regard these professionals as doing little more than putting pills in jars, but the reality is your pharmacist is a crucial partner in protecting your total health.

However, it’s tough to gauge their level of expertise unless you have a medical license yourself, and not everyone is a doctor. Accreditation is an important step for independent practitioners to take for many reasons, not the least of which is protecting patient trust.

Think about the stakes. You provide life-changing — sometimes life-saving — medications to people who need them. Your decisions impact your patient’s daily existence and everyone who cares about them. The COVID-19 pandemic illustrated the problems that can arise¹ when individuals mistrust their care providers, as it leads to them failing to follow medical advice.

You owe it to your patients to do everything you can to assure them they have made the right choice in trusting you with their health. Here’s why accreditation is so important in pharmacy and what to expect when going through the process.

Why Is Accreditation Important for Pharmacists?

Who do experts rely upon for oversight? It’s other professionals. The medical field is highly specialized, and only those with the requisite expertise can judge the quality, safety, and effectiveness of various protocols. Accreditation boards consist of a multidisciplinary team with experience in multiple aspects of pharmaceutical science.

Accreditation means your pharmacy has voluntarily submitted to a professional review process to evaluate the standard of care you deliver. As your team prepares for the accreditation process, you’ll perform an in-depth review of your present procedures², assessing how well they conform to the guidelines and where you have room to improve. These steps alone elevate your standard of care by improving quality and efficiency.

However, the benefits don’t stop there. Accreditation requires regular evaluations to ensure you continue to adhere to the standards. According to Jodi Sibell, RN, director of accreditation and document manager at AllianceRx Walgreens Pharmacy, “Achieving accreditation validates compliance with the industry’s most rigorous standards³, provides a quality framework and ensures continuous quality improvement.”

Pursuing accreditation provides you and your business with the following valuable benefits. 

1. Protects Patients by Maintaining Trust and Standards

Perhaps no profession involves higher stakes than medicine. Such professionals make life-or-death decisions regarding patient care. However, they’re also human and must act amid the same pressures facing everyone else.

Adhering to standards and procedures reduces the potential for human error. It guides pharmacists as they make daily decisions, reminding them to cross every “T” when things get hectic. They provide clear guidelines for what to do when questions arise so that you can coordinate with the patient and their doctor on the best course of care.

Sadly, patients now have reason to distrust pharmacists as conflicts between the law, personal belief systems, and patient care arise. For example, several states allow pharmacists to refuse to fill birth control prescriptions⁴ — even though contraception isn’t the only reason some women take these medications. They’re also used in balancing severe hormonal disturbances, which can greatly impact quality of life.

Leading pharmacy chains CVS and Walgreens have both endured complaints. Although they’ve implemented policies requiring pharmacists to direct such patients to other help sources, the onus often falls on the patient to ask. Mara Gandal-Powers, director of birth control access at the National Women’s Law Center, advises patients receiving denials to immediately ask for a different pharmacist⁵ and file a complaint with the state pharmacy board if they’re refused service.

Anything you can do to increase patient trust will positively impact your business — and bottom line. Accreditation tells prospective customers that you adhere to the guidelines generally accepted by your profession, giving them greater assurance that they can trust you with high-stakes health decisions.

2. Allows Oversight From Professionals From Multiple Disciplines

Medicine is incredibly complex. Two physicians can have the same level of educational attainment and yet disagree on the most effective procedures. Arriving at the best answer for most requires a consensus.

However, it isn’t enough to have pharmacists alone oversee such processes. Bringing in members from other medical disciplines maintains transparency over how the moving pieces of the medical puzzle work together and provides valuable insights that affect patient care. For example, they may provide information about potential drug interactions that can save lives.

3. Creates Ways to Identify and Share Areas of Improvement

Avoid looking at accreditation as a hurdle. The standards exist to protect safety but also to improve processes. Doing so results in higher-quality patient care.

Furthermore, relying on business consultants unfamiliar with the industry to improve profits can result in more harm than good as they don’t understand the intricacies of medicine. You’re better off spending that money on preparing for accreditation.

Besides, few things are more valuable than sounding ideas off other professionals. If you look at the accreditation process as a partnership with the mutual goal of improving efficiency, quality and outcomes, you’ll sail through the process while improving your business model.

4. Enforces Educational Standards for Incoming Professionals

Most pharmacies seeking accreditation primarily do so through the Utilization Review Accreditation Commission (URAC). They may also seek accreditation⁶ through the Joint Commission on Accreditation of Healthcare Organizations (TJC) or the Accreditation Commission for Health Care (ACHC).

However, each new pharmacist entering the profession must also adhere to certain standards. The Accreditation Council for Pharmacy Education⁷ ensures incoming members achieve PharmD Program accreditation, ensuring they have fulfilled the educational requirements to practice.

5. Supplies Risk Management and Liability Protection

Accreditation provides another layer of protection against liability. It provides evidence in court that the facility adhered to the proper procedures as generally accepted by the profession, safeguarding them somewhat from damages if a staff member does something to violate protocol.

Accreditation also serves to improve staff compliance with facility policies. It’s one thing for the owner or manager to say, “This is how we do things.” It’s quite another to have the rules explained by an outside agency. Staff members who violate guidelines could find it difficult to obtain work at other accredited pharmacies, providing real-world consequences for noncompliance.

6. Allows Pharmacies to Conduct Business With Certain Entities

Perhaps the biggest reason accreditation is important in pharmacy is that it opens doors. Failure to accredit your facility may result in difficulties with the following daily operations:

• Working with pharmaceutical manufacturers: Some manufacturers may refuse to do business with non-accredited pharmacies to protect themselves from liability. For example, it’s common for physicians to prescribe medications for off-label use, but pharmaceutical companies may doubt the pharmacist’s commitment to preventing potentially dangerous interactions. If they deem the risk isn’t worth it, you could have a hard time stocking your shelves.
• Partnerships with health insurance companies: Many patients rely on insurance to cover all or most of the cost of their prescription drugs. Pharmacists must partner with these organizations to receive payment for their services. Some insurers may decline to do business with non-accredited pharmacies because of the liability risk, limiting what payments you can accept.
• Government grant funding: Pharmacies can sometimes receive government grants, but the government will likely only provide funding for accredited businesses.

What Is the Accreditation Process Like?

The accreditation process looks slightly different depending on which organization a pharmacy chooses for this purpose. Here’s a quick rundown of the procedure for each.

1. URAC

URAC is the most widely used pharmacy certification. Accreditation through URAC takes 10 to 12 months on average. It involves five steps:

1. Application process: This step consists of assigning an account manager and uploading information to the web portal. It’s also the lengthiest step.
2. Desktop review: The organization does an initial examination to evaluate potential areas of deficiency.
3. Validation review: This step involves a site visit to interview your staff members and observe your processes.
4. Committee review: The URAC Accreditation Committee performs a final review and determines the application status.
5. Monitoring: Involves annual reporting and occasional mid-cycle reviews with 14 days' notice given.

2. TJC

TJC doesn’t have a separate accreditation process for pharmacies — they must go through the Home Care designation. The accreditation process takes 18 to 36 months. It entails an initial visit and follow-up visits within 18 to 36 months by a team of surveyors with at least five years of experience in the industry.

These surveys are generally unannounced, and accredited organizations receive the TJC Gold Seal of Approval. Those with deficiencies can resubmit evidence of making the necessary improvements and compliance.

3. ACHC

ACHC is the youngest accreditation organization through which pharmacies can pursue a credential. They follow a six-step process:

1. Create a customer account and download the standards.
2. Submit the application and deposit.
3. Sign the accreditation agreement.
4. Submit the PER checklist when ready and compliant.
5. Participate in an onsite survey.
6. Receive your determination.

It’s possible to gain accreditation through more than one entity. In an interview with “Pharmacy Times,” Erica Diamantes, specialty pharmacy manager at UW Medicine, describes cases where such an approach is best.

For example, a pharmacy with no accreditation may pursue dual accreditation despite the labor intensity and costs because they can compare standards across organizations⁸, hitting unique ones another governing body may miss. In essence, the more oversight, the better in terms of patient safety and outcomes.

How Much Does Accreditation Cost?

Accreditation is an investment in your business. While the cost varies depending on which organization you choose, you’ll foot more than filing, registration and site survey fees. Most facilities going through the process also hire a team of consultants to ensure they get it right the first time, as repeated applications drive up costs.

For example, URAC scales its prices per specialty prescription volume, but its minimum is $39,000⁹ for a three-year term. The annual data validation requirements cost between $11,000 to $20,000 per year. Outside consultants often charge more than $10,000 for their services, meaning you’ll pay more upfront and incur continued costs if you retain their services to handle your annual and periodic reviews.

The Competitive Advantage of Accrediting Your Pharmacy

Accreditation matters more than ever in today’s environment. The COVID-19 pandemic and conflicts between competing laws and personal belief systems have fostered distrust between patients and medical providers. Anything your organization can do to assure customers that their money — and lives — are in good hands will ultimately benefit your business.

Now that you understand the importance of accreditation in pharmacy, it’s time to earn yours. Choose the best organization or more than one, and embark on a powerful journey of improving patient outcomes while bolstering your bottom line.

References:

1. Lamuda, Phoebe, et. al. “Latent class analysis of medical mistrust and COVID-19 vaccine hesitancy among adults in the United States just prior to FDA emergency use authorization.” 2023 Apr 17; 41(16): 2671–2679. 2023 Mar 13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008805/
2. URAC. “Why Do You Need Health Care Accreditation?” 2023 August 23. https://www.urac.org/blog/why-you-need-health-care--accreditation/
3. AllianceRX Walgreen Pharmacy. “The Importance of Accreditation.” 2022 January 11. https://www.alliancerxwp.com/contents/blogs/the-importance-of-accreditation.html#:~:text=%E2%80%9CAchieving%20accreditation%20validates%20compliance%20with,management%20at%20AllianceRx%20Walgreens%20Pharmacy.
4. Stark, Sam. “Can a pharmacist deny medication based on their values?” 2023 May 22. https://www.kxan.com/news/texas/can-a-pharmacist-deny-medication-based-on-their-values/
5. Edwards, Sara. “What to Do If CVS, the Nation’s Largest Pharmacy, Refuses to Fill Your Birth Control.” 2022 July 27. https://www.usatoday.com/story/money/retail/2022/07/27/pharmacist-wont-fill-birth-control-because-faith/10154078002/
6. Byrne, Michelle. “Specialty Pharmacy Accreditations: The Big Three.” 2019 April 17. https://www.pharmacytimes.com/view/specialty-pharmacy-accreditations-the-big-three
7. Accreditation Council for Pharmacy Education. “Information for Pharmacists and Pharmacy Technicians.” n.d. https://www.acpe-accredit.org/
8. Pharmacy Times. “Experts Discuss Specialty Pharmacy Accreditation, Re-accreditation.” 2023 January 3. https://www.pharmacytimes.com/view/experts-discuss-specialty-pharmacy-accreditation-re-accreditation
9. Harlow, Jason, et. al. “How to Be Successful in Credentialing and Accreditation: Dos and Don’ts.” NCODA. 2019. https://www.ncoda.org/wp-content/uploads/bp-attachments/7897/FRI-2PM-Tower-D-_2019-NCODA-FRI-How-to-Be-Successful-in-Credentialing-and-Accreditation-Dos-and-Donts.pdf