Starting next month, hospital pharmacists’ workload is to be limited to 70 prescriptions per day to reduce dispensing errors, according to the National Health Insurance Administration (NHIA).
Agency official Lin Shu-fan (林淑範) said the new guideline follows a resolution made by the National Health Insurance Committee acknowledging that pharmacists needed time to make prescriptions, including giving advice before dispensing drugs to patients.
A notice of the impending change has been issued stating that pharmacists working in medical centers are each restricted to 70 prescriptions per day for both outpatient and emergency departments. The number of inpatient prescriptions are to be limited to 40 per day, and special drugs 15 per day.
Those working in regional and district hospitals have a relatively lighter “reasonable prescription volume,” the agency said.
For prescriptions filled by a pharmacist, payments by the NHI are to be made based on the number of days of supply and difficulty in dispensing the drug.
For instance, payments by the agency for dispensing a one-week supply of outpatient prescription would be much lower — or about one-sixth of — the payment for filling a prescription for total parenteral nutrition injection or for cancer chemotherapy, Lin said..
She added the agency has allocated a budget of NT$300 million (US$ 9.9m) this year to encourage hospitals to follow the latest guidelines on pharmacists’ dispensing workload.
If pharmacists are found to exceed the given prescription volume, NHI payments for the excess prescriptions will only be half of the amount, Lin said.
Prior to the introduction of the new regulatory guideline, there was no reasonable threshold set for prescriptions dispensed by pharmacists in hospitals’ outpatient, inpatient and emergency departments.
The Taiwan Healthcare Reform Foundation has said that overworked nurses and pharmacists have turned hospitals into sweatshops. Burned-out nurses and pharmacists are more prone to making medical and dispensing errors, it said, adding that pharmacists have little time to counsel patients on drug use.