compounding vs nonprofit community

[yovee]

Hi, I have been working at a small independent pharmacy for my entire career of 10+ years. I don't really have to deal with as much as my brethrens in chain pharmacies so I don't really have anything to complain about, though I think I should try to jump ship to find more job security if there is such a thing in pharmacy.

I have received one job offer and possibly another one soon so I would like to solicit advice beforehand if I may:

1) A multistate 503A compounding pharmacy, cash only, majority is weight loss, hormone replacement products etc. Don't get me wrong I do think about how legit the place is but but haven't found any complaints against them (and that is another discussion). I'll be a staff pharmacist. I have zero compounding knowledge and most of their products are unfamiliar to me so I will need to learn everything from scratch. I am just not sure how desirable these skills are in the current market.

2) A non profit community place that primarily serves HIV patient. They are a network of pharmacies and clinics. I'll be the PIC and the only pharmacist there with like 2 techs. Not sure how big the headache will be. There will be 340b to deal with which I had not dealt with before. This is at least closer to my previous experience.

I am not worrying about the pay difference at this moment, just pondering how to stay relevant in this day and age. I know ageism is a thing and it's also easy to become obsolete so I need to watch my steps.

Much appreciative of any advice I may have!

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[PharmDBro2017]

Do you have student loans? The nonprofit maybe ideal then. Compounding can be a massive pain, especially with the new regs dropping Nov 1st.

 

[yovee]

Do you have student loans? The nonprofit maybe ideal then. Compounding can be a massive pain, especially with the new regs dropping Nov 1st.

Thank you for your input. No, I am done with student loans. Yeah, I am going to have to go back to square one and relearn everything in compounding so I am just wondering if there is a good outlook in this field that makes it worth the pain. I guess sterile and non sterile compounding are nice things to add to a resume but I am not sure how desirable they are to employers.

 

[CetiAlphaFive]

Hi, I have been working at a small independent pharmacy for my entire career of 10+ years. I don't really have to deal with as much as my brethrens in chain pharmacies so I don't really have anything to complain about, though I think I should try to jump ship to find more job security if there is such a thing in pharmacy.

I have received one job offer and possibly another one soon so I would like to solicit advice beforehand if I may:

1) A multistate 503A compounding pharmacy, cash only, majority is weight loss, hormone replacement products etc. Don't get me wrong I do think about how legit the place is but but haven't found any complaints against them (and that is another discussion). I'll be a staff pharmacist. I have zero compounding knowledge and most of their products are unfamiliar to me so I will need to learn everything from scratch. I am just not sure how desirable these skills are in the current market.

2) A non profit community place that primarily serves HIV patient. They are a network of pharmacies and clinics. I'll be the PIC and the only pharmacist there with like 2 techs. Not sure how big the headache will be. There will be 340b to deal with which I had not dealt with before. This is at least closer to my previous experience.

I am not worrying about the pay difference at this moment, just pondering how to stay relevant in this day and age. I know ageism is a thing and it's also easy to become obsolete so I need to watch my steps.

Much appreciative of any advice I may have!

340b can be an absolute nightmare if the health system is not set up well.

 

[yovee]

340b can be an absolute nightmare if the health system is not set up well.

You were a community pharmacist working in an independent right? Are you still working in the same setting or have you transferred out? Interested in hearing your opinion.

 

[CetiAlphaFive]

You were a community pharmacist working in an independent right? Are you still working in the same setting or have you transferred out? Interested in hearing your opinion.

Yeah, i used to be. I transitioned to a clinical job.

I would ONLY touch it if they have an analyst hired to monitor 340b *and* they've shelled out the dough for the software to handle automated accounting for dispensing to eligible patients.
Some systems think it's acceptable to have a tech perform the role of an analyst just because they have accumulator software, but that can get scary really fast.

Tbh if i could get another independent gig like the last one I had except with better benefits I'd go back lol

 

[owlegrad]

Yeah, i used to be. I transitioned to a clinical job.

I would ONLY touch it if they have an analyst hired to monitor 340b *and* they've shelled out the dough for the software to handle automated accounting for dispensing to eligible patients.
Some systems think it's acceptable to have a tech perform the role of an analyst just because they have accumulator software, but that can get scary really fast.

Tbh if i could get another independent gig like the last one I had except with better benefits I'd go back lol

Real question - does that software exist? We do manual checks and I am skeptical that software even could do it.

 

[CetiAlphaFive]

Real question - does that software exist? We do manual checks and I am skeptical that software even could do it.

Yup. I can't imagine having a "neutral" inventory instead of a physically separate inventory without it.

Basically, it's integrated into the EMR and dispensing software so it can see when eligible patient gets dispensed an eligible drug and then "accumulates" the number of dispenses until you hit a threshold.
It then generates a 340b Sales Order to equal the quantity that has already been dispensed to eligible patients.

Thus, the qualified quantity has already been dispensed, and the system orders you 340b priced stuff to replace the stuff that already got dispensed.

Q: How can we increase savings with our outpatient 340B Drug Pricing Program? A: Use an integrated accumulator to improve your capture rate.

Accumulators work behind the scenes to track medication dispenses that are eligible for certain programs.

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