Other Pharmacist Roles: Non-dispensing and/or Work from Home Roles

Many of us desire to use our top-notch expertise as a medication expert to help others in a way that is profitable and flexible.  The world outside of work continues to demand more and more of us.  There’s a big buzz about creating work/life balance.  Work/life balance is having equilibrium where an individual feels they are equally prioritizing the demands of their career responsibilities and of their personal life. More and more companies are in the news offering flexible work hours, the ability to telecommute or work from home, unlimited PTO, paid maternity and paternity leave, in addition to other millennial worker requests such as competitive compensation, comfortable offices, opportunities for growth and advancement and social connections. Pharmacy doesn’t seem to be as progressive in these enhancements or modifications as other industries.

However, there are pharmacy career options that offer remote work, part-time work and/or flexible scheduling. Adding more time into the day by eliminating a commute to and from work can be life-changing. Being able to reduce hours or set your own hours can allow time for personal activities and responsibilities. These careers can be difficult to find and it can be hard to get an initial interview when an opening is available.  Some may require brave steps of making your own company or creating your own career.  Others may require you to continue your primary job while you begin your own side hustle start-up with hopes of it generating enough income that you can then cut back from your primary job.  

Medication Therapy Management

Prescription Approval and/or Remote Order Entry

Prior Authorization Review

Drug Information

Quality Improvement

Medical writing and/or Reviewing Medical Literature

Create your own – Consulting, Pharmacogenetics, Coaching, Entrepreneurship 

How do I find one of these positions?

Check out job board websites like Indeed, LinkedIn, SimplyHired and LinkUp.  Download their apps and then create alerts to notify you when there is a posting that may match your ideal position.  Find out what companies are hiring for positions of interest and create alerts to notify you when those companies post a new position.  Review the qualifications, requirements, licenses, certifications and skills the employer is looking for and gain experience and skills in those areas.  

Hire a professional to review your resume and cover letter.  A candidate with experience and skills but a poor resume may not even be asked to interview.  An impressive resume and cover letter are essential!  There are individuals and companies that specialize in resume templates, reviews and custom writing for pharmacists. If you think yours could use some improvement check out these services. A simple google search of pharmacist resume service will bring up options. I would recommend using a service dedicated to pharmacists or healthcare professionals.

Network. Network. Network.  Network virtually and in person.  Places to consider are LinkedIn, local, state and national pharmacist organizations and Facebook groups of interest.  A resume and profile can be created and kept up to date on LinkedIn listing experience, education, licenses, certificates, skills and accomplishments.  State pharmacist organizations can be a great way to get to know other pharmacists and companies in your region.  Many niche pharmacy groups have larger national organizations with committees, meetings, continuing education programs and more opportunities to get involved with pharmacists working in your area of interest all over the country.  If you can, volunteer to service on a committee or help with a project. There are Facebook groups for several pharmacist and pharmacy areas of interest.  Try searching a topic of interest such as MTM, consulting, etc. and pharmacist.  Join any groups that seem interesting or relevant to your pursuits.  There is much that can be learned from these groups and it creates a community for discussion, posting jobs, and collaboration.

Be brave, be vulnerable. Try new things, meet new people and put yourself out there.   

Check out our self-guided course and instant download study guides. on Teachable for Texas MPJE, Iowa MPJE, Maryland MPJE and Federal Law Review!

Drug Approval Process

My tests had several questions that referenced to the drug approval process. I suggest that anyone planning to take the MPJE for any state be familiar with the drug approval processes

Investigational New Drug Application

•1stapplication before drug is given to humans

•Federal Drug Administration (FDA) has 30 days to decide if suitable for testing

•Must provide clinical protocols to be used in human testing

Clinical Trials

Initiated after FDA approves the investigational new drug application

3 phases before marketing and 1 phase after marketing

Phase 1: Small group of healthy individuals to evaluate toxicity, kinetics, safety

Phase 2: Large group (100+) with the disease being treated to evaluate effectiveness, safety, and adverse drug events (ADEs)

Phase 3: Large group (1000+) to evaluate effectiveness, double-blinded with placebo

Phase 4: Post-marketing surveillance to determine if drug should stay on the market

New Drug Application (NDA)

Can apply once data on safety, efficacy, toxicity, stability, production methods, packaging and clinical trial data exists

Typically takes 6 months for review 

Abbreviated New Drug Application (ANDA)

For introducing a generic of an already approved drug

Requires proof of kinetics, bioequivalence/bioavailability

Supplemental New Drug Application (SNDA)

For changes to synthesis, production, manufacturer location, packaging and/or labeling

For new dose form, strength or therapeutic use

Epidiolex – What is it? Is it a controlled substance?

What is it?

First and only FDA-approved prescription cannabidiol (CBD)

What is it used for?

Seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome or tuberous sclerosis complex (TSC)

Mechanism of action for the reduction of seizures is unknown.

How is it dosed and taken?

Titrated dosing given orally or via feeding tube (non PVC) twice daily, administered consistently with or without food.

LGS or Dravet syndrome:

Initial dose: 5mg/kg/day (2.5mg/kg twice daily)

Recommended dosing: 10 to 15mg/kg/day (5 to 7.5mg/kg twice daily) increased in weekly increments of 5mg/kg/day (2.5mg/kg twice daily)

Maximum dosing: 20mg/kg/day (10mg/kg twice daily) 

TSC:

Initial dose: 5mg/kg/day (2.5mg/kg twice daily)

Recommended dosing: 10 to 20mg/kg/day (5 to 10mg/kg twice daily) increased in weekly increments of 5mg/kg/day (2.5mg/kg twice daily)

Maximum dosing: 25mg/kg/day (12.5mg/kg twice daily) 

If rapid titration is necessary, dose may be increased no more frequently than every other day.
Dose adjustment and a slower titration is recommended in patients with moderate to severe hepatic impairment.
Should not be stopped suddenly due to the risk of increased frequency of seizures and status epilepticus. 

Recommended lab work: 

Transaminase and bilirubin levels prior to starting treatment, at month 1, month 3 and month 6 then periodically thereafter.

Patients on valproate or are at increased risk of elevated transaminase levels and/or hepatocellular injury.  

If levels are elevated, consider a dose reduction or discontinuation of Epidiolex or other medications known to increase transaminase levels such as valproate and/or clobazam.  

Common side effects (> 10% and greater than placebo): transaminase elevations, somnolence, fatigue, malaise, asthenia, decreased appetite, diarrhea, vomiting, pyrexia, rash, insomnia and infections.

Other important side effects to be aware of: suicidal behavior and ideation

Potential interactions to consider:

Several potential drug-drug interactions to consider, most commonly run into potential drug-drug interactions with other anticonvulsant medications:

Clobazam, diazepam, & valproate

Recommended to counsel patient or caregiver on signs/symptoms to watch for and recommend lab work as appropriate.  

Strawberry flavored but does not contain strawberry.

Compatible with a ketogenic diet.

Federal law no longer considers Epidiolex to be a controlled substance.  It had originally been federally scheduled as a CV.  Now it is federally non-controlled.  There are a handful of states that have it scheduled as a controlled substance.  

https://www.drugtopics.com/view/dea-deschedules-antiepileptic-cbd-oral-solution-epidiolex

Controlled StatusState
CIVLouisiana
CVFlorida
CVGeorgia
CVIdaho
CVMaryland
CVMontana
CVNebraska
CVNorth Dakota
CVPuerto Rico
Controlled Substance Status of Epidiolex (all other states are non-controlled)