Risks Facing Pharmacists, and Their Associated Costs, Are Increasing

Pharmacists have a significant hand in patient care—from dispensing medication to compounding formulas and even administering vaccinations, a function that has been especially important over the past few years. As the role of the pharmacist expands, so do the risks pharmacists face every day.

As the role of the pharmacist expands, so do the risks pharmacists face every day. Image Credit: © photon_photo - stock.adobe.com

Healthcare Providers Service Organization and CNA recently released the third edition of the Pharmacist Professional Liability Exposure Claim Report analyzing 187 closed professional liability claims and 280 closed license defense matters that involved a pharmacist, pharmacy technician, or pharmacy covered through a CNA-insured health care business over a 5-year period (2017-2022).¹ The goal of the report is to equip pharmacists with data and tools that can help them enhance their practice and reduce their professional liability exposures.

The cost to defend license matters is increasing. The average cost of defending a complaint made against a pharmacist to their state board is $7650—a 43% increase compared to the 2018 dataset ($5349). Further, this cost has more than doubled since the 2013 dataset ($3685).

Key findings in the 2023 dataset related to licensing board complaints are:

1. Professional conduct (41.1%), medication management (29.3%), and scope of practice allegations (9.3%) reflect the highest distribution of license protection board matters.
2. Approximately 70% of license protection matters led to some type of board action against a pharmacist’s license. Common actions included probation (19%); letter of warning or reprimand (16.4%); continuing education (CE), a fine, or both (14.6%); and agreement, consent order, or stipulation (6.4%). The more severe board decisions—such as surrender of license (6.4%), suspension (3.9%), and revocation (2.9%)—were less common but can effectively end a pharmacist’s career.

Malpractice claim costs are on the rise. The average total incurred amount for a malpractice claim involving pharmacy professionals rose to $136,000—an increase of nearly 3% since 2018. Notably, claims that resolved in the $50,000 to $99,000 range represented 13.9% of all claims in the 2023 dataset compared to 7.8% in the 2018 dataset.

Compounding pharmacies tend to have higher incurred amounts. Claims associated with compounding pharmacies tend to be some of the most severe compared to other pharmacy types, with an average total incurred of $438,221. This category represents less than 10% of all claims.

The most common allegation against pharmacists is related to dispensing the wrong drug. Wrong drug-related allegations represented nearly 42% of all allegations against pharmacists and continue to be the leading allegation through the 2018 and 2023 datasets. In addition, this wrong drug category reflected a 16% increase in the average total incurred amount from $80,974 in 2018 to $94,194 in 2023.

Risk Control Recommendations

The following risk control recommendations can serve as a starting point for pharmacists seeking to evaluate and enhance their patient safety and risk management practices:

• Practice within the requirements of your state practice act, in compliance with organizational policies and procedures, and within the national standard of care.
• Document your patient care assessments, observations, communications, and actions in an objective, timely, accurate, and professional manner.
• Respond promptly to patient outcomes. Every pharmacy should have written policies and procedures for handling and responding to medication errors. Pharmacists should regularly review their organization’s policies and procedures and familiarize themselves with the specific guidance so that the process is clearly understood.
• Maintain files that may be helpful with respect to your character. Retain copies of letters of recommendation, performance evaluations, thank you letters from patients, awards, records of volunteer work, and continuing education certificates.

In Summary

Awareness and implementation of guidelines and recommendations from professional and safety organizations, governmental agencies, liability insurers, and other recognized sources serve as guidelines to continuous improvement in the goal of safer practice. This newly published updated analysis of professional liability closed claims and license protection paid matters provides insights that can enable pharmacy professionals to recognize and understand loss patterns and trends, which will help them enhance their practice, so they can provide high-quality care to patients.

About the Author

Jennifer Flynn, CPHRM, is a vice president and risk manager for Healthcare Providers Service Organization in the Healthcare Division of Aon’s Affinity Insurance Services, Inc. Jennifer can be reached at Jennifer.Flynn@aon.com.

This information is provided for general informational purposes only and is not providing individual guidance. This information is not a substitute for any workplace practices and is not establishing a standard of care.

Reference

1. Pharmacist Professional Liability Exposure Claim Report: 3rd Edition. Healthcare Providers Service Organization and CNA; 2023. Accessed September 20, 2023. https://www.hpso.com/Resources/Legal-and-Ethical-Issues/Pharmacist-Liability-Claim-Report-Third-Edition