Pharmacist FAQs

Frequently Asked Questions for Pharmacists on Pharmacy Responsibilities For Patient-Requested Transfers

Q: What are a pharmacy's responsibilities when a patient requests a transfer?

A: On a semi-regular basis, Board staff receive calls from pharmacists raising concerns or complaints about prescription transfer practices.  Typically, the concern or complaint takes one of the following forms:  (a) the pharmacist complains that another pharmacy (or, more frequently, a particular pharmacist) refuses to transfer prescriptions upon request; (b) the pharmacist complains that another pharmacy (or pharmacist) agrees to transfer prescriptions, but takes a long time to do so; (c) the pharmacist complains that another pharmacy (or pharmacist) is “tricking” or “coercing” patients into transferring prescriptions. 

Let’s set the table.  Board of Pharmacy Rule .1806 (21 NCAC 46.1806) authorizes the transfer of prescriptions among pharmacies, and it sets forth procedural and recordkeeping requirements for doing so.  Pharmacists seldom have questions about these procedural or recordkeeping requirements.  Instead, most of the focus in these situations is one word in the rule – “permissible.”  The introductory language of Rule .1806 says that the “transfer of original prescription information for the purpose of refill dispensing is permissible between pharmacies . . . .”  Pharmacies or pharmacists who have refused to transfer a prescription typically respond to a complaint by saying that the rule makes transfers “permissible,” and not “mandatory.”  What tends to get lost in this blinkered argument is the most important factor – the patient.

Patients have the right to select their pharmacy provider.  Patients have many reasons for choosing a particular pharmacy in the first instance, or deciding that they wish to change to a different pharmacy.  Whatever those reasons, the patient is the decision maker.  A patient’s wishes must be respected not only because it’s the right thing to do, but also to avoid interruption of care that could well prove harmful to the patient. 

With this background in mind, this is how Board staff approach transfer complaints:

1.  Pharmacists are expected to consult with one another professionally and politely to resolve transfer issues.  Staff often find that the root of a transfer dispute is a personal or business conflict among pharmacists or pharmacies.  These sorts of disputes are not a reason to involve the Board, nor are they a reason to delay (or deny) a patient’s care. 
   
2. In some cases, a pharmacist alleged to have wrongly refused a transfer will state that he/she simply wants to confirm the request with the patient.  That, in and of itself, doesn’t necessarily raise an issue.  But “I’m checking with the patient” must not become a pretext for denying a transfer or delaying one to such a degree that the patient’s continuity of care is jeopardized.   And pharmacy policies and procedures that incentivize staff pharmacists to delay or deny transfers place those pharmacists, the pharmacist-manager, and the pharmacy permit in potential jeopardy.
   
3. Board staff treats a transfer complaint from a patient as a higher priority matter than a transfer complaint from a pharmacist.  This is because, as noted above, transfer complaints relayed by pharmacists are often rooted in personal or business conflicts.  Direct patient complaints are more typically rooted in potential harm resulting from interrupted drug therapy.  A patient who alerts the Board that his/her transfer request is not being honored, or is not being honored in a timely fashion, will find a ready ear and a helping hand from Board staff. 
   
4. If, after a patient complaint, neither professional consultation among the pharmacists nor informal intervention of Board staff (usually by way of a phone call to both pharmacists with a suggestion that the patient’s request be met without further delay), Board staff will open a case and pursue it as a disciplinary matter focusing on potential negligence in a pharmacist’s/pharmacy’s outright refusal to transfer or a dilatory transfer.
   
5. Pharmacies are expected to have adequate staff on hand to fulfill a patient’s transfer request in a timely fashion.   As noted in Item 2389 of the July 2019 Newsletter (http://www.ncbop.org/Newsletters/July2019.pdf), in recent months some pharmacies have abruptly closed without adequate (and legally required) notice to patients.  Predictably, this results in the pharmacy receiving the prescription files getting bombarded with transfer requests.  The pharmacist-manager of the receiving pharmacy must staff it sufficiently to accomplish timely transfers.  Failure to do so will lead to a Board staff investigation and potential discipline.
   
6. If a pharmacy or pharmacist complains to the Board that it believes a patient was “tricked” or “coerced” into transferring prescriptions, Board staff needs, at a minimum, the patient’s name and contact information and strongly prefers to receive the complaint from the patient directly.  In Board staff’s experience, most often the patient explains that he/she did authorize a transfer but was uncomfortable admitting this to his/her now-former pharmacy.  But if a patient directly alleges that he/she experienced a transfer that he/she did not authorize, that is a serious matter that could involve not only the Board of Pharmacy, but also law enforcement agencies or the North Carolina Attorney General’s office.

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