National Pharmacy Association Research Articles

How to implement a “standard of care” regulatory model for pharmacists

National pharmacy associations have increasingly explored regulation according to a “standard of care.” In such a model, pharmacists can provide a wide range of clinical services aligned with their education and training. Based on Idaho’s experience implementing this model, there are five critical steps states must take to enact a standard of care: 1) Adopt a broad definition of “practice of pharmacy;” 2) Allow elasticity for practice innovation over time; 3) Decide which limited instances still necessitate prescriptive regulation; 4) Eliminate all unnecessary regulations; and 5) Strengthen accountability for deviations from the standard of care. States wishing to adopt a standard of care approach can follow this five-step process to enhance patient care and mitigate the lag that is otherwise constant between laws and practice.

Pharmacy and Genomic Medicine: A UK-wide survey of pharmacy staff assessing their prior education, confidence and educational needs

Abstract Introduction Pharmacy teams are key in helping patients to get the most from genomic medicine.1,2 However, genomics has only recently been included in undergraduate curricula, and it has been suggested that all healthcare professionals could benefit from education in pharmacogenomics2. We surveyed pharmacy staff to gather information on previous education, current practice and future educational needs in genomics and pharmacogenomics. Aim This survey aimed to establish existing levels of education and confidence in genomics and pharmacogenomics in pharmacy staff working in any role, in any sector, across the UK, and to investigate respondents’ preferences in delivery of genomic education. Methods The survey was based on a 2021 survey of genomic knowledge among medical staff by Health Education England (HEE)3, and amended to reflect pharmacy roles and practice following discussion with pharmacy leads from the 7 NHS Genomic Medicine Service Alliances in England, and from Scotland, Wales and Northern Ireland. SmartSurvey software was used to host the survey, with data held securely. The survey was open between 1st March and 16th May 2022, and was publicised via pharmacy groups including the Royal Pharmaceutical Society, National Pharmacy Association, Local Pharmaceutical Committees, chief pharmacists networks in primary and secondary care, and social media. This work was assessed using the NHS Health Research Authority Research screening tool and judged as ‘not research’; therefore ethical approval was not required. Results 1,552 responses were received from pharmacists, pharmacy technicians, dispensers and other pharmacy staff across the UK; 68% of responses were from England, 13% from Scotland, 10% from Northern Ireland and 9% from Wales. The majority of responses (69%) were from Pharmacists, with 24% from Pharmacy Technicians and 4% from Pharmacy support workers. Only 13% of respondents had received any formal training in genomics. Most respondents felt unprepared to use genomic testing in their practice; just 8% of pharmacists (including trainees), and 1% of pharmacy technicians (including trainees) felt prepared. However, 65% of respondents thought that genomics would change their practice within the next 5 years, and over 70% of pharmacists, and 56% of pharmacy technicians, could envisage ordering, advising on, or counselling patients on genomic testing in the future after appropriate training. 29% of respondents (mainly pharmacy managers) did not currently see patients and therefore might not train personally in genomics. Discussion/Conclusion This work suggests that pharmacy teams are likely to require educational support to embrace the opportunities of genomic medicine. High survey engagement suggested that respondents were keen to make their voices heard. Pharmacists appeared more confident in their ability to advise patients on genomics than Technicians, however both groups seemed keen to receive training. One limitation is that respondents were likely interested in genomics; those with no interest may not have completed the survey. Additionally, pharmacy managers who do not see patients might not train personally in genomics, but may influence strategy for pharmacy genomics service development and delivery. National bodies should capitalise on enthusiasm across the sector to help drive pharmacy genomics services forward through education and training.

The Basis for Elimination of the Jurisprudence Examination as a Condition of Pharmacist Licensure in Idaho

Some national pharmacy associations have recently joined in advocacy for a more portable pharmacist license. One impediment to accomplishing this is the state-specific nature of the pharmacy jurisprudence examination, leading to calls for the exploration of alternatives to, or outright elimination of, such examinations. This manuscript reviews the rationale for the elimination of the pharmacy jurisprudence examination in Idaho. The Idaho Board of Pharmacy reviewed the absence of similar jurisprudence examinations in other health professions, the role schools of pharmacy and employers play in preparing pharmacists for lawful practice, and how the adoption of a “standard of care” regulatory model changed thinking about the need for a jurisprudence examination. Idaho eliminated the examination in 2018, and no evidence demonstrating a public safety impact has yet materialized, while the number of Idaho licensed pharmacists has grown at a higher rate than its border states. State boards of pharmacy are in a position to decide whether keeping the pharmacy jurisprudence examination is necessary, and this manuscript reviews key considerations for other states.

Measuring drug name similarity to prioritise the application of tall-man lettering in a computerised pharmacy dispensing system

Abstract Introduction Medicine name similarity is a contributory factor to medication errors.1 Published lists exists highlighting medicine pairs that are easily confused; locally a Look-Alike-Sound-Alike (LASA) list has expanded over time with no formal system of triage. A multipronged approach is required to address LASA risks. Tall-Man Lettering (TML) is one intervention that uses uppercase lettering for the dissimilarities in look-alike drug names to alert staff to the risk of error.1 For greatest impact, it should be reserved for pairs with the highest risk for patient safety. Aim This study aimed to use Levenshtein Distance (LD), Bigram (Bi) and Trigram (Tri) methods to prioritise medicine pairs for TML in the Pharmacy dispensing system. Objectives were to: Produce a comprehensive list of medicines pairs; Establish normalised thresholds from LD, Bi and Tri to prioritise medicine pairs for TML; and, measure drug name similarity using validated software2 applying LD, Bi and Tri to medication pairs as a method of triage for orthographic assessment. Methods Approval was obtained by the Trust Pharmacy Research Committee. The need for ethical submission was waived. A LASA list was developed combining medicine name pairs from National Pharmacy Association list3, historical local list and internal incidents where medicine name confusion was cited. Duplicated, branded and non-stock pairs were excluded. A literature search was undertaken to identify published thresholds for accuracy and sensitivity of the methods in the measure of medicine name similarity. LD measures the minimum number of edit operations needed to transform one string into another; Bi and Tri measures the frequency in which two/three similar sequential strings appear within a medicine name respectively. Two assessors independently entered medicine pairs through a validated computer program2 applying LD, Bi and Tri to measure orthographic similarity. Normalised computed similarity scores (between 0-1 where higher values represent increased drug similarity) were collated on Microsoft excel for comparison against thresholds. Results Two-hundred and twelve medicine pairs were identified for review. The literature defined Bi and Tri thresholds at ≥0.3 and ≥0.1 respectively; in absence of this for LD, in-house thresholds were assessed then defined at ≥0.6. LD identified 84 medicine pairs; Bi identified 144; and Tri identified 158; none were uniquely found by LD, four by Bi and 18 by Tri. A final look-alike list with 82 medicine pairs meeting all three thresholds was identified for TML. Discussion/Conclusion Screening using all three methods led to a 61% reduction in medicines pairs allowing prioritisation of TML as an effective intervention based on look-alike pairs with the highest risk of error. This study focused on identifying orthographic similarity in ‘look-alike’ medicine pairs only. With no single intervention available to prevent LASA errors, future work can explore other interventions. In the absence of literature around normalised LD, the definition of an in-house threshold posed to be another limitation and an area where further exploratory work should be considered. As new LASA incidents arise or the Trust catalogue increases, these methods should be applied to triage their look-alike potential, confirming if TML is an appropriate intervention.

An audit on patient safety in a community pharmacy using DATIX: reporting near misses

Abstract Introduction Pharmacy contractors are required to log patient safety events and report them to a national system, currently, the Learn From Patient Safety Events (LFPSE) system.1 Professional guidance recommends that pharmacy staff record, learn, discuss, act and analyse both dispensing errors and near misses.2 The National Pharmacy Association defines a near miss as a “patient safety incident that is detected before the patient or patient’s representative is handed the dispensed prescription preventing any unintended/unexpected harm”.3 This audit from a single community pharmacy in the West Midlands region, provides baseline data on the accuracy of the DATIX system (a web-based platform) to record near miss incidents. Aim This audit aimed to establish if the number of near miss incidents recorded on a paper log equated to the number of incidents recorded on DATIX over a 4 week period. A standard of 100% was set i.e. all incidents logged on paper should be entered onto DATIX. In addition, the record of near misses in the pharmacy were analysed and compared with national data over the same four week period for the previous five years. Methods Established company near miss log sheets were used for data collection. For four weeks in November 2021, the responsible pharmacist manually recorded all near miss incidents that occurred in the pharmacy. At the end of each week, a staff member volunteered to input the data onto DATIX. At the end of the audit period, data from paper logs were compared with that recorded on DATIX. In addition, the company Head Office provided national company archived data covering the same time period for the previous five years. Data was analysed descriptively using MicroSoft Excel®. Ethical approval was not required as this was an audit. Results The percentage of near misses from log sheets input into DATIX was 72%, therefore the audit standard was not met (n = 46 on paper log versus n = 33 on DATIX). When the paper-based data collected in store over the four month period was analysed, it was found that the number of near misses recorded (n = 46) equated to 0.29% of all prescriptions dispensed. Near misses occurred most frequently on a Monday and Tuesday and least on a Wednesday. Analysis of the types of near miss incidents identified picking the wrong formulation as most frequent, followed by wrong strength and wrong medicine. Four of the errors were ‘look alike sound alike’ switches. Analysis of store data recorded in DATIX over the previous five years showed a positive trend with the number of incidents reported increasing from 19 in 2017 to 33 in 2021. This compared favourably with the average number of near miss incidents reported per store across the company; this store reported approximately double the average number year on year. Discussion/Conclusion Although a small audit in a single community pharmacy, this study highlights the importance of accurate recording of data so that lessons can be learned. Recommendations include further staff training on use of the DATIX system and a reaudit to assess impact.

Essential services: Quantifying the contributions of America’s pharmacists in COVID-19 clinical interventions

BackgroundAs the COVID-19 pandemic spread across the United States, America’s pharmacists and their teammates expanded their clinical services to help their communities from every practice setting: community and ambulatory care, inpatient, long-term care, academia, public health, and many others. ObjectivesThe objective of the study is to begin to quantify contributions of U.S. pharmacists in providing clinical interventions that mitigate and control the pandemic. These interventions span the gamut of diagnosis, prevention, treatment, and support, intervening patient by patient with vaccines, diagnostic tests, convalescent plasma, monoclonal antibodies, antiviral medications, and supportive therapies. MethodsReview of published literature, relevant web pages, and queries to national and state professional pharmacy associations and government agencies. ResultsFrom February 2020 through September 2022, pharmacists and their teammates conducted >42 million COVID-19 tests, provided >270 million vaccinations (including 8.1 million COVID-19 vaccinations for long-term care residents) within community pharmacy programs alone, and provided >50 million influenza and other vaccinations per year. Pharmacists plausibly accounted for >50% of COVID-19 vaccinations in the United States. Pharmacists prescribed, dispensed, and administered an uncounted number of antibody products and antiviral medications, including care for 5.4 million inpatients and innumerable outpatients. Using conservative estimates, pandemic interventions by pharmacists and teammates averted >1 million deaths, >8 million hospitalizations, and $450 billion in health care costs. ConclusionsPharmacists and their teammates contributed to America’s health and recovery during the COVID-19 pandemic by providing >350 million clinical interventions to >150 million people in the form of testing, parenteral antibodies, vaccinations, antiviral therapies, and inpatient care. The number of lives touched and people cared for by pharmacists continues to rise.

‘Thousands’ of pharmacies at risk of closure without additional government funding, warns report

A report commissioned by the National Pharmacy Association (NPA) has warned of a “looming pharmacy collapse” in England that could see thousands of community pharmacies close if the sector does not receive additional funding. The report, ‘Protecting UK Public Interests in NHS Community Pharmacy‘, written by David Taylor, emeritus professor of pharmaceutical and public health […]

Big four pharmacy chains call on health secretary to introduce Pharmacy First in England

The chief executives of the four biggest UK pharmacy chains, the Pharmaceutical Services Negotiating Committee (PSNC), the National Pharmacy Association, the Company Chemists’ Association and the Association of Independent Multiple Pharmacies have written to the health secretary calling on him to introduce a ‘Pharmacy First’ service in England. The letter, written to Steve Barclay, also […]

Low public awareness of community pharmacy services, survey reveals

Only half of people were aware that GPs can formally refer patients for same-day clinical advice from their local pharmacist about minor ailments, a survey from the National Pharmacy Association (NPA) has shown. A survey of just over 1,000 adults in England found that 51% knew about the GP Community Pharmacist Consultation Service (CPCS) and […]

National pharmacy associations in the commonwealth: current scenario and future needs to maximise effective contributions of the pharmacy profession towards universal health coverage

BackgroundThe Commonwealth Pharmacists Association (CPA) is a charity representing pharmacists across the Commonwealth, with the vision of empowering and collaboratively develop the profession and fully utilise the potential of pharmacists to strengthen health systems through supporting better access to, quality and use of medicines and related services. Commonwealth comprises predominantly of low- and middle-income countries, where limited data often exists in pharmacy practice. There is a recognised need across the Commonwealth to focus on developing, implementing and fully utilising pharmacy professional services to progress universal health coverage and achieve the sustainable development goals, particularly in low and middle-income countries; however, currently a knowledge gap exists in understanding the national priorities in Commonwealth nations. CPA is ideally positioned to access to these nations. The aim of this study was thus to explore the priorities and focus areas of NPAs across the Commonwealth and create evidence for a needs-based approach to inform the support that the Commonwealth pharmacists association can collaboratively and strategically provide to its members to progress towards shared goals.MethodsData were collected virtually on Zoom by conducting interviews using a semi-structured interview guide developed for this study with CPA councillors representing NPAs or their equivalents if no official body existed. An inductive, reflexive, thematic analysis was performed for data analysis.ResultsIn total, 30 councillors were interviewed from 30 low- and medium-income countries. The three main overarching priority areas identified across respective Commonwealth nations developing extended pharmacy services, improving pharmacy education, and developing and redefining the role of NPAs.ConclusionsThis novel study highlights the collective priorities for the pharmacy profession across the low and middle-income countries of the Commonwealth and the urgent need for supporting NPAs around the three identified overarching priority areas. The mapped-out priorities will inform an evidence-based approach for the CPA to better support NPAs in their mission through advocacy and practitioner development, to fully harness pharmacists’ unique skill set and maximise their contribution to progressing universal health coverage.

Pharmacist provider status: Geoprocessing analysis of pharmacy locations, medically underserved areas, populations, and health professional shortage areas

BackgroundPayment reform for pharmacists is both an important and urgent issue that needs to be addressed. Objective(s)The purpose of this paper is to assess the use of medically underserved areas, medically underserved populations, and primary care health professional shortage areas in The Pharmacy and Medically Underserved Areas Enhancement Act; and provide policy recommendations for national pharmacy associations to achieve provider status. MethodsPharmacy location addresses were determined using public domain data from the National Plan & Provider Enumeration System (NPPES) National Provider Identifier (NPI) Registry. Medically Underserved Areas/Populations (MUAs/MUPs) and Health Professional Shortage Areas (HPSAs) were gathered through public data provided by the Health Resources and Services Administration as Keyhole Markup Language (KML) files. Addresses and KML files were analyzed and mapped using the geographic information software, QGIS. A series of maps depicting the location of all MUAs/MUPs, HPSAs, HPSA facility locations, and community pharmacy locations in the U.S. were then created. These maps were overlayed, and geoprocessing tools were used to create the analysis. ResultsAfter analyzing all community pharmacy locations in the United States, we found that only 56% are located within a current MUA/MUP or HPSA. The percentage of pharmacies in healthcare underserved areas differs widely between states from the lowest in New Jersey of 18.26% of pharmacies to the highest of Guam, the Northern Mariana Islands and the Virgin Islands with 100% of pharmacies. ConclusionsAligning the pharmacist business model to be comparable to other health care professionals will ensure patients receive access to pharmacist-provided cognitive patient care services, which have higher value than product-centered services. Future attempts to recognize pharmacists as providers and allow for their reimbursement under Medicare Part B should consider strategies to increase the number of pharmacists that are eligible to participate in order to exemplify value to the public and elected leaders.

Are NHS England and NHS Improvement serious about equality, diversity and inclusion?

Despite 6% of pharmacists and 2% of pharmacy technicians being black, there is little black representation in the senior leadership positions of many pharmacy organisations. Some have a total lack of black faces in top positions, such as the Royal Pharmaceutical Society (RPS), General Pharmaceutical Council, National Pharmacy Association and Association of Pharmacy Technicians UK […]

Thousands of pharmacies in deficit could close owing to COVID-19, trade body warns government

Thousands of pharmacies could close if they do not receive extra funding to cope with COVID-19 pressures as around half were already in deficit at the start of the pandemic, the National Pharmacy Association has told the government.

Pharmacist-Patient Relationship: Commitment to Care

Pharmacist-Patient Relationship: Commitment to Care

Relationship between regulatory barriers to entry and pharmacy technician wages.

Pharmacy technicians are vital to the operation of pharmacies, and national pharmacy associations have advocated for mandatory education and training requirements. While these requirements may improve patient safety, there is a risk that laws and regulations which impose substantial education and training requirements on technicians could create barriers to entry which restrict the workforce and increase wages. This study has two objectives: 1) Describe changes in barriers to entry and wages over time; and 2) Evaluate the correlation between changing barriers to entry and pharmacy technician wages. Data come from Bureau of Labor Statistics Occupational Employment Statistics from 1997 to 2017 and National Association of Boards of Pharmacy Surveys of Pharmacy Law from 1997 to 2014. A barrier to entry was defined as adoption of registration, licensure, or certification. Wage data was adjusted to 2017 dollars using the Consumer Price Index. Ordinary least squares regression evaluated the correlation between the proportion of states which had at least one barrier to entry and wages. An interrupted time series model estimated the impact of adopting a barrier to entry on the trend in technician wages over time. Technician wages increased between 1997 and 2007 but remained flat between 2008 and 2017. A strong correlation was observed between the proportion of states which had at least one barrier to entry and technician wages (R2 = 0.93, p < 0.0001). However, the interrupted time series models did not identify any relationship between adoption of a barrier to entry and the trend in technician wages (p = 0.363). This research suggests adoption of legal/regulatory barriers to entry did not have a significant influence on the trend in technician wages over time. More research is needed to evaluate the impact of barriers to entry on non-wage practice variables, such as privileges and satisfaction.

National Perspectives Bring Unity to Pharmacy Profession

In March 2018, I had the great privilege of being inducted as the president of the National Alliance of State Pharmacy Associations (NASPA). The National Alliance of State Pharmacy Associations was founded in 1927 as the National Council of State Pharmacy Association Executives and is dedicated to enhancing the success of state pharmacy associations in their efforts to advance the profession of pharmacy. NASPA's membership is composed of state pharmacy associations and over 70 other stakeholder organizations. NASPA promotes leadership, sharing, learning, and policy exchange among its members and pharmacy leaders nationwide. Although I was just recently elected as president, I have served on the NASPA Board of Directors since 2012 and, in that time, have come to appreciate the benefits and impact NASPA serves as a resource to the profession.It is easy throughout the course of our daily work lives to get a bit of tunnel vision for the multitude of activities that are front and center on our desks. Whether it be legislation that our state pharmacy associations are advocating, curriculum and administration of our nation's schools and colleges of pharmacy, or caring for patients in the many practice settings our pharmacists are serving, we all get busy with our daily affairs.That is where the power of organizations like NASPA are realized. Its mission and purpose are to enhance the success of state pharmacy associations in their efforts to advance the profession of pharmacy. This is done through a number of modes that require an in-depth working relationship with multiple national pharmacy interest groups, including national pharmacy associations, federal agencies, and companies within the pharmacy space. This liaison role is critical for ensuring that those of us who represent the “boots on the ground” in our little corners of the world have a source of information and communication to understand the larger context of issues and opportunities that may be developing.The other importance for having an organization like NASPA participating in the national discussion is its ability to take a number of similar local issues that develop organically and to produce a national compilation of policy or practice reviews. Having a national resource that provides a perspective and linkage to other regions and stakeholders experiencing the same situation is extremely helpful as the profession looks to create common best practices around the country.There is a saying in political circles that “all politics are local.” In pharmacy, that may be true for many more subjects than just politics, and organizations like NASPA are important to ensure there is consistency and communication between local activities and national stakeholders. You may not have ever heard of NASPA, but it should be reassuring to know that there is a national organization that is championing the linkage between what is happening in your sphere of influence in pharmacy and ensuring those important issues become part of a national conversation. If you would like to learn more, please go to www.naspa.us.Jon R. Roth, MS, CAEExecutive Editor

AIHP Welcomes Board of Pharmacy Specialties as New National Pharmacy Association Sponsor

AIHP Welcomes Board of Pharmacy Specialties as New National Pharmacy Association Sponsor

Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators.

As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing home-based care. Such evidence is needed to justify the expansion of this service nationally, including consistent and adequate remuneration from governments or other payers.

Report of the APhA Stakeholder Conference on Improving Patient Access to Injectable Medications

ObjectivesThe APhA Stakeholder Conference on Improving Patient Access to Injectable Medications was convened to foster national dialogue to advance the pharmacist's role in the provision of injectable medication administration services (MAS) and related patient care services, and to establish pharmacy as a site of care for these injections. Participants discussed the distinct opportunities to maximize pharmacist scope of services, expand patient access to care, improve medication adherence, and enhance outcomes for patients on injectable medication therapies for a range of conditions. These elements were framed in terms of the practice model, the business model, and the necessary training and resources to support these activities. Data sourcesNational thought leaders within pharmacy practice, pharmacist employers, national pharmacy associations, and pharmaceutical companies were invited to participate in the conference on December 15, 2016. Participants provided perspectives on a series of structured questions around administrative and patient care issues associated with the expansion of pharmacy-based MAS. Outcomes from the discussions were supplemented with related information from the literature. SummaryThe APhA Stakeholder Conference on Improving Patient Access to Injectable Medications explored how the pharmacy profession could advance a broad-based, profession-wide practice model for MAS across a wide spectrum of therapeutic classes. There is a significant public health need to expand access to patients and make MAS a widely available, predictable, measurable, and scalable service provided by pharmacists. Conference participants discussed scope of practice, service delivery, and business model barriers. They also identified tools and resources that are necessary to overcome those barriers to advance opportunities and develop long-term, sustainable strategies to increase access to MAS from community-based pharmacist practitioners. ConclusionConference outcomes provided specific guidance around the need to develop practice support to address public health needs and effectively advance pharmacist provision of MAS and related patient care services. Key recommendations included the development of national practice guidance, standardized education and training, practice-level tools and resources, and enhanced technology solutions.

Engagement of the private pharmaceutical sector for TB control: rhetoric or reality?

BackgroundPrivate-sector retail drug outlets are often the first point of contact for common health ailments, including tuberculosis (TB). Systematic reviews on public-private mix (PPM) interventions for TB did not perform in-depth reviews specifically on engaging retail drug outlets and related stakeholders in the pharmaceutical sector. Our objective was to better understand the extent to which the World Health Organization’s (WHO) recommendation on engaging retail drug outlets has been translated into programmatic policy, strategy, and intervention in low- and middle-income countries.MethodsThe study included a content analysis of global-level documents from WHO and the Stop TB Partnership in five phases. A country-level content analysis from four data sources was performed. Global-level findings were tabulated based on key messages related to engaging retail drug outlets. Country-level findings were analyzed based on four factors and tabulated. National strategic plans for TB control from 14 countries with varying TB burdens and a strong private sector were reviewed.Results33 global-level documents and 77 full-text articles and Union World Lung Health conference abstracts were included for review. Based on experience of engaging retail drug outlets that has emerged since the mid-2000s, in 2011 WHO and the International Pharmaceutical Federation released a joint statement on promoting the engagement of national pharmacy associations in partnership with national TB programs. Only two of 14 countries’ national strategic plans had explicit statements on the need to engage their national pharmacy professional association. The success rate of referrals from retail drug outlets who visited an approved health facility for TB screening ranged from 48% in Vietnam to 86% in Myanmar. Coverage of retail drug outlets ranged from less than 5 to 9% of the universe of retail drug outlets.ConclusionsFor WHO’s End TB Strategy to be successful, scaling up retail drug outlets to increase national coverage, at least in countries with a thriving private sector, will be instrumental in accelerating the early detection and referral of the 3 million missing TB cases. The proposed PPM pharmacy model is applicable not only for TB control but also to tackle the antimicrobial resistance crisis in these countries.