Apply to Offer Central Fill Services
Centralized prescription processing (central fill) refers to a service one licensed pharmacy provides to another where:
an originating pharmacy receives a prescription from a patient, collects and documents relevant patient information, assesses therapeutic appropriateness, identifies and resolves drug-related problems, and provides patient care; and
a central fill pharmacy acts as an agent of the originating pharmacy to prepare and package prescription orders on the originating pharmacy’s direction.
Central Fill Pharmacy Responsibilities
Ensuring that prescriptions are prepared in accordance with the requirements of federal and provincial legislation, the Standards of Pharmacy Operation, and Standards of Practice, and the terms of the agreement with the originating pharmacy, including but not limited to, the accuracy of labelling, packaging, processing, and record keeping of the drug product preparation;
ensuring that, in addition to meeting the prescription labelling requirements set forth in the Standards of Pharmacy Operation, the prescription label also identifies that a central fill pharmacy was involved in preparing the prescription and includes the name of that pharmacy; and
ensuring that prescription delivery takes place per the requirements set forth in the Standards of Pharmacy Operation. The central fill pharmacy is responsible for maintaining the safety and integrity of the drug product, including the maintenance of the cold chain, until received by the originating pharmacy. There must be an established process in place that gives assurance to the originating pharmacy of this integrity. In situations where the central fill pharmacy delivers the drug product directly to the patient or the patient’s agent (e.g. long term care facilities), they are responsible for the safety and integrity of the drug product until it is received by the patient or agent.
Originating Pharmacy Responsibilities
receiving the prescription from the patient or the patient’s agent. All interactions with the patient, the patient’s agent, and prescribers are the responsibility of the originating pharmacy;
with the exception of a drug dispensed in a hospital pharmacy, ensuring that the patient or the patient’s agent has provided informed consent to the fact that the prescription will be processed by a central fill pharmacy and that there will be transfer of personal health information. This consent must be appropriately documented and maintained by the originating pharmacy;
meeting the requirements of federal and provincial legislation, the Standards of Pharmacy Operation, and Standards of Practice for all prescriptions, including but not limited to, collecting and documenting all relevant patient information, performing the patient assessment, reviewing all prescriptions for appropriateness, identifying and resolving drug therapy problems, providing all patient education and information and performing monitoring and follow-up;
meeting the terms of the agreement with the central fill pharmacy, including but not limited to, prescription order entry and filing and storing of all documentation relating to the prescription and the patient for a minimum of ten years as per the record keeping requirements set forth in the Standards of Pharmacy Operation;
ensuring there is a method of identifying which prescriptions were transmitted to the central fill pharmacy for processing. A copy of the prescription should be retained in the originating pharmacy; and
maintaining the safety and integrity of the drug product from the time it is received from the central fill pharmacy until it is released to the patient.
Pharmacists-in-charge can apply to offer central fill services through their account in the CPNL Pharmacy Portal.
Controlled Drugs and Substances
Centralized prescription processing of any drugs listed in the Controlled Drugs and Substances Act (e.g. narcotics, controlled drugs, benzodiazepines, and other targeted substances) and its related regulations may only be undertaken:
in compliance with the Controlled Drugs and Substances Act and its related regulations; and
if the central fill pharmacy is a licensed dealer under the Narcotic Control Regulations, CRC, c1041, the central fill pharmacy may, subject to the terms and conditions of its licence under the Narcotics Control Regulations.
Eligibility
The central fill pharmacy and the originating pharmacy must be either:
both located in Newfoundland and Labrador and be licensed by the College of Pharmacy of Newfoundland and Labrador; or
be licensed in a Canadian jurisdiction that has an agreement or formal undertaking with the College for this form of collaboration.
REQUIRED DOCUMENTATION
The following documentation is required to be submitted with the Pharmacy Authorization Application.
Policy and Procedure Manual
Policy and Procedure Manual Outline
the workflow involved in processing each prescription, including how prescriptions will be transmitted from the originating pharmacy to the central fill pharmacy and how prepared prescriptions will be returned to the originating pharmacy or delivered to the patient;
how patient confidentiality and the privacy of patient health information will be maintained and meet the requirements of federal and provincial legislation;
how the central fill pharmacy will receive requests from the originating pharmacy and maintain records of such for the purposes of filing and record keeping;
how effective two-way communication between the pharmacies on pertinent patient and prescription issues will be maintained;
how medication incidents and near-misses related to prescriptions involved in central fill prescription processing will be addressed and reported in accordance with NLPB’s Continuous Quality Improvement and Medication Incident Reporting in Community Pharmacy standards;
how prescriptions will be able to be tracked through the stages of the patient care and prescription preparation processes, including documentation of the pharmacist(s), pharmacy technician(s), and other pharmacy staff involved in the various stages of the process; and
a description of the quality assurance processes that will be implemented at each pharmacy to enable:
monitoring of the quality and integrity of the central fill program,
identification of opportunities to improve patient care, and
identification of issues that need to be reviewed and resolved.
Application
If you have obtained all the required documentation, you may apply through the College’s online pharmacy portal by following the steps below.
Click Pharmacy Portal in the Portal Login menu at the top right of the webpage.
Log into your account and, if more than one pharmacy profile is linked to your account, click the Select button next to the appropriate pharmacy profile.
Click the Pharmacy Authorization Application link on the side menu.
Click the Start button under the Pharmacy Authorization Application table.
Select “Central Fill” from the Authorization Type dropdown box.
Follow the instructions to submit the application and pay the application fee.
Completed applications may take 10-14 business days to process once all required documentation and fees are received. Applicants will be notified by email once a decision has been made.
Post-Approval Requirements
Provide a copy of the policy and procedure manual to the originating pharmacy.
A written agreement between the central fill pharmacy and the originating pharmacy that outlines the services to be provided and each pharmacy’s roles, responsibilities, and accountabilities.
Written Agreement Requirements
Must be in compliance with federal and provincial legislation, the Standards of Pharmacy Operation, and Standards of Practice.
Must be signed by the owners and pharmacists-in-charge of both the central fill pharmacy and the originating pharmacy. If the two pharmacies have common ownership, the agreement may take the form of a corporate policy.
A new agreement must be signed within seven days of any change in ownership or pharmacist-in-charge.
Must be available to College of Pharmacy of Newfoundland and Labrador upon request.