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Nuclear pharmacy began as institutionally-based operations within large medical centers and universities. In the early 1970s, the concept of a centralized nuclear pharmacy providing radiopharmaceuticals and adjunct medications to area hospitals, clinics and doctor’s offices emerged and quickly became the dominant business model.
Although many large research-focused and university-based institutions continue to benefit from onsite nuclear pharmacies, they are often not viable profit centers, and instead provide customized services specific to their immediate location without a primary focus on material efficiencies.
Alternatively, centralized nuclear pharmacies specialize in servicing multiple customers within their geographic markets while driving cost control, material efficiencies and broad product access for the direct benefit of their customers.
What is a nuclear pharmacist?
Nuclear pharmacists are members of the nuclear medicine team and specialize in the procurement, compounding, quality assurance, dispensing, distribution and development of radiopharmaceuticals.
In addition, nuclear pharmacists assist in the monitoring of patient outcomes and provide information and consultation regarding health and safety issues.
A detailed description of the expected knowledge and competencies for a nuclear pharmacist can be found within the BPS Content Outline for the Nuclear Pharmacy Specialty Certification Exam.
The role of a nuclear pharmacist
As members of the nuclear medicine team, nuclear pharmacists specialize in the procurement, compounding, quality assurance, dispensing, distribution, and development of radiopharmaceuticals. In addition, nuclear pharmacists assist in the monitoring of patient outcomes and provide information and consultation regarding health and safety issues. A detailed description of the expected knowledge and competencies for a nuclear pharmacist can be found within the BPS Content Outline for the Nuclear Pharmacy Specialty Certification Exam.
In addition to specialized pharmacy practice knowledge, nuclear pharmacists are called upon to become experts in aseptic technique, radiation safety, regulatory compliance and radiation detection and measurement equipment. They must also have a strong understanding of complex logistical and supply chain structures. Nuclear pharmacy is a highly regulated, time-critical and hazardous-materials-centered practice area requiring skilled professionals at all levels.
How the nuclear pharmacy environment differs from other areas of pharmacy practices
- Nuclear pharmacists rarely, if ever, have direct patient contact. The majority of external communications take place between nuclear pharmacists and other healthcare professionals. Prescriptions are provided verbally, via fax, or through web-ordering systems. Clinical questions typically come from nuclear medicine technologists, physicians and other pharmacists.
- Nuclear pharmacists do not deal with third party insurance. Both institutionally based and centralized nuclear pharmacies provide prescription radiopharmaceuticals to other healthcare professionals for administration.
- Commercial centralized nuclear pharmacies establish pricing primarily through purchase agreements and other contractual arrangements that free the pharmacist from any day-to-day financial concerns other than the efficient use of materials and pharmacy resources. There are no cash registers to balance, and no checkout lines to staff.
- Nuclear pharmacies rarely, if ever, handle controlled substances.
- Nuclear pharmacies are secure facilities with redundant security provisions mandated by various regulatory bodies. The lack of public access and the absence of controlled substances results in a safe working environment.
- Nuclear pharmacies typically do not maintain patient profile information, fill prescriptions with refills, or deal with transferred prescriptions.
How to become a nuclear pharmacist
While nuclear pharmacy enjoys a special status as the first recognized specialty practice area, the number of practicing nuclear pharmacists remains small when compared to other practice settings. There are somewhere between one and two thousand nuclear pharmacists practicing within the industry at any given time, including positions in both centralized and other types of nuclear pharmacy operations. Of course, with such a large footprint, it should be no surprise that Cardinal Health employs more nuclear pharmacists than any other organization in the country. Cardinal Health currently has approximately 550 nuclear pharmacists within our nuclear pharmacy network, as well as in various management, sales, and corporate support roles.
What you need to practice nuclear pharmacy
To practice pharmacy, it is necessary to have a pharmacist's license for the state in question. If you wish to practice in a nuclear pharmacy setting, you must also be designated as an "Authorized Nuclear Pharmacist" by The Nuclear Regulatory Commission and/or applicable state radiation control agency.
In addition to the successful completion of the NAPLEX exam, a pharmacist must complete the following nuclear pharmacy and radiation safety training to become an authorized nuclear pharmacist.
- The candidate must participate in a minimum of 500 documented hours of hands-on experience under the direct supervision of an authorized nuclear pharmacist, within a nuclear pharmacy facility that possesses the appropriate radioactive material license(s).
- The candidate must complete 200 hours of didactic education specific to the practice setting.
Training requirements
Several options exist to obtain the required 500 hours of work experience. Most commonly these hours are provided to the candidate by the nuclear pharmacy organization that employs them, typically while paying a full salary. It is also possible to get the 500 hours as an intern prior to graduation from pharmacy school.
The didactic education is typically offered in one of three ways. A few pharmacy schools offer nuclear pharmacy elective classes that satisfy the regulatory requirements. In these cases, students who have taken at least 200 hours of nuclear pharmacy electives, and have worked as interns within licensed nuclear pharmacies, can graduate as authorized nuclear pharmacists - pending their successful completion of the NAPLEX.
A second option for obtaining the needed 200 hours of didactic education that is available to both new graduates and established pharmacists practicing in other areas is the use of an online correspondence course.
Nuclear pharmacy training program of Cardinal Health
The final avenue to authorized user didactic education is to participate in a comprehensive, company-sponsored, university-affiliated educational program. As the world's largest employer of nuclear pharmacists, this is the option that Cardinal Health has chosen for our newly hired pharmacists. Cardinal Health offers a combined distance-learning and an on-site educational experience that exceeds the minimum authorized nuclear pharmacist educational requirements. Our internal program, affiliated with The Ohio State University, includes a six-week distance learning curriculum followed by an intensive three-week on-site educational event.
Cardinal Health annually educates more authorized nuclear pharmacists than all other programs combined, including commercial and academic. Because of our dedication to a quality program, The Nuclear Regulatory Commission has awarded Cardinal Health with the unique ability to self-approve authorized users and authorized nuclear pharmacists. All other authorized user programs require the candidate to submit proof of their experience and education to a governmental agency for approval prior to being permitted to handle radiopharmaceuticals unsupervised.
Authorized user training program
Nuclear pharmacy training program of Cardinal Health
As the world's largest employer of nuclear pharmacists, this is the option that Cardinal Health has chosen for our newly hired pharmacists. Cardinal Health offers a combined distance-learning and an on-site educational experience that exceeds the minimum authorized nuclear pharmacist educational requirements. Our internal program, affiliated with The Ohio State University, includes a six-week distance learning curriculum followed by an intensive three-week on-site educational event.
Cardinal Health annually educates more authorized nuclear pharmacists than all other programs combined, including commercial and academic. Because of our dedication to a quality program, The Nuclear Regulatory Commission has awarded Cardinal Health with the unique ability to self-approve authorized users and authorized nuclear pharmacists. All other authorized user programs require the candidate to submit proof of their experience and education to a governmental agency for approval prior to being permitted to handle radiopharmaceuticals unsupervised.
Board Certification
In addition to authorized nuclear pharmacy education, many nuclear pharmacists choose to continue their development with the goal of achieving certification from The Board of Pharmaceutical Specialties (BPS). A Board Certified Nuclear Pharmacist (BCNP) brings an extra measure of quality to the hiring process with demonstrated initiative and a commitment to professional excellence. BCNP certification is also a highly visible credential to colleagues that signals an elevated level of excellence in a specialty practice, and often produces increased acceptance by the nuclear medicine community.
An exclusive group, there are currently approximately 500 board certified nuclear pharmacists in the world. Though by no means an easy process, certification proves one's commitment to the specialty practice area, and Cardinal Health is proud to employ more BCNPs than any other organization.
