Hospital-owned retail pharmacies face a unique set of vulnerabilities that often go unaddressed, leaving them at high risk for drug diversion and noncompliance. Unlike inpatient pharmacies, procedural areas, and nursing settings – retail pharmacies are often excluded from health system diversion detection programs or monitored to a lesser degree. Despite this lack of monitoring, these pharmacies still handle significant volumes of controlled substances with minimal pharmacy automation, and it is common to see Schedule III-V medications dispersed on open shelves instead of secured in locked cabinets.
To monitor controlled substances, many retail pharmacies rely on inventory reconciliation – whether using software or manual methods – to align purchased, received, and on-hand inventory. However, inventory reconciliation alone is not enough to proactively detect and address potential diversion or noncompliance. To strengthen your program, retail pharmacies should monitor these four critical analytics:
- Count Corrections
What to watch: Manual inventory adjustments, or “count corrections,” entered into the Pharmacy Management System (PMS).
While count corrections are common in retail settings, excessive or unexplained adjustments can signal deeper issues, including potential diversion or poor inventory handling practices. By trending these corrections over time, health systems can create benchmarks to establish what “normal” looks like for each retail site.
Monitoring count corrections by date, medication, and staff member helps pinpoint unusual patterns and identify when an investigation may be warranted. Tracking this metric transforms individual data points into actionable signals, shifting your approach from reactive reconciliation to proactive monitoring.
- Prescribing Patterns
What to watch: Provider-level prescribing trends, especially for controlled substances.
Although high-profile opioid prescribing cases often involve private clinics, hospital-owned retail pharmacies are not immune to suspicious prescribing. By comparing current prescribing activity to historical benchmarks, you can flag outliers, such as:
- A physician consistently prescribing beyond system norms.
- A sudden uptick in order frequency from a specific department or provider.
- Patterns of prescribing high-risk medications in higher-than-expected volumes.
Monitoring prescribing patterns helps pharmacies partner with compliance teams and medical leadership to intervene early before a potential diversion issue escalates.
- Cycle Count Compliance
What to watch: Frequency and completion of required cycle counts.
The DEA requires biennial controlled substance inventories, while many state boards of pharmacy (BOP) require annual counts or additional counts during events like a Pharmacist-in-Charge transition. Retail pharmacies should track the last completed cycle count for each medication and staff member and proactively schedule the next required count to ensure continuous compliance.
Monitoring cycle count compliance not only reduces regulatory risk but also reinforces a culture of accountability and accuracy within your retail sites.
- Excessive Dispensing
What to watch: Dispensing activity outside expected thresholds by medication, staff, and site.
Dispensing patterns that deviate from historical or system-wide benchmarks can indicate diversion risk. For example, a staff member consistently processing an unusually high volume of a specific controlled substance, or a pharmacy location with sudden increases in dispensing certain medications, should trigger review.
By analyzing dispensing metrics across medications and sites, pharmacies can distinguish between legitimate changes in prescribing trends and suspicious activity requiring intervention.
Centralizing and Automating Retail Analytics
Spotting diversion trends is challenging when reporting is fragmented across multiple retail sites or when historical data is inaccessible within your PMS. On the other hand, a centralized, system-level monitoring approach allows you to:
- Benchmark across all retail sites for a clear view of “normal.”
- Detect outliers quickly.
- Drill down by medication, staff, provider, and time period.
- Systematically conduct follow-up and document findings.
- Reduce manual tracking burdens while strengthening compliance.
ControlCheck’s retail pharmacy functionalities now include analytics and customizable reporting to monitor these critical metrics. By equipping your hospital-owned retail pharmacies with tools to track count corrections, prescribing patterns, cycle count compliance, excessive dispensing, and more, you move from relying on cumbersome inventory reconciliation to a combination of automated inventory reconciliation and proactive diversion prevention.
To see how ControlCheck can support your health system in building a stronger diversion detection and compliance program for your retail sites, request a demo today.