Academic Pharmacy Now: 2019 Issue 3

Academic Pharmacy

The News Magazine of the American Association of Colleges of Pharmacy

NOW

Volume 12 2019 Issue 3

Can Drug Costs Be Contained?

Pharmacists are in a position to reduce healthcare spending by helping patients manage chronic illness and medication use. 16 Also in this issue: How Cuba Handles Healthcare 5 Empowering Women to Use Medicines Responsibly 14

Pharmacists Help People Live Healthier, Better Lives.

who we are @AACPharmacy

Academic Pharmacy The News Magazine of the American Association of Colleges of Pharmacy

Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.

NOW

CEO & Publisher

Lucinda L. Maine Editorial Advisor

Lynette R. Bradley-Baker

Editorial Director

Maureen Thielemans Managing Editor

Letters to the Editor

Jane E. Rooney

We welcome your comments. Please submit all letters to the editor to communications@aacp.org.

About Academic Pharmacy Now

Academic Pharmacy Now highlights the work of AACP member pharmacy schools and faculty. The magazine is published as a membership service.

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For address changes, contact LaToya Casteel, Member Services Coordinator, at lcasteel@aacp.org.

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©2019 by the American Association of Colleges of Pharmacy.

All rights reserved. Content may not be reprinted without prior written permission.

Freelance Writer

AACP’s Professional Supporter Program Achievement Supporter

Joseph Cantlupe

Promotion Supporter

Freelance Writer

Emily Jacobs

Freelance Writer

Athena Ponushis

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Academic Pharmacy NOW  2019 Issue 3

Volume 12 2019 Issue 3

@AACPharmacy a look inside

campus connection

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Behind Cuba’s Healthcare Curtain An AACP delegation got a peek at how the past and future come together to comprise Cuba’s healthcare infrastructure.

Pharmacy Education Goes Global Shane Desselle shares his experiences creating an assessment center at the University of Pristina in Kosovo through the Fulbright Specialist Program.

community impact

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Improving Birth Control Access, Improving Lives

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A UC San Diego pharmacy professor is working to make birth control more readily available to women at pharmacies nationwide.

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Can Drug Costs Be Contained?

Lowering the cost of prescription drugs is a perennial priority. Pharmacists are in a position to help patients manage chronic illness and medication use, which can greatly reduce spending.

Extending a Hand to Caregivers A FIP report examines how pharmacists can support women caregivers and encourage appropriate medication use.

@AACPharmacy

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#PharmEd19: Put Your Career First in the Second City Connect with colleagues in Chicago and learn from experts in leadership, education and science, including keynote speaker and Pulitzer Prizewinning historian Dr. Doris Kearns Goodwin.

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community note publisher’s impact

Dear Colleagues: As the busy spring season transitions to the sometimes less frenetic days of summer, I look forward to seeing so many of you at Pharmacy Education 2019 in the heart of downtown Chicago. This will be the third time in my tenure as AACP Executive Vice President that we have met in the Windy City. Each time we have set a new attendance record!

I am truly excited that Doris Kearns Goodwin will be our opening keynote speaker.

Almost every year at Annual Meeting at least one person mentions her 1999 keynote in Boston at the kickoff of AACP’s centennial year. In their opinion, she was the best we ever had. Her new historical perspective on leadership in turbulent times is so thoughtful with lessons that all of us can apply to our work and our lives.

The primary feature in this issue of Academic Pharmacy Now is on a topic that we rarely cover: the price of medications. Recognizing that drug pricing is highly visible in the state and federal public policy arena, to not attend to how it is central to the debate about controlling healthcare spending would be a mistake. The article focuses on how pharmacists can play a role in lowering costs. This was also the focus of an opinion piece that was published almost a year ago in The Hill, a widely read policy publication by Hill staff and lobbyists from every sector. In the piece, entitled “Pharmacists can help manage drug costs if state and federal laws just let them,” I offered the following insights about drug pricing: But there is another high cost of prescription drugs often overlooked: The most expensive drug may be the one not taken, or not taken as recommended by physicians and pharmacists. The good news for patients is that they are not alone when dealing with medication challenges. Pharmacists are in a good position to assist, if state and federal laws would allow.

AACP knows that you have amazing stories to tell that validate the statement above and we have begun to collect them as part of the “Pharmacists for Healthier Lives” campaign. There are now six national and six state partners engaged in spreading the word to consumers that they will achieve and maintain better health if they fully engage the expertise and compassion of your graduates.

We will provide details about ways you can share your stories with the campaign during the Annual Meeting and via the campaign website. Don’t be shy! People love stories and we want to tell them for you.

Enjoy your summer. See you in Chicago!

Sincerely,

Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher

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campus connection

Behind Cuba’s Healthcare Curtain An AACP delegation got a peek at how the past and future come together to comprise Cuba’s healthcare infrastructure.

By Joseph A. Cantlupe A recent trip to Cuba by a group Contrasting Priorities of pharmacy university deans and “Their emphasis is basic healthcare; it’s other officials from the United States a national priority,” said Dr. Joseph revealed a country with pharmaceutiT. DiPiro, dean and Archie O. McCalcal practices rooted in the past but a ley Chair of the School of Pharmacy medical system where large numbers of at Virginia Commonwealth University. doctors provide easily accessible care “Given all the things they can spend to citizens. In a program sponsored by money on, clearly a substantial portion the American Association of Colleges goes into building an integrated sysof Pharmacy (AACP), the delegation tem, from clinics to regional to specialmet with representatives from the ty centers,” continued DiPiro, group Cuban national health system, drug de- leader and an AACP past president. velopment and the local primary care For the pharmacy academics, the clinics during a four-day tour through Cuban pharmacies represented the Havana last January. apothecaries of a different era, with a The U.S. entourage found Cuba’s relatively sparse selection of drugs, in healthcare reflected two distinct sharp contrast to the multi-dimensionworlds, its medication-dispensing al stores in the United States. Cuban pharmacies a throwback to years ago pharmacists focused on dispensing like the 1950s cars lining Havana’s essential drugs as they negotiated streets. But its universal healthcare around many drug shortages in the delivery system exemplified home country, with a surprising number of health: doctors and nurses live within naturopathic options from China or the communities and open their doors India. The pharmacies were described to all-hour care for their neighbors. as virtual drug distribution centers but did not offer widespread healthcare In between official meetings, the services such as immunization, which delegation found Cubans warm and are routinely provided by pharmacies gracious, hard working and receptive here. to their visitors to their historic homeland. They described wonderful dinners at local restaurants, for instance, in what ostensibly seemed a stress-free environment, although neighborhood signs reflected the aura of the Communist state. And yes, some visitors cruised downtown in vintage cars.

While pharmacists regularly communicate with patients, the visitors were told that those conversations may not be as wide-ranging as they are in the U.S. because the usual give-and-take questions about healthcare are referred to doctors and nurses. Indeed, Cuba

has a large number of physicians, with an estimated one provider for every 121 people, according to information provided to the delegation. Many physicians and nurses live in apartments that also serve as clinics, and they are available 24 hours a day. Physicians and nurses routinely make “house” calls to check on patients recently discharged from the hospital or for those who are physically unable to get to the clinic.

“We know that Cuba has many more primary care doctors than any other country,” said another member of the entourage, Dr. Paul Larrat, dean of the University of Rhode Island College of Pharmacy. “They devote considerable human resources to providing care and doctors are basically embedded in the neighborhoods. When something is wrong they can react quickly. They have achieved a high quality of life for their patients for the most part, which wasn’t a surprise.”

The availability of medical care in Cuba sharply contrasted to practices in the U.S., DiPiro agreed. “The number of physicians per unit of the population is very high,” he said. “They have much better access to physicians for primary care than we have.” In the United States, “it’s difficult to see a primary care provider even for routine care, and even if you have good insurance it could be weeks or months for routine types of things.”

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campus connection

Cuba’s Challenges

“Pharmacy services in Cuba in primary care are still primarily dispensingIn a country challenged with an aging oriented, as they have been for many population and serious chronic diseasyears,” said Dr. Beatriz Manzor Mitrzyk, es like cardiovascular diseases, cancer clinical assistant professor and assisand diabetes, Cuba’s emphasis is on wellness and preventative care. In most tant research scientist, University of Michigan College of Pharmacy, who is cases, that care was certainly linked to physicians and nurses, not pharmacists. writing a paper about the trip. “I think this continues because resources are “Seeing how the (Cuban) system operlimited in Cuba and the pharmacist in ates, it’s an incredibly efficient system, much more centralized than ours,” said the community setting has an important, time-consuming role managing Dr. Russell DiGate, dean of the College the supply of medications and assessing of Pharmacy and Health Sciences at St. the medication needs of the community.

John’s University. “It’s socialized and Cuba has a national health system that everybody is considered the same here. is universal, free and founded on the People are entitled to be healthy and principle of preventive medicine.” they stick to that. They spend a lot of time on the front end rather than dealWhile U.S. pharmacies can link to ing with diseases on the back end. It’s providers, hospitals and other crucial surprising how well they are doing with elements of the healthcare system the limited resources they have. It’s a through electronic medical records, lesson that preventative care can work. the Cuban pharmacists are precise in They have specific institutes that deal their own way. They use pen and paper with specific disease states.” and “take copious notes,” according Dr. Shirlette Milton, interim dean of the Texas Southern University College of Pharmacy and Health Sciences, described Cuban pharmacies and healthcare generally as having an emphasis on “naturopathic products, diet, wellness and population health. It was good to see that integrated into the culture.”

During the wide-ranging tour, the visiting pharmacy faculty discussed policy at the Cuban Ministry of Health; learned about Cuba’s pharmaceutical research network; visited the National Center for Medical Sciences and community-based clinics; and met with representatives of Cuba’s regulatory Center for State Control of Drugs and Medical Devices (its version of the Food and Drug Administration) and the University of Havana Medical School. The delegation only briefly visited pharmacies but did discuss their issues.

AACP’s Cuba delegation visited the University of Havana Medical School.

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to DiGate. For the Cuban officials, the electronic medical records were basically a curiosity.

With data perhaps moving more easily in the U.S. from the patients to pharmacists to physicians, Cuban healthcare professionals “can learn from the U.S. how we deliver clinical

information to the patient and how we follow up,” said DiPiro. “We can learn from them the importance of being personal communicators and knowing the patient.”

Moving Ahead in Research The American pharmacists were introduced to medical research and the biotechnology industry in Cuba, which is moving ahead despite the economic consequences of the half-century embargo by the United States, Mitrzyk said. She said the country’s biological programs were equipped with the latest technology “to guarantee that best practices are followed through the National Coordinating Center.”

The Cuban officials spoke about developing high-end biologics products and being involved in advanced clinical trials through a large academic and medical center in Havana. Cuba makes many of the generic medications and vaccines administered in its country. Cuba’s immunization rates have improved infant mortality in a way that “is comparable or better than in more prosperous countries,” DiPiro said. Because of high vaccination compliance, Cuba reportedly eradicated measles in 1993.

A key research project in Cuba was the

campus connection

development of Heberprot-P, a recombinant human epidermal growth factor that is injected into a diabetic wound, which appears to accelerate healing of diabetic foot ulcers and reduces amputations, according to Mitrzyk. “We visited their version of the FDA, and I was surprised at the quality of the laboratories they had there,” said Larrat. “The equipment was all first-rate, I was expecting something at a much lower level.”

country. Since shortages are prevalent, pharmacists often have to keep tabs on medication scheduling as well as drug development, specifically vaccines and biological and complementary medicine. While there is an emphasis on research, the U.S. pharmacists noted that Cuba is still hamstrung in some areas by a lack of advances in drug development.

“They have a lot of problems with drug shortages,” DiPiro said of Cuban ofThe pharmacists said that a recent ficials. The U.S. embargo dramatically partnership between the U.S. and Cuba limits the type of drugs that Cuba can was considered a first biotechnology import, and often the country relies on venture, with the effort geared toward pharmaceuticals manufactured within advancing cancer therapy development. the country and also from others such Although the Cuban pharmacists aren’t as India and China, he said. “They have using electronic medical records, the complicated supply paths to get medination has an online system that intercations.” That’s one of the reasons, the connects information centers and the visiting pharmacists said, that Cuba medical libraries in Cuba. appears to have, in certain cases, drugs that are not considered the most curDrug Shortages and Trip rent and also why the country appears Takeaways to rely on naturopathic, holistic or alternative medications.

Still, drug shortages are a constant in the country and pharmacists in Cuba “Often they may be out of certain drugs were often preoccupied with mainso management of them is important,” taining the flow of medications in the

Mitrzyk said. “The pharmacist focuses on supply and demand and letting the government know what they need.”

As the participants recalled their trip, they said both sides can learn from each other. U.S. pharmacists can appreciate the length and breadth of the socialized medical system and medical accessibility to patients. Cuba can learn about the benefits of having a teambased approach to patient care, particularly pharmacists’ relationships with other members of a healthcare team.

The pharmacy faculty who were part of AACP’s delegation offered recommendations for any future trips to Cuba. They said it would be fruitful to extend the visit beyond Havana and see clinical care in the countryside and talk to patients outside the city. They also advised future travelers to read about Cuba’s healthcare system before making such a trip, and especially to have someone in the group who speaks the language.

The group enjoyed learning about and experiencing the country’s culture.

“I’m a history buff and I really enjoyed seeing the influence of so much poetry and history and the modern artwork, the development from a bygone era,” Milton said. Mitrzyk termed the trip “very educational and emotional for me.”

A Cuban-American, Mitrzyk’s late father and grandfather were physicians in Cuba. Her family left Cuba for the U.S. in 1960. “Cubans are taught from an early age to care for themselves as part of the country’s public health mission and to be good members of society,” she said. “ I believe we were shown the best that Havana has to offer.” P Joseph A. Cantlupe is a freelance writer based in Washington, D.C.

Trip participants met with representatives from the National Center for Medical Sciences.

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Pharmacy Education Goes Global Shane Desselle shares his experiences creating an assessment center at the University of Pristina in Kosovo through the Fulbright Specialist Program.

By Athena Ponushis

Dr. Shane Desselle, professor at Touro University California College of Pharmacy and former AACP board member, has seen a push around the globe for pharmacists to take a more prominent role in public health and be more directly involved with patient care. Serving as a Fulbright Specialist Scholar in Kosovo over 19 days last July, Desselle helped inform the creation of an assessment center at the University of Pristina. He found his Fulbright experience to be exhilarating. As he took in the culture and savored the food, he knew he wanted to share his story so that in the midst of this global move to elevate pharmacy practice and education, other pharmacy scholars in the United States might take advantage of the Fulbright Specialist program, make an impact abroad and bring insights back home.

The opportunity for cultural and scholarly exchange has always appealed to Desselle, but he did not see how he could participate in the Fulbright Program, leaving his family and work for several months. Continually hearing about the compelling work Fulbright scholars were doing, he explored Fulbright further and found the specialist program, which allows academics and established professionals to engage in project-based exchanges with host institutions around the globe for two to six weeks. Desselle thought he could

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do that. “To be able to travel and share scholarly discourse and scholarly ideas with people in similar disciplines as mine in other parts of the world, while getting to experience their food and culture, learn some things about how their government works and how pharmacy works in that particular country, as well as how things are financed regarding medication use systems and policy, is extraordinarily compelling,” Desselle said.

Though it’s recommended that applicants develop a relationship with a potential host, Desselle did not.

He built his application around his strengths: being a scholar with expertise in assessment and development of mentorship programs, as well as being productive in writing, as the founding editor-in-chief of the peer-reviewed journal Research in Social and Administrative Pharmacy. During a fortuitous conversation with a fellow academic abroad, Dr. Kreshnik Hoti, vice dean for the Faculty of Medicine at the University of Pristina, Desselle casually mentioned being on the Fulbright roster. The University of Pristina was looking for someone with experience in assessment who could help the school be more productive in scholarship of teaching and learning. Hoti submitted an application for Desselle’s services and Desselle was off to Kosovo.

Building an Assessment Culture The University of Pristina is the largest university in Kosovo. The flagship university of a developing country, it’s almost entirely funded by the government. Looking to become more elite and join the upper echelon of European institutions, Pristina leaders knew they had to develop an assessment center and improve their assessment of student learning outcomes. They decided that bringing in someone from the outside would be advantageous.

The focus of Desselle’s assignment was to inform the creation of a Center for Assessment for the Faculty of Medicine at the University of Pristina (Faculty of Medicine being akin to a College of Medicine that includes the schools of medicine, pharmacy, dentistry and other allied health sciences). Once the Faculty of Medicine got the assessment center up and running, it would serve as a model for other faculty/colleges to do the same. Leadership supported the project, envisioning the eventual establishment of an assessment center at the university level. During Desselle’s first few days there, he met with the rector (basically the president or chancellor of the university) as well as with all the vice rectors and deans of other faculties. This allowed Desselle to see what was currently in place at the university and showed him how much they supported his work.

campus connection

“So here we are, we’re at a university that’s centralized, bureaucratized, resource-constrained, and yet I met with faculty and students who are doing some really interesting, theory-driven work, and that was very compelling.”

— Dr. Shane Desselle

While the university was trying to deal more perfunctory tasks, such as being with concerns over the integrity of its sequestered in a room to write quesexams, it was also trying to set a higher tions [ensuring the integrity of exams], standard regarding scholarly productiv- to higher-level cognitive and more ity of the academic staff within the Fac- engaged sorts of tasks that deal with ulty of Medicine, adding another aspect assessment,” he noted. Since his time to Desselle’s project. “A lot of people in there, Desselle said the assessment cendeveloping countries, even though they ter is taking root, as the university has have good data and so forth, tend to appointed an individual to work with publish their results in more regional the government to secure resources for journals because their research might the center. already have been conducted elsewhere, but they’re being done for the first time Attracting International in that particular country,” he said. “So Students “What I took away from the UniverI came in, among other things, to help sity of Pristina is just how passionate them leverage the research they have, change or tweak the research ideas that people can be in a university system that’s inherently centralized and buthey have to make them more acceptable on a global scale, and to design and reaucratic, how passionate its scholars are and how tremendously desirous conduct the research in a way that it they are of taking the university to the provides something novel. This might next level,” said Desselle, who specialallow them to publish the results of izes in social pharmacy and was able their studies in global and impactful to meet students working in social journals.” pharmacy and presenting their masDesselle found that the resource-conter’s thesis defenses. “So here we are, strained environment presented myriwe’re at a university that’s centralized, ad challenges, given that the institution bureaucratized, resource-constrained, has to rely on much of its revenue and, and yet I met with faculty and students to some degree, approval of its decision who are doing some really interesting, making from the government. “With a theory-driven work, and that was very few more people getting training and compelling.” becoming more versed in the language One student, Hyllore Imeri, presented and culture of assessment, and with her project on facilitating patient acsome investment in things like course management and assessment and tools, tivation among community pharmacy clients, using Internet ads and social they might be able to free up people’s media means to more actively engage time and move away from performing

Dr. Shane Desselle with University of Pristina faculty and staff; Desselle presenting at an assessment workshop; the city of Pristina.

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“Anyone ranging from medicinal chemist to pharmacy practitioner to social pharmacy scientist to pharmacologist, there’s room for everyone within our broader pharmacy discipline to be able to contribute something to the Fulbright Specialist Program.”

— Dr. Shane Desselle

patients. Given the theory-based nature of the work, quality of research and Imeri’s extraordinary English language proficiency, Desselle spoke with Imeri and Hoti, her academic advisor, about having her apply to a Ph.D. program in social pharmacy in the United Staes. Imeri was accepted into several programs and will begin her studies at the University of Mississippi in August.

Desselle will co-author a few papers to come out of Imeri’s master’s thesis. He and Hoti intend to continue publishing her work, hoping to keep working with her in a collaborative effort among the University of Mississippi, Pristina and Touro University California College of Pharmacy, where Desselle teaches.

“Just as I’ve seen in the past with students from Beijing, China, and from Mumbai, India, when the first students

from another country end up in Ph.D. programs at a particular school or two in the United States, it opens doors for others,” Desselle said. “The hope is that Hyllore will encourage other students and when they see her coming to the United States and succeeding, they will want to apply to Ph.D. studies here, as well. So it establishes a gateway for potential Ph.D. students in pharmacy, because even though we have a number of applicants from certain countries, we definitely could open the door for students from more regions around the world to at least entertain the thought of doctoral training in the United States.”

To pharmacists interested in the Fulbright Specialist Program, Desselle advises contacting a potential host institution and finding an advocate, not only for the application to be success-

ful but for the visit to be successful. He said Hoti’s advocacy was instrumental the entire time he was in Kosovo.

Academics must gain support from their universities as soon as possible, so whenever they are called upon their schedules can be flexible. Presenting a formidable application that builds trust using a strong record of publishing in a certain area is key to Fulbright application evaluators. He encourages his peers to consider the program and keep an open mind about all the places they might go. “Anyone ranging from medicinal chemist to pharmacy practitioner to social pharmacy scientist to pharmacologist, there’s room for everyone within our broader pharmacy discipline to be able to contribute something to the Fulbright Specialist Program.” P Athena Ponushis is a freelance writer based in Ft. Lauderdale, Florida.

Help Us Recognize Your Preceptors of the Year AACP is launching a search for 2019 Preceptors of the Year with the goal of providing programming, resources and tools that will enhance the professional development of adjunct/affiliate preceptors, who are key members of the educational and patient care team.

Using the online submission form, schools can identify up to 3 adjunct/affiliate preceptors to be eligible for the 2-year complimentary membership. AACP requests that one member of the Experiential Education Department completes the online submission form in order to reduce multiple submissions from an institution.

Submit your Preceptor of the Year here: http://bit.ly/2019PoY. Questions? Email membership@aacp.org.

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community impact

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community impact

Improving Birth Control Access, Improving Lives A UC San Diego pharmacy professor is working to make birth control more readily available to women at pharmacies nationwide.

By Heather Buschman, Ph.D. A woman’s ability to delay and plan for childbirth is essential to her health, as well as her education and career goals, said Dr. Sally Rafie, pharmacist at the University of California San Diego Health and assistant clinical professor at Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego. “There’s a lot of evidence that when a woman has control over when she has children, and how many, she is more likely to stay in school, earn an advanced degree and work, which in turn positively contributes to her family’s income and stability, as well as her own and her children’s mental and physical health,” she said.

tion, a woman is typically required to make an office or clinic visit, but Rafie said not everyone has the insurance, time, transportation and child care needed to get to an appointment during normal working hours. Then the woman must visit a pharmacy to fill the prescription, and insurance companies have different strategies for what’s covered. That means women often have to negotiate to get the best birth control method for them, at the best price. “And these barriers most affect women who are already socioeconomically disadvantaged, making their lives even more difficult,” Rafie said.

But in order to use birth control, a woman must be able to get what she needs in a timely and affordable manner, whether that be in the form of a pill, implant, patch, shot, intrauterine device or vaginal ring. (This may also apply to transgender or gender nonconforming/non-binary individuals, but for simplicity’s sake, we’ll just use “woman” and “she/her” in this article.)

In California and some other states, women can now obtain many forms of prescription birth control directly from a pharmacist without going to the doctor first. That’s great news, Rafie said, but pharmacies aren’t required to do So far, they are uncovering a number of it and since only some have opted into organizational and logistical challenges. the service, that puts the burden on women to find those that do. To make “For example, pharmacists need to it easier, Rafie and colleagues created be able to carve out extra time in Birth Control Pharmacies, an easy-totheir normal workflow to provide the use map that now includes more than required counseling when a woman 1,000 birth control-prescribing pharrequests emergency contraception,” macies nationwide. These grassroots Mody said. “They aren’t necessarily efforts have made Rafie a go-to expert. compensated for that extra time, and so Legislators in states that don’t yet offer the pharmacy may not have the incenbirth control prescriptions at pharmative to offer it.”

“Birth control access in this country is challenging,” Rafie said. “Most of our methods are only available with a prescription, and there are a lot of steps involved in getting and filling that prescription.” In order to get a prescrip-

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Map It

cies are reaching out for her expertise as they seek to implement new policies.

In addition to standard birth control, Rafie wants to understand the challenges that keep pharmacies from opting to provide emergency contraception, also known as the morning-after pill or Plan B. To this end, she and Dr. Sheila Mody, director of the Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences at UC San Diego Health, recently received a pilot Dissemination and Implementation (D&I) grant from the UC San Diego Altman Clinical and Translational Research Institute to survey and conduct interviews with pharmacies statewide. They are interviewing pharmacists and pharmacy technicians throughout California to assess their knowledge of emergency contraception and the barriers to prescribing it.

community impact

“If we want to improve health equity among all populations, we need to design programs that meet patients where they are and take into account the social factors that prevent equal access to healthcare. That’s reproductive justice.”

— Dr. Sally Rafie

Next, Mody and Rafie are planning a cluster randomized controlled study to determine the best way to provide pharmacies with the emergency contraception education they need, with a focus on addressing the implementation barriers identified in the survey and interviews. Some pharmacies will receive a standard emergency contraception handout, while others will receive “academic detailing,” an approach that involves face-to-face training that addresses potential logistical barriers to prescribing emergency contraception at their pharmacies.

Where the Barriers May Be the Highest

what they know, what they want, who they’d prefer to talk to about it, and the best mechanisms for receiving contraceptive information in a culturally appropriate manner.

Both Mody and Rafie are especially interested in improving birth control access in underserved and underprivileged communities. Mody, in collaboration “Sometimes it’s the little things that with Dr. Bonnie Crouthamel, a family can make a big difference,” Mody said. planning fellow, and Morgen Chalm“For example, I often hear from these iers, an M.D.-Ph.D. student at UC San women that they would feel much more Diego School of Medicine, works with comfortable talking to a doctor about the Syrian and East African refugee birth control if they had a female interwomen in San Diego to understand their preter compared to a male interpreter.” unique reproductive health needs. Mody Rafie was recently accepted as a fellow received a Howell Foundation Grant to of the Robert Wood Johnson Foundaconduct focus groups among the East tion Interdisciplinary Research Leaders African refugee women to determine Program. With this support, she will work with colleagues at UC Berkeley and the nonprofit ACT for Women and Girls in California’s Central Valley to learn about the rural community’s birth control needs and preferences for pharmacy services, as well as to understand the drivers and challenges for pharmacies in prescribing birth control.

“If we want to improve health equity among all populations, we need to design programs that meet patients where they are and take into account the social factors that prevent equal access to healthcare,” Rafie said. “That’s reproductive justice.” P

from https://www.birthcontrolpharmacies.com/

Dr. Heather Buschman is senior manager, communications and media relations, at UC San Diego Health. Reprinted with permission.

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community impact

Extending a Hand to Caregivers An FIP report examines how pharmacists can support women caregivers and encourage appropriate medication use.

By Emily Jacobs Many women around the world are caregivers at some point in their lives, often becoming the unofficial healthcare managers in their households. These responsibilities frequently involve the use of medicines, whether that means providing medication to a sick child, helping an aging parent take medicine correctly or picking up a spouse’s prescription at the pharmacy.

When female caregivers are better informed about the appropriate use of medicines, this can positively influence the health of their households and wider communities.

This idea provides the basis of “Pharmacists Supporting Women and Responsible Use of Medicines,” a recently released report from the International Pharmaceutical Federation (FIP), an organization that represents pharmacy and pharmaceutical sciences across the globe. Dr. Carmen Pena, FIP’s first female president, initiated the work during her presidency from 2014-2018. In the report, FIP addresses how pharmacists can promote gender equality and encourage appropriate medication use through the support of unpaid women caregivers. Pharmacists can positively impact these women and their communities by promoting policy changes, participating in public health programs and demonstrating compassionate care.

Women as Caregivers and Household Health Managers Women disproportionately become the unofficial health managers in their

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homes, taking on the greatest burdens of unpaid care. The FIP report found that, in the United States, women spend 50 percent more time in caregiving roles than men. Data from six African countries showed that 81 percent of informal caregivers are women.

The report also cites a 2011 survey that found that Costa Rican women spend about 70 hours per week working, of which an estimated 15 hours includes informal care.

Despite being considered a “lesser” role in many societies, unpaid caregiving has an enormous influence on homes and communities. Women are usually the ones to encourage family members to see a healthcare professional and to make sure that they take medicines as instructed. Women are most often the ones to address their children’s health needs or make medical decisions for sick or elderly family members.

Because women most often care for family health and well-being, they are usually the ones to oversee medication use in the household. Women often search for information about their children’s, spouse’s or parent’s medications and how to use them correctly. They also want knowledge and support for the proper use of medicine during pregnancy, breastfeeding and menopause.

“Women are, as we can see from data from the report, most often the person in the household that assumes the role of informal caregiver,” said Ema Paulino, FIP professional secretary

and board member, and chair of the Working Group on Women and the Responsible Use of Medicines. “Therefore, women visit pharmacies frequently, due to their proximity and accessibility, to seek information and health solutions for problems for themselves and also for other family members. The pharmacist, having this opportunity, should seek to proactively empower women in this role.”

Educating and Empowering Women The correct use of medicines in society can reduce mortality, improve quality of life and decrease overall healthcare costs. A 2012 study by the IMS Institute for Healthcare Informatics estimated that the appropriate use of medicines could save $500 billion worldwide.

Despite these benefits, however, the World Health Organization reports that only about half of patients in developed countries take their medicines correctly. That rate may be even lower in undeveloped countries.

As trusted, public-facing health providers, pharmacists are in a key position to provide female caregivers with appropriate education on the use of medicines. Pharmacists can offer and simplify health information, alter the flavor of medicine for children or adjust medication dosages during pregnancy.

Pharmacists also can make other health recommendations, such as encouraging breastfeeding, and teach women to recognize disease symptoms and risks.

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“Pharmacists have the potential to contribute as agents of women’s empowerment through supporting and promoting their education and providing them with the information they need to ensure medicines are used responsibly.” ­— Zuzana Kusynová

“Pharmacists have the potential to contribute as agents of women’s empowerment through supporting and promoting their education and providing them with the information they need to ensure medicines are used responsibly,” said Zuzana Kusynová, FIP’s lead for policy, practice and compliance and editor of the report.

This kind of support will help women more effectively apply health knowledge and use medicines safely and responsibly. This could not only improve household health but also empower women in health decisionmaking. The support a woman receives can influence the health of her children, as well as her children’s behavior and attitudes toward healthcare, the use of medicines and the importance of caregivers.

FIP originally created the report for pharmacist associations working at the local level. The data and discussion in the report can encourage pharmacy groups to create new services for women or adapt existing services to better target women. The report’s highlights of existing initiatives could help pharmacy groups create new ways to support women as caregivers, and may inform and inspire individual pharmacists.

Pharmacy schools could design curricula to highlight gender disparities in health information access and discuss how to use that information to achieve better use of medicines. “We suggest that pharmacy schools could embed the information [in the FIP report] across various elements in the course, align the course content to ‘impact in practice’ sections, and ensure the students understand the increased relevance and impact of the profession in our communities,” said FIP CEO Dr. Catherine Duggan. “FIP will support pharmacy schools with the implementation and use of the report findings across the courses and curricula for students everywhere.”

Empowering women in their caregiving and health-related decisions can improve the use of medicines across communities and countries. Supported by better health knowledge from pharmacists, empowered women caregivers may find more opportunities to be assertive in their healthcare knowledge and exert their influence. Women may become better appreciated as experienced caregivers, an appreciation that could extend to women in other roles. P

Learn More About FIP FIP is currently developing an official statement, based on information in the report, with recommendations for member organizations, governments, and individual pharmacists. To read the report, go to https://www.fip. org/files/fip/publications/Pharmacists-supporting-womenresponsible-use-medicines.pdf.

Pharmacists supporting women and responsible use of medicines Empowering informal caregivers 2018

Emily Jacobs is a freelance writer based in Toledo, Ohio.

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Can Drug Costs

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Lowering the cost of prescription drugs is a perennial priority.

Pharmacists are in a position to help patients manage chronic illness and medication use, which can greatly reduce spending.

By Jane E. Rooney Academic Pharmacy NOW  2019 Issue 3

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Given the country’s aging population and the increasing prevalence of chronic diseases, healthcare spending isn’t likely to decrease anytime soon. With the presidential election only a year away, it’s also guaranteed to be a topic that receives plenty of attention. The Centers for Medicare & Medicaid Services reported that U.S. healthcare spending increased 3.9 percent to reach $3.5 trillion, or $10,739 per person, in 2017.

Healthcare spending growth in 2017 was similar to average growth from 2008 to 2013, which preceded the faster growth experienced during the 2014-15 period that was marked by insurance coverage expansion and high rates of growth in retail prescription drug spending. A CNBC report from 2017 indicated that experts predict spending per person will reach $14,944 in 2023. Prescription drug spending, which accounted for almost one in every 10 dollars spent on healthcare in 2013, saw spending growth on account of a number of blockbuster drugs getting generic competition in 2012.

“Increasing public access to and coverage for pharmacists’ medication management services is an essential component of the formula for achieving a healthier and more productive society.

As the nation’s third largest health profession with frequent direct contact with patients, pharmacists are well situated to intervene on patients’ behalf.”

— Dr. Lucinda L. Maine

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A 2018 Washington Post article explains why drug prices have gotten so high: “In 2006, prescription drug coverage became part of Medicare, introducing a massive influx of patients with prescription drug coverage into the market. Pharmacy benefit managers (PBMs) took on an additional role for a wide range of health plans: helping plans set formularies (the terms on which patients can access drugs) and negotiating prices with drug companies. The rise in prices that followed has been dramatic. Between 2006 and 2014, prices for drugs rose by an average of 57 percent, and prices for drugs with no generic substitutes rose by 142 percent.”

The issue of drug pricing is central to the debate about how to control healthcare spending. U.S. Department of Health and Human Services Secretary Alex Azar identified drug pricing as one of four main priorities for the agency. The goal is to lower the cost of prescription drugs for all Americans and to boost transparency around price and quality.

Pharmacists, with their firsthand knowledge of pricing and insurance issues, can play a key role in reining in costs thanks to their direct access to patients and ability to provide medication management services including preventive treatment. In an op-ed in The Hill last year, AACP EVP & CEO Dr. Lucinda L. Maine wrote, “The importance of saving lives through better prevention and treatment cannot be overstated. The American Association of Colleges of Pharmacy has long advocated for legislative and regulatory changes to professional practice that would help some 200 million Americans better manage their chronic diseases so that more lives could be saved. Increasing public access to and coverage for pharmacists’ medication management services is an essential component of the formula for achieving a healthier and more productive society. As the nation’s third largest health profession with frequent direct contact with patients, pharmacists are well situated to intervene on patients’ behalf.” As the administration moves toward greater regulation, the pharmacy community can advocate for itself by touting its role in helping patients understand why medication adherence leads to better health outcomes and lower costs.

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Pharmacist-Patient Communication Key to Lowering Costs Launched in 2009 as a partnership between the University of Southern California School of Pharmacy and the USC Price School of Public Policy, the USC Leonard D. Schaeffer Center for Health Policy & Economics provides action-oriented, evidence-based analysis to inform policy to address the nation’s healthcare challenges. Dr. Dana Goldman, the center’s director and a professor at the USC School of Pharmacy, noted that the United States is spending a larger fraction of its GDP on healthcare than any other nation by a considerable amount. Drugs are one of the most visible components of that spending. “People are facing high co-payments with their prescriptions.

Everything is expensive in healthcare in some ways, but there’s this visceral response to the fact that patients are paying a disproportionate share of drug costs out of pocket,” Goldman explained.

The Trump administration is exploring how to tweak Medicare Part D and prescription drug costs. “How do you reduce costs to consumers—making sure you have reasonable coverage and out-of-pocket maximums—and then looking at how to make the supply chain more efficient? You have very expensive and sometimes rare products and it’s not clear where the rebates are going,” he said. Meanwhile, pharmacists are caught in the middle. “A good example is gag clauses,” he continued. “The market for generics is very competitive. In a lot of cases the price of the generic is actually less than the co-payment. Some pharmacists had gag clauses stating that they would not be able to tell the patients that the cost was much less. It puts them in a very

Between 2006 and 2014, prices for drugs rose by an average of 57 percent, and prices for drugs with no generic substitutes rose by 142 percent.

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awkward position. [Congress] just signed legislation that would ban that practice. That type of transparency will be very helpful to the pharmacist.”

The two bills signed into law late last year ban the use of gag clauses by PBMs and pharmacies. These clauses prohibited pharmacists from telling customers when they could save money by paying cash instead of their insurance co-payment.

With bigger players having more market power, independent pharmacists are being squeezed. “It’s a challenge to be able to secure dispensing fees and other payments that are necessary to provide the level of support patients need,” he said. “As drugs are an important part of patients’ management of chronic disease, it creates a very important role for pharmacists.

We have these practitioners who can help manage this and we need to figure how to utilize that. Looking at the scope of practice is very important because pharmacists can be a solution to this health policy conundrum.”

Goldman said pharmacists should be allowed to suggest substitutions and switch from a brand-name drug to a generic if the evidence supports it.

“My doctor doesn’t know which statin is going to be cheaper,” he pointed out. “But we know that when people pay less they’ll be more adherent. The pharmacist knows all of this information and should be able to make care recommendations.”

“The key to saving money is keeping people out of the hospital. That puts pharmacists on the front lines. They play a role in making sure patients are adherent and are on the best regimens for their condition. They are part of the solution to the high cost of treating chronic illness.”

— Dr. Dana Goldman

Dr. Inmaculada Hernandez, assistant professor, pharmacy and therapeutics, University of Pittsburgh School of Pharmacy, agrees that patients often need help navigating complicated cost and insurance issues and that affordability can be a barrier. “We need to teach students to be familiar with how the healthcare system works and how it pays for drugs so they understand if they need to deal with prior authorization, co-pays and deductibles,” she said. “We need to expose student pharmacists to the research we are doing so they serve as advocates for the profession and understand how the whole system is paying for drugs, which is also tied to how pharmacists are paid.

It’s crucial that we provide strong education in all of these areas so they can advocate for patients and also for our profession.”

More Transparency in Pricing Data Hernandez’s research examines trends in drug prices and drivers of drug price increases, including to what extent it is due to new products entering the market. She found that with brand-name drugs, year over year inflation is the main driver of rising prices. Moreover, in certain markets, the entry of new drugs increases prices rather than leading to lower costs.

“Often drug prices hit the headlines because of astronomic prices of novel therapies, however, inflation in the prices of widely used drugs also plays a very important role in rising prices, burden for payers and out-of-pocket costs,” she said. “The results are very contingent on what market we’re looking at. It also relates to the social pressure and specifics of the pharmaceutical market of each drug.”

Her research focused on pricing leads Hernandez to believe that there isn’t a single piece of regulation that can help the country control healthcare spending. “The U.S. healthcare system is very fragmented. Different mar-

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kets are subject to different financial incentives,” she pointed out. “Europe hasn’t seen large price increases, so we should look at what they are doing.

[European] countries have many policies to stop prices from going up, and it is this regulatory environment, not a single policy, which prevents price increases. It should be acknowledged, however, that most European countries have some sort of national healthcare system.” Given the fragmentation here, she added, the negotiating power is much lower, so some European policies may not be as effective in the United States.

Going forward, Hernandez said she wants to concentrate on figuring out to what extent net prices are changing compared to list prices. “Every time we present findings, we get heavy criticism because most of our research is related to list prices, but that’s the data we have,” she said. “We want to look at net pricing data. In what markets is competition happening? In what markets do list prices translate into net price increases? We need to provide transparency about what we’re paying for drugs. The current system relies heavily on rebates, but it’s hard to fix the drug pricing problem without trying to increase transparency.”

Elsewhere, research by pharmacy school faculty is focused on the value that medication brings. Goldman believes more attention should be devoted to the reimbursement side. “This move toward personalized medicine means we need to integrate economics with pharmacogenomics and epidemiology to understand who benefits from what treatment,” he said. “Pharmacy schools need to take a leadership role in saying we’re spending too much and in some cases we’re spending too little. We are undertreating some things and overtreating others.”

He sees schools starting to focus on outcomes research, which is an important part of how products are covered, priced and reimbursed globally. “It’s exciting to me that we’re starting to see these changes in the United States,” he noted. “Pharmacy schools can start to be part of the solution in figuring out which drugs to cover and who benefits. We can move away from the traditional formulary design to ensuring that patients have better outcomes.”

“We need to expose student pharmacists to the research we are doing so they serve as advocates for the profession and understand how the whole system is paying for drugs, which is also tied to how pharmacists are paid. It’s crucial that we provide strong education in all of these areas so they can advocate for patients and also for our profession.”

— Dr. Inmaculada Hernandez

Pharmacists on the Front Lines Discussions around drug pricing include taking a hard look at Medicare, which is expected to account for 18 percent of federal spending by 2028, according to the Schaeffer Center. There is a particular sense of urgency about addressing Medicare Part D, the Medicare prescription drug benefit.

A proposed plan to end kickbacks in the pharmacy distribution chain would lower the list prices of drugs in the Medicare Part D system. PBMs argue that eliminating rebates could result in higher costs for seniors who have Part D insurance. But earlier this year, Goldman and his colleague Dr. Erin Trish estimated that beneficiaries would be responsible for only a small portion of the increase (an average of $4.31 per month, which is in line with the estimate from HHS) and most would be insulated from the costs.

“The Affordable Care Act was a success in starting to close the donut hole, but with the program as a whole there was a lot of concern about making sure that plans would participate,” Goldman explained. “We set it up

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with the government providing reinsurance. In some ways you can think of it as a policy program on training wheels. It’s time to take the training wheels off. There are a lot of plans playing in the space and we need to update the features they are offering. We’ve created some perverse incentives rather than have the plans truly compete. We need to revisit it.”

As the election approaches and healthcare spending continues to be in the spotlight, Goldman urges pharmacists to emphasize their crucial role in controlling costs. “Pharmacists have access to some of the most effective tools for managing chronic illness,” he said. “The key to saving money is keeping people out of the hospital. That puts pharmacists on the front lines. They play a role in making sure patients are adherent and are on the best regimens for their condition. They are part of the solution to the high cost of treating chronic illness.”

Hernandez said there has been a lot of talk without much action when it comes to controlling costs, but she is optimistic that change is coming. “I’m hopeful we’re in the best environment for something to happen on drug prices,” she said. “Around 80 percent of the public agrees that drug prices are too high. Both political parties recognize that this is a problem that needs to be addressed. With the Senate investigation on insulin prices, we have been talking to senators and it’s interesting to see people on both sides of the aisle want to work together. So I think we’re in the greatest time to get some regulation around this.” P Jane E. Rooney is managing editor of Academic Pharmacy Now.

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@AACPharmacy

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Put Your Career First in the Second City Pharmacy Education 2019 will showcase exceptional leaders, outstanding thinkers and a profession ready to be seen on the national stage.

From leadership in turbulent times to the opioid crisis and mental health, world-renowned speakers and more than 100 member-driven programs will explore key issues facing pharmacy education and healthcare at-large, at the year’s largest gathering for academic pharmacy.

Featuring keynote speaker Dr. Doris Kearns Goodwin, experts in leadership, education and science are primed to educate and inspire at Pharmacy Education 2019, July 13–17, in Chicago.

Photo: Annie Leibovitz

Dr. Doris Kearns Goodwin At the Opening General Session, the world-renowned presidential historian Dr. Doris Kearns Goodwin, will reflect on more than 150 years of U.S. history to put into context our most recent unprecedented presidency and provide insight for today’s leaders on how to lead during turbulent times. Meet Dr. Kearns Goodwin immediately following the session, as she signs copies of her book, Leadership in Turbulent Times, available for purchase on-site.

Dr. Julie A. Johnson and Dr. Kristin Wiisanen Pharmacists are increasingly being called upon to implement precision medicine in practice, but educational and training resources are limited. At the Science Plenary, Drs. Johnson and Wiisanen will identify strategies and tools needed to prepare the future pharmacy workforce for a leadership role in precision medicine implementation.

Participate in Personal Genotyping The University of Florida College of Pharmacy will offer personal genotyping for a limited number of attendees at Pharmacy Education 2019. This service will offer insight into your personal pharmacogenomics data and provides you with innovative tools you can employ to educate your students about pharmacogenomics and precision medicine.

For only $99, you can add genotyping to your current registration— http://bit.ly/AM19Registrations—or select it as part of a new meeting registration here: http://bit.ly/NewAM19Registration.

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@AACPharmacy

Dr. Kari Mader and Dr. Andrew Morris-Singer As healthcare systems shift their focus from volume to value, academic institutions must seize opportunities to establish collaborations between pharmacists and physicians. At the Tuesday General Session, Dr. Kari Mader will not only highlight the timely value proposition of the clinician-pharmacist partnership to improve care delivery, but how to lead efforts that create broader integration of clinical pharmacists on the frontlines of primary care. Joining her will be Dr. Andrew Morris-Singer, a primary care clinician and professional community organizer.

Other Meeting Highlights: Blessings in a Backpack: 13 million children in the U.S. don’t know where their next meal will come from. AACP will be accepting supplies and donations to fill backpacks for children to receive nutritional meals over the weekends, when school meals aren’t an option.

Innovate Education and Practice in Only 10 Minutes: Recipients of Scholarship of Teaching and Learning Grants will share brief, 10-minute summaries of their winning projects.

Bark Breaks: Network with your colleagues and a few furry friends, as therapy and shelter dogs will be available for a break in the Pharmacy Education 2019 exhibit hall.

Get an Early Start on #PharmEd19 with Pre-Sessions Take advantage of exceptional pre-conference programming at the 2019 AACP Annual Meeting. But hurry, space is filling fast. Already registered, but want to add a pre-session?

That’s easy, just modify your existing registration by visiting https://my.aacp.org/Events/My-Registrations.

Administrative and Financial Officers SIG Program: This pre-session is specifically designed for those interested in key administrative issues that influence the operations of a college of pharmacy. Engage in meaningful discussions about communication and facilities planning within a college, and other responsibilities within AFO roles.

Teachers Seminar: Collaborative Team Teaching: Faculty in the health sciences are moving towards models of team teaching and team-based learning. Explore different reasons for why reintroducing material in a different context can help students learn more effectively, and the various strategies that have been shown to help students begin to develop an appreciation and understanding for why curricula should be structured this way.

Admissions Workshop: The admissions pre-session will provide PharmCAS updates, WebAdMIT training, and featured sessions on student recruitment, holistic admissions, PCAT and more. The workshop is open to any staff from your college or school of pharmacy interested in sharing ideas, developing conversations and gaining insights on all things admissions.

Early Career Faculty Program: Collaboration and Developing as a Faculty Researcher: Learn to create successful research collaborations in this early career faculty pre-session. The workshop will introduce a competency framework and tools attendees can use to assess skills and set goals for development of successful research collaborations. Meet successful faculty researchers as they share insights and strategies on individual development, mentoring and sustaining productive collaborations.

Registration is still open!

Visit aacp.org/PharmEd19 for full programming, hotel information, registration rates and more.

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AACP greatly appreciates the support from our meeting sponsors, whose contributions make this event possible: Platinum Sponsors

Educational Day Sponsor

For more than 20 years, Liaison has streamlined the process by which higher education institutions identify, recruit and enroll best-fit students. More than 5,000 programs on over 800 campuses nationwide reach prospective students, outsource administrative tasks and create exceptional experiences for applicants across the full enrollment cycle—from first interest to first day on campus— through our admissions management and enrollment marketing solutions.

Certiphi Screening is a leader in student screening, creating AACP’s centralized student screening program and helping individual schools and other fields of study build thorough, compliant student screening programs. Certiphi Screening also provides applicant screening services to top healthcare organizations.

Certiphi Screening’s applicant screening services are endorsed by the American Hospital Association.

Gold Sponsors

As healthcare in the United States shifts to a patient-centered, value-based system that rewards positive outcomes, the NACDS Foundation is researching innovative care delivery that improves patient health, system efficiency and the quality of care.

The Foundation is particularly interested in projects that are scalable and sustainable, which increase accessibility, improve chronic disease conditions, and generally improve patient outcomes.

Silver Sponsors Pharmacy

The PCAT is a specialized test that helps identify qualified applicants to pharmacy colleges. It measures general academic ability and scientific knowledge necessary for the commencement of pharmaceutical education. The PCAT is constructed specifically for colleges of pharmacy.

Rite Aid is an innovative health and wellness company. We are in a position to deliver personalized experiences to every patient, customer and associate.

Above all, we have a talented team that is dedicated to our mission of improving the health and wellness of our communities. Come grow with us!

The University of Maryland School of Pharmacy leads pharmacy education, scientific discovery, patient care, and community engagement in Maryland and beyond. It’s the home of Pharmapreneurship™, which is the School’s unyielding commitment to positioning its faculty, staff, and students to address our nation’s health care, research, policy, and societal needs.

McCreadie Group is a software solutions company serving colleges of pharmacy and residency programs globally with PharmAcademic™ & research pharmacies with Vestigo®. Pharmacy educators are choosing PharmAcademic™ to automate & streamline operations and to support the achievement & maintenance of accreditation standards & requirements.

Walmart Pharmacists are empowered to use their expertise to ensure that patients are cared for and safe, ultimately being able to live better. Pharmacists are able to spend more time providing direct patient care with the support of proprietary, best in class technology, incredible staff collaboration, and flexible schedules.

Bronze Sponsors Community Pharmacy Foundation TM

Community Pharmacy Foundation

Community Pharmacy Foundation

TM

TM

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Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org

Earn CE Credit with New Webinar Series Earlier this year AACP launched a new webinar series, Understanding CAPE, PPCP, and the EPAs for New Pharmacy Graduates, to assist faculty members in ensuring that pharmacy school graduates are prepared for the needs of patients and their caregivers in the current and future healthcare landscape.

Missed any of the first three webinars? You can listen to them now by following the links below. The final webinar, Relating the CAPE 2013 Outcomes, PPCP, and EPAs All Together, will be held on June 20 at 2:00 p.m.

• Center for the Advancement of Pharmacy Education (CAPE) 2013 Outcomes, 0.5 CEUs: http://bit.ly/CEwebinarCAPE • Pharmacists’ Patient Care Process (PPCP), 0.5 CEUs: http://bit.ly/CEwebinarPPCP • The Entrustable Professional Activities (EPAs) for New Pharmacy Graduates, 0.5 CEUs: http://bit.ly/CEwebinarEPA • Relating the CAPE 2013 Outcomes, PPCP, and EPAs All Together, 0.5 CEUs: http://bit.ly/CEwebinarFinal