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IACPRx.org/Publications | Summer 2015

MEET YOUR ROBOT HELPER 7 Hiring Tips Every Pharmacy Should Know Creating Snackable Content Moving to the Music

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M E S 4TH ANNUAL

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Join Us for Freedom’s 4th Annual Seminar in Denver, Colorado! A revolutionizing seminar with two days of education and networking with compounding industry leaders and colleagues. During this unique seminar, we will have expert speakers presenting on topics that matter most to you and your pharmacy. We will also feature a speaker panel segment which will allow you the opportunity to discuss key issues that our industry faces more in depth. The Annual Seminar will correspond with Freedom’s September (17th) CPCSI training course. What: Freedom’s 4th Annual Seminar When: Sept 18-19, 2015 Where: Denver, Colorado @ Grand Hyatt Hotel Reception: Thursday 7-10pm @ Howl at the Moon Cost: $600 / person More info at: freedomrxinc.com | 877.839.8547 Registration Closes: August 31, 2015 CPCSI Training: Sept 17, 2015 @ Grand Hyatt Hotel IACP Regional Meeting: Sept 19, 2015 (following conclusion of seminar)

Daymond John The Five S.H.A.R.K. Points: Fundamental Keys to Business and Personal Success

Jonathan Levitt Industry Updates from a Legal Perspective

Dr. Nayan Patel Future of Compounding Pharmacy

Dr. Hamid Bakhteyar Hypothyroidism and Compounding Pharmacist’s Opportunities in Patient Care

Dan Benamoz, RPh, CEO Creating Employees on Fire: How to Radically Transform Your Pharmacy for More Profit

Dr. Andy Ruiz Utilizing BHRT and How to Monitor

All ACPE accredited lectures are knowledge based activities and continuing education credit will be awarded upon completion of the activity evaluation forms.

Summer | 2015 Issue 15 IACPRx.org/Publications

Contents

IACP STAFF David G. Miller, R.Ph.

A NOTE FROM THE PUBLISHER

CREATING SNACKABLE CONTENT

7 HIRING TIPS EVERY PHARMACY SHOULD KNOW

Cynthia E. Blankenship, Esq. Dagmar Anderson

by Luke Weatherlow

Scot Maitland Jennifer L. Petska, CPhT Ashlyn Grant

by Val Holden & Kelly Gust

Michelle McMahan Macy Pruitt Teresa Roberts

MOVING TO THE MUSIC

MEET YOUR ROBOT HELPER

MODERN TECHNOLOGY TO EMPOWER THE PHARMACY PATIENT WELLNESS

by Jennifer Petska, CPhT

COMMUNICATION COMMITTEE Richard B. Moon, Pharm.D., R.Ph., FIACP, Chair

by Andrew Cole

Lisa Ashworth, BS, Pharm.D., R.Ph. Kim Hansen, R.Ph. Robert Harshbarger, III, Pharm.D. James Matthias, CPhT Linda McElhiney, Pharm.D., R.Ph., FIACP, FASHP Lauren Onsa, BA

by Todd Eury

MARKET WITH THESE UPCOMING OBSERVANCES

THE PHARMERâ€™S MARKET EXO

Andy Ruiz, Pharm.D., M.Sc., FACA Scott Wepfer, R.Ph., FIACP PHOTOGRAPHY Scot Maitland DESIGN Dianne Stone Pharmacy Marketing Quarterly is published four times per year as Spring, Summer, Fall, and Winter. Online subscriptions and print editions are available for purchase at PMQuarterly.com/magazine Pharmacy Marketing Quarterly makes all attempts to publish accurate information; however, this publication may contain technical inaccuracies or typographical errors. The reader assumes all risk concerning the suitability and accuracy of the information within this publication. Pharmacy Marketing Quarterly assumes no responsibility for and disclaims all liability for any such inaccuracies, errors or omissions in this publication and in other documents referred to within or affiliated with this publication.

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RECYCLE IT

A NOTE FROM THE PUBLISHER Welcome to the summer issue of Pharmacy Marketing Quarterly. I was on vacation not too long ago, taking a break away from technology. I’m not going to lie. It was grand. No voice mail, email, no social media. Until I got back to the office. But it’s worth it from time to time to take a complete break from technology to reconnect with yourself. In this issue, Andrew Cole shares with us a way to use technology to take one task off of your list of things to do. Namely, sending the elusive “Thank You” note. But “Thank You” notes are important. They carry a sense of value and in Meet Your Robot Helper on page 14 you’ll learn about a technology that may change your life! Speaking of changing your life, IACP’s very own Jennifer Petska has some thoughts on how the Tango helped her get out of a rut and the lessons learned that may help you! So put on your dancing shoes and glide over to page 12 for that article! It may inspire you to get out of your marketing rut. Don’t miss Luke Weatherlow’s advice to Creating Snackable Content, which is on page 6! In addition, to getting in some R&R this summer, I got a little adventurous and ate some crickets. Seriously, I did, and you can too! Check out the Pharmer’s Market on page 18. And speaking of adventure, we all know that hiring new employees is an adventure most of us don’t enjoy. So you’ll want to read 7 Hiring Tips Every Pharmacy Should Know on page 8. And rounding out our Technology issue is an article from Todd Eury of the Pharmacy Podcast on Modern Technology to Empower the Pharmacy Patient Wellness on page 16. So dive in. Read the articles. Share them with your colleagues. Discuss them. And leave us feedback on our social channels like Facebook and Twitter!

Here’s to the health of your pharmacy!

Spring 2015 | IACPRx.org/Publications

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CREATING

SNACKABLE CONTENT by Luke Weatherlow

If you only take one thing away from this article, make it this: Your social media posts should be the hors d’oeuvres and your website, the entrée. In an info-driven and media-saturated world, the most shareable content is rarely long-format. As more stories, posts, and images clamor for our attention, we spend more time plugged in, but less time taking in each bit of content. Instead of savoring a single in-depth article, most Internet users prefer to flick through several small and “snackable” posts.

Making it Catchy

From a marketing point of view, snackable content is key to gaining readership. Generating small chunks of information that are “easy to digest” is the best way to pique initial interest in your brand. Breaking it up makes it easier to read and doesn’t overwhelm viewers. Follow up that interest by having a long-format version that goes into more in-depth if you want to dive into an issue.

First, the material should be worth your readers’ time. Naturally, there’s no single metric to gauge and predict exactly what your audience wants, but it’s in your best interest to investigate. Will the content amuse them, inform them, inspire them, or help them? If none of these basic wishes are met, your post becomes unwelcome noise instead of desirable content, no matter how well it is packaged. Straight-out promotion for your business is usually uninteresting. Instead, make yourself a resource, sharing interesting industry news or writing relevant and informative commentary pieces.

Instantly Appealing Content Recent studies estimate that the human attention span is just 2.8 seconds, about the time it takes to read 140 characters. Instead of settling in to turn page after page, we scroll and click through from one headline to the next. As an example, think for a moment about what times of day you simply idle around on the Internet. For most Internet users, a good share of online reading and browsing takes place on a mobile device. Whether waiting in line at the supermarket or sitting on public transportation, mobile phone users are unlikely to engage in longer, more challenging forms of content. Therefore, the most snackable posts should be easy to access by mobile devices and easy to understand. It should come as no surprise that images, infographics, and videos regularly beat out text-only forms of content.

Spring 2015 | IACPRx.org/Publications

How you present the content is just as important as what you choose to post. Before sharing anything online, it’s worth checking whether it meets some basic shareability (or “snackability”) guidelines. There’s no need to get draconian over every single post, but successful online brands tend to internalize and live by a few basic ground rules.

Reward Your Readers’ Attention

First Impressions Count As you learn to more keenly anticipate what your readers want, focus on how you package each post. For articles, catchy headlines are key. Remember that many readers won’t stick around after the first 140 words or so. In that space, you’ll need to give your readers something sufficiently intriguing so that they stick around for more. Because those first seconds are vital, go for visual media whenever possible. In those first critical 2.8 seconds, infographics and images convey far more than a block of text.

Break Things Down When you’re brainstorming topics for posts or a great idea strikes you, give some attention to how you can best present the idea. For example, you may find that a theme you’re particularly excited about can be broken into multiple, smaller posts instead of sacrificing quality. In most cases, it’s a tough sell to ask your readers to stay the course for a long-format article. Drum up interest in your brand by releasing the series of posts over several days or weeks. There’s a reason that the snacking metaphor applies so well to online marketing. Rarely do you plan to eat an entire bag of potato chips. More likely, you enjoy eating just one, and then another, and then another. By and large, Internet readers aren’t interested in novels as blog posts. But they are hungry for quality content that connects with their interests. Adjust your online presence accordingly, and they will come back for seconds.

Luke is the Sr. Web Developer at Storey Marketing, an IACP Corporate Partner, and has worked on hundreds of websites helping businesses grow online for eight years. His focus now includes building independent pharmacy brands via the web and finding the best solutions for each individual client. IACP_2015_CCH_IJPC_HalfPg_Ad_r_Layout 1 8/12/14 3:44 PM Page 1

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IACPRx.org/Publications | Spring 2015

7 HIRING TIPS EVERY PHARMACY SHOULD KNOW by Val Holden & Kelly Gust

A pharmacy owner once told me, “If you could help me hire good staff, you would solve my biggest problem.” He didn’t say that to disparage his existing staff - there were quite a few rock stars on his team. Rather, he wanted to delve into the science of hiring more high performers, decreasing turnover and yes, reducing his chances of the occasional bad egg.

Hiring Rock Stars Your staff is an extension of yourself and has a direct impact on the level of service provided and volume of business your pharmacy is capable of managing. Your team is on the front-lines – creating the experience your business is known for and building a reputation with every script and smile. High performers can produce up to 400% more than the ‘average’ employee. https://hbr. org/2014/11/what-high-performers-want-at-work Finding (and keeping) good staff is key to your business success.

Decreasing Turn Over When you turn over a team member, regardless of whether it is your decision or theirs, there is a definitive cost. Turnover incites a loss in bandwidth, incurs hiring costs and means slow productivity while the new employee gets caught up to speed. Turnover can cost up to 20% of the salary of the impacted position. https://www.americanprogress.org/issues/labor/ report/2012/11/16/44464/there-are-significant-businesscosts-to-replacing-employees/

you see through interview politeness and truly get a handle on what the candidate will bring to the table?

Our Experiment H. D. Smith collaborated with a selection of its independent pharmacy customers to identify the traits that make pharmacy employees “awesome” at their jobs. We applied a tool used in hiring at H. D. Smith, known as a pre-hire assessment, typically administered in a survey format. A pre-hire assessment can be used to dive deeper into the candidate’s personality and behavior. It assists hiring managers in better understanding the candidate as a whole. These assessments can measure traits such as autonomy, confidence, introversion/extroversion, work pace and attention to detail. Not surprisingly, our exploration turned up some common patterns. While there are so many characteristics to consider, these four rose to the top during our exploration of what made for awesome pharmacy staff. Perhaps you can use these findings in your next hiring process to identify your next great candidate!

Teamwork

Finding good people who will stay and avoiding hires you regret ensures your pharmacy continues to operate like a well-oiled machine.

Pharmacy employees should be good at working in teams and with other people. Being cooperative, agreeable and possessing an innate desire for team harmony were consistent traits among the most awesome pharmacy employees we found. It’s not about “them” - it’s about the team! When interviewing future pharmacy staff, ask for examples of a past time when the potential candidate worked well in a group.

Reducing Bad Egg Hires

Extroversion

Have you ever hired someone and then wondered later how you misread the interview? Now you’re stuck with a bad egg employee, forced to swallow the consequences of turnover or suffer the less-than-great productivity. Your number one concern is how to avoid making the same mistake next time. What do you look for? How can

Awesome pharmacy employees also tend to be peoplepeople. The ability to communicate well with customers and demonstrate empathy for challenges and issues that pharmacy patients may be dealing with is a critical trait. These extroverts are naturally more attuned to people and often better at reading and anticipating needs. Continued on Page 11

Spring 2015 | IACPRx.org/Publications

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Continued from Page 8

Pace

4. Build an Interview Game Plan

We specifically wanted to measure the speed at which ‘awesome’ employees worked. Was the label of awesome related to the volume of work they produced?

Prepare in advance of the interview. Build a list of questions based off your ideal candidate profile. Ask the same questions of each candidate, but don’t be afraid to dive deeper if the answers produce interesting (or potentially disappointing) responses. Phrase your questions in such a way that it requires the candidate to give examples of how they have handled something in their experience. This is called behavioral interviewing. Anyone can give the right answer to an expected interview question. It’s more insightful to hear what they have done in the past – and may result in a more candid answer. Ask the candidate what questions they have for you. This will tell you a lot about what matters to them and how seriously they are taking the interview. Have a minimum of 2, if not 3, interviews. Anyone can have a good day. Watch for consistency in answers and probe deeper with each conversation.

Our finding? Not necessarily! The pace at which an employee worked seemed to depend more on the pharmacy and the uniqueness of the individual position. Some people are naturally more fast-paced and work with a sense of urgency; however they also tend to prefer variety and change. If your pharmacy or the position requires a more methodical, relaxed or steady approach, or if redundant tasks are required, be sure to ask questions about how much variety and what pace the candidate prefers during the interview. There is no perfect answer here – just be attuned to your pharmacy’s unique needs.

Preference for Structure and Process Again, this trait will vary by your unique pharmacy environment. If your pharmacy has frequent changes, growth or process changes, dive into the candidate’s experience with adapting to change. Consider someone who is more flexible with structure and tolerant of ambiguity. Other pharmacies naturally are more structured, process-driven and have long stood established procedures. In this case, you may want to explore how the candidate feels about processes. While it can seem great to hire people who want to produce change, if there is truly little opportunity or willingness to change, you may want to avoid hiring a go-getter who may get bored and move on quickly.

7 Tips For Hiring 1. Assess Your Pharmacy Take some time to consider the environment. Is it fast-paced or steady? Are there rapid changes or is it procedure driven? Now, evaluate if this is the environment you wish to continue. Are things working great or are there deficits in certain areas? Decide if you’re hiring to keep things status quo or to create change. Then go a step further. What makes your pharmacy a great place to work? Happy employees have a direct impact upon your customer service. If you’re experiencing high turnover, it’s time to decide the problem is your pharmacy or them.

2. Profile Your Ideal Candidate This sounds simple enough, but too often this step is often skipped in the rush to stem the lost productivity of a vacated position. Take some time to decide what success looks like for this role. What characteristics will they need to be successful?

3. Know How to Recruit Great fishermen know where and when the fish are biting. Successful recruitment requires the same. Don’t be afraid to scout out your competitors, professional associations, pharmacy schools and even think out of the box. Unless you’re hiring for a technical role, your next clerk may come from a completely different industry. Think creativity, then go fishing! Don’t just let job boards bring in your next catch.

5. Don’t Just Fill a Spot Take the time to find your next rock star. Don’t settle for the best candidate at the time. Wait until you have the right person for the job. Trust your instincts, watch for red flags. Your new team member can influence the existing morale, organization and culture of your company. Avoid settling for a potential bad egg.

6. Always Check References There is a perception that anyone listed as a reference is only going to say good things. But you might be surprised. Previous managers are typically honest and may provide insight beyond your discussion with the candidate. Listen to what is said and how it is said. If the reference has to choose their words carefully, consider it a red flag.

7. Make Your Final Evaluation This is where research and instincts come together to form a decision. Can the candidate do the job? Are they a long term fit? Will they be accepted? What will they need to be successful? Are they excited and passionate about the job? What motivates them?

Go and Hire Hiring isn’t a perfect science. Even these characteristics and tips won’t keep you from hiring an occasional bad egg or prevent a higher rate of turnover than you would wish. But with a little preparation, probing and patience, bringing on great new team members can become the norm of your hiring mojo.

Val Holden wields diverse background in healthcare, strategy, program development and technology. She enjoys creating solutions that differentiate organizations and providing innovative tools that make a real impact. Kelly Gust is a founding member of the Learning & Development team at H. D. Smith. She takes pride in helping people do what they do, better and influencing organizational culture through better hiring and training.

IACPRx.org/Publications | Spring 2015

MOVING TO THE MUSIC by Jennifer Petska, CPhT

Anyone who knows me knows that I love to dance. If the music moves me, I move, chair dancing, grooving in the grocery store, Two-Stepping round the dance floor, or spinning through moves in West Coast Swing. I love to dance. With that being said, I was bored. I was complacent with my skills, and I was on autopilot. Then a friend I used to dance with 15 years ago came to town to visit and we got to talking while dancing of course. He told me that he had a new passion for dance, and he lit up when he talked about it. I was curious what changed, and how that happened. He and I both have been “dancers” for about 20 years, and we followed a similar arc in our paths. We both started in Country Two-Step and then moved on to add West Coast Swing and dabbled in ballroom. About six years ago he found Tango, purely by mistake. He went to a dance studio expecting another type of class to be taught and stayed since he was already there, and the rest they say is history. As he talked about Tango with such passion, he convinced me to give it a try. I was hesitant, because I didn’t like other ballroom dances because the music didn’t move me, like swing does. Tango music is very distinctive and different, but because he was so convincing I agreed to try it. He told me, “you’ll either love me for introducing you to this, or hate me.” Tango music is the same all over the world. It is the same songbook, and the same collections from the 1920s and on, and there’s comfort in that, but every dance is different. It has different energy. It’s different because the people are different. What I find interesting is that with other styles of dance, we crave new music all the time searching for the next great song, but with Tango, you look for sameness in the music, not something new. Tango is a shared experience, not to say other dances aren’t, but this “feels” different. It is a shared energy. You feed off the other person’s energy. Tango is a global community. Most of the people I have met are from another country or speak another language fluently: Argentina, Russia, and Spain. They communicate through dance; it has no language barrier.

Spring 2015 | IACPRx.org/Publications

Tango is different. Very different from any other dance I’ve ever done before. All the dance knowledge I have does not apply here, other than: be light on your feet, follow where you are lead, stay over your axis and be in control of your body. This dance throws everything else out. It doesn’t have the thrill of fast spins or funky styling. There are no set patterns to follow, no set of moves to learn, it’s okay for our feet to touch each others, it’s okay for my feet to be tangled; it’s very freeing in a strange way. All the things that would normally be “wrong” are totally acceptable and expected. Tango is strangely subtle and nuanced. It’s a conversation without saying a word. It’s stretching my comfort level. I always play it safe and do what I know I can do well; this is a new puzzle for me to figure out. My brain can’t stop thinking about the technicalities of this dance, how to make it work, how to do it. I’m intrigued. I’m excited about it. I feel like I’m back. As I start this journey of learning to Tango, I’ll reserve judgment for now if I should thank my friend or not for the introduction, but if we are in the same town dancing together, I think I’ll have a “conversation” with him. My ennui with dance can correlate to any number of things, marketing, sales, educating others. You can get stuck in a rut and even though you enjoy those things, they don’t hold the same thrill they used to when you have success. Sometimes you have to stretch out of |your comfort zone and try something new to reignite your passion.

Jennifer is responsible for IACP membership with goals to increase all levels of membership while maintaining retention with existing members. She coordinates with other IACP Events & Education and Communications & Publications staff to promote the visibility of IACP and the IACP Foundation.

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MEET YOUR ROBOT HELPER by Andrew Cole

As a marketer, the first time we visit a prescriber’s office, we send them a thank you note promptly. When a physician writes for their first compound, we send another thank you note. We never miss a single one. Sending a thank you note is always a priority, because of this we spend more time in the pharmacy. Time is money, and as a marketer - time spent in a pharmacy is less money in your pocket. What if I told you that you could create a card on custom stationery, in your handwriting in a waiting room, in the restroom, and in the near future while driving? Thanks to a new start-up named Bond, this is all possible. Bond has combined calligraphers from around the world, software engineers, and robotic engineers to create a custom “hand written” note or card for anyone. Sending this card is as simple as sending an email. What sets Bond apart from other similar companies, is that Bond programs a robot to learn your handwriting, uses an actual pen, and the other companies simply use a printer. Do yourself a favor and check out the video at www.hellobond.com, Seeing how everything comes together is rather interesting. Bond first started curating and delivering high-end gifts for Wall Street executives with custom thank you cards included. Early customers were more enthusiastic about the correspondences than the actual gift. Bond responded and completely re-vamped their business plan. Some investors include the rapper Nas, the CEO of MakerBot, and the CEO of Goldman Sachs. Bond’s customers include Wall Street CEOs, politicians, large retailers, and financial institutions. When I talked to the Director of Sales, Mitchell Jean in May, Bond had sent more than 1,000,000 cards since they launched in November. In a 10-hour day, they are printing 500-700 correspondents.

Spring 2015 | IACPRx.org/Publications

Why use Bond? Bond takes the hassle out of sending a note. You can customize stationery that features your logo and other information you would like. Think of it as personalized stationery on demand for each member of your team. Everything is high quality including the stock of the paper, a Mont Blanc pen, and the ink. Let’s face it, the biggest part about mailing something to your prescribers is having everything you need when you are thinking about it, and having the time to do it. Bond makes it possible to send a thank you card anywhere you are with just a phone or tablet. Bond can be integrated with almost any customer relationship management software including Salesforce. With a Gmail account and the Zapier plugin, sending physical mail can be accomplished from sending an email. Zapier gives you a personal Bond in your email. Bond has hired calligraphers from all over the world to design and program different types of handwriting, which can include your own. There is a form you can fill out that will be analyzed and programmed by Bond. Then Bond’s calligraphers look at every detail of your handwriting, including spacing between letters, how the letters connect, how you space your words and where you apply pressure with the pen. The robots will make your handwriting perfectly imperfect, you could write a large number of notes and none of them will look exactly the same. Bond is so busy right now, to get your hand writing analyzed is by invitation only, takes 4-6 weeks to get processed, and costs $200. Don’t worry, there are currently 17 different types of handwriting anyone can use that range from cursive to casual print. A couple of the options for handwriting is Nikola Tesla and the CEO of Bond Sonny Caberwal.

How much you ask? $2.99 plus postage, about the price of a regular greeting card. There is the option of prepaying for a large number of greeting cards that can generate a discount. It takes 2-3 Bond’s notes to be sent to the receiver. Think of the opportunity cost you would save by “writing” a thank you card in the doctor’s office versus setting time aside to write it.

into the ability to have more than one signature on the note. This would be extremely beneficial when you want to send something from the marketer and pharmacist. Coming late 2015, Bond will release its App that allows you to dictate what you want to say. You will then receive an email to give your final approval and make any changes before submitting it.

You may be asking yourself, does the note lose its personal touch when you don’t write it. Well, as a person with horrible handwriting, a lot of times I have a tech write thank you notes for me so the doctor can read it. By doing that the note is written twice and doesn’t take up my techs valuable time. I tried Bond out to get people’s reactions. I sent a handful of notes out to some of my prescribers, customers, and family members. I spoke with Dr. Marla Wilson DPM, a friend of my pharmacy. For HIPPA regulations, I used John Doe. For the ultimate test, I sent one to my grandma.

In a world where everything is going from analog to digital, here is a company going digital to analog, and making the personal touch easier. The Director of Sales said to me that the best place he has heard Bond being used is at a restaurant’s bathroom while the salesmen were at dinner with the potential client. Mitchell also told me some of their clients have seen an increase of 40% in lead conversion rate. Some of their not-for-profits they work with have seen a $74 higher donation after using Bond’s service. Is Bond worth it? When there isn’t enough time in a day and forgetting to send a thank you card is not an option, this makes a lot of sense. I am excited about using Bond from now on, and look forward to using it for my Thank you cards after my wedding. Remember, it’s the thought that counts.

HOW DID YOU FEEL ABOUT THE QUALITY OF THE CARD? Dr. Wilson: “Very nice paper with extremely solid stock.” JD: “Everything was very clean, simple, and top of the line quality.”

GMA: “Very nice quality of the paper.” HOW DO YOU FEEL IF I TOLD YOU I HAD SOMEONE ELSE WRITE THE NOTE, BUT IT IS MY WORDS? Dr. Wilson: “Well I know how busy you are, so it doesn’t affect the meaning.”

Andrew is the Director of Business Development at the Medicine Shoppe Pharmacy in Springfield, Illinois. He has received a Bachelor of Arts degree in Media Marketing and Management from Southern Illinois University, and a Masters in Business Administration at University of Illinois. Andrew is a central Illinois native. His sales and marketing experience has come from three corporations and state government.

Customer: “Well, I figured that someone else did because the penmanship was excellent.”

GMA: “I did notice it was a little nicer handwriting than you usually have.”

DOES IT CHANGE ANYTHING, IF THAT SOMEONE ELSE WAS A ROBOT THAT USES AN ACTUAL PEN? Dr. Wilson: “It does look kind of computer generated, but not actually from a printer. Being I know you, it doesn’t change anything. If it were from a large publishing company or something like that, I would know I am just a number, and it doesn’t mean anything. The card was very sweet, thoughtful and made me feel like you value my patients.” JD: “Well that doesn’t surprise me because I know how busy you guys are, and I know that technology can make a lot of things easier.”

GMA: Well I couldn’t tell, so it doesn’t affect the thoughtfulness of the card. The conclusion is Bond uses high-quality paper, ink, and pens. The fact that it was written by someone else does not take away from the personal touch or meaning behind the correspondence, even when it is a robot who writes it. Right now, Bond is only in the United States, but plans to expand with branches in other countries. “We would put locations throughout the country so that it would be local postage,” said Mitchell Jean. Currently, you can only have one handwriting style, but Bond is looking

IACPRx.org/Publications | Spring 2015

MODERN TECHNOLOGY TO EMPOWER THE PHARMACY PATIENT WELLNESS by Todd Eury

Invest in Technology, blah, blah, blah . . . How many articles, webinars, or presentations have you observed which convey the importance of using technology and automation in your pharmacy to help increase efficiency, productivity, and profitability? It sounds nice but sometimes it seems more like a bunch of buzzwords than actual reality, and it can be frustrating.

can seem daunting. As someone who spent more than ten years consulting and counseling pharmacy owners helping them to find the right pharmacy software and automation for their businesses, I can appreciate the challenge and resentment in adopting new technologies. The bottom line is technology is supposed to enhance and support your pharmacy business not make daily operations more complicated.

There are a staggering amount of small business owners who still have not evolved their business processes past the pen, paper, and spreadsheet for everyday operations. A national small business research survey was conducted in the fall of 2014 by Yodle - an online marketing platform, that showed only about half of small businesses have websites. The survey uncovered some shocking statistics about small business owner’s non-use of technology.

A Unique and Powerful Pharmacy Software System One example of many available pharmacy software systems I recently researched is EnterpriseRx originally launched in 2006 by McKesson. EnterpriseRx is both practical and affordable and offers a pharmacy owner or management team some of the most modern workflow operational features found in some of the most modern national pharmacy chains.

Many small business owners are still not adopting modern technology and marketing approaches. Although just over one in two SMB owners (51%) use technology to help with accounting operations, this dwarfs technology utilization for appointment booking and scheduling (39%), customer relationship management (34%), point-of-sale systems (25%), and acquisition marketing (14%). Additionally, more than half of small business owners do not have a website (52%) or even measure the results of their marketing programs (56%). So, why do so many small business owners still rely on pen and paper to cover the aspects of daily operations management? One word: Habits. Independently owned pharmacies are run by entrepreneurs who are used to getting things done right away. If no one else does it; they simply do it themselves with whatever means they have at their immediate availability. Sometimes what these pharmacy owners find is a pen, paper and spreadsheets are effective regardless of their non-technological features. Pharmacy owners build a process that works and move on with their business. Spending the time and money to implement a new process and or technology into your pharmacy business 16

Spring 2015 | IACPRx.org/Publications

EnterpriseRx – hosted and customer premise hosted deployment was developed for the pharmacy operator who wants to customize workflow to maximize time with their patients by leveraging different innovative features like the auto-refill functions with an outbound calling feature to the patient when the prescription is ready base on specific perimeters. The new customizable clinical solutions features will assist in helping with patient medication adherence and enable a pharmacy to use other vendor clinical programs. The inventory control features and the product pricing features, including purchase ordering groups, helps a pharmacy save additional money per month. An example of technological advancement in McKesson’s application build out is partnerships with high-tech organizations like ForgeRock. ForgeRock – developer’s of identity technologies for online web applications and e-commerce gives a glimpse into the exciting future of pharmacy management software. Another partnership to deliver mobile technologies to independent pharmacies was formed between McKesson Pharmacy Systems and MScripts. The mobile technology provides an innovative way for patients to communicate with their pharmacies through 2-way, interactive text messaging for a wide range of phones including iPhone, Android, Windows Phone. Features

of the mobile solution include the ability for patients to refill prescriptions, receive pickup and dosage reminders, and get a complete view of their health information, while pharmacies can proactively send patients information on health clinics, drug recalls, and coupons. Giving pharmacies the flexibility to integrate different business modules into their pharmacy system is critical. Expanding pharmacy business opportunities with integrating different types of pharmacy workflow and modules is important. Software features which give the pharmacy operator flexibility - like becoming a correctional pharmacy services providers, long-term care, central fill functionality, multiple store activity load balancing, delivery tracking, and point of sale are all examples of the advanced features of EnterpriseRx. Integrating Your Pharmacy into the Changing Healthcare Model Working closer with patient wellness providers like physicians, hospital systems, and laboratory testing results are several ways the pharmacy system has expanded capabilities to keeping the pharmacy centered as the patient’s primary wellness source. Keeping your pharmacy operations team up-to-date with a news update feature presents a pharmacy operator with an easy way to communicate efficiently and consistently. Independently owned pharmacies have the advantage in positioning themselves as patient-centric wellness centers and leveraging the right technology can make all the difference in a profitable and productive operations. Your community pharmacy is already known for its exemplary service, and your community pharmacy can differentiate itself from chain drug stores because you have a personal relationship already established with your patients. Your pharmacy also has more flexibility in developing destinations within your store that can include a cross-merchandised section, quick care clinic, protein juice bar, or a variety of customer options that offer a total health, beauty, and wellness solution for any given condition. TeleHealth Technologies = Game Changer Another innovative approach, which will be considered “standard operating procedure” in 3 – 5 years of all community retail pharmacies, is offering your patients a telemedicine kiosk “doctor on demand” option located in your independent pharmacy. As healthcare providers, we need to create local “wellness destinations” and “health hubs” as an extension of hospitals and specialists’ offices: your pharmacy needs to consider developing partnerships with health systems and ACOs, and telemedicine provides a bridge for patients to leverage their community pharmacy services as local “health hubs” — for post-op, lab testing, and chronic illness exams. Offering these technology benefits to your community will enable community pharmacies to establish themselves as credible alternatives before the inevitable in-home devices become ubiquitous, as well as support providers’ desire to extend their practices outside their offices. Your competition is technology adoption, national chains, and Health-Spot like models already being implemented.

Community pharmacies must consider aggressively expanding multi-channel health benefits and become part of the “digital health ecosystem”. Patients can manage prescriptions, buy OTC items, check symptoms and schedule chats with pharmacists or visits to a local retail clinic with the major retail pharmacy websites and apps. Telemedicine represents a natural extension of this seamless experience, and independent pharmacies cannot risk being left out of this digital evolution. Things won’t change overnight, and telemedicine is far from standard operating practice within community pharmacies. But, assuming that telemedicine achieves an estimated 3.2 million patient visits by 2018 and the growth rate is cut in half to 30% a year, telemedicine patient visits would hit 20 million by 2025 — double the number of patients clinics see today and a very credible threat. An independent pharmacy located in Waynesville Ohio – called Waynesville Pharmacy isn’t waiting for the ‘community pharmacy telemedicine’ adoption rate to reach national proportions. Ken and Kyle Fields are releasing the first version of ApproConnect – a telemedicine kiosk for their patient’s simple health clinic like needs. “You don’t want to tell your customers to go to another, competing, pharmacy for these services,” Kyle Fields said. “I don’t want to tell customers to think of a pharmacy other than mine for their health needs.” This is similar to the business model for Appro Rx, which handles prescription benefits management for about 110,000 lives among 550 clients, mostly small to mid-sized businesses with 150 to 1,000 lives each. The company employs 19 out of Waynesville, OH. Fields and is investing the $100,000 in start-up costs for ApproConnect from Appro Rx. As we continue moving toward a more integrated health care delivery system, the opportunities telemedicine pose for today’s retail community pharmacies are obvious. Pharmacies cannot sit and wait, and should be considering how to integrate telemedicine into future operations, examining it from an overall strategy and differentiation standpoint. Small bets now — whether through partnerships, test pilots or other means — will provide valuable insight for future strategies and help today’s pharmacies and retail clinics avoid becoming tomorrow’s Hollywood Video or Blockbuster video tape rental outlets. Adopting a modern, affordable, and scalable pharmacy management software system like EnterpriseRx and considering an investment into Telemedicine technologies through an in-house kiosk could make all the difference in running a thriving pharmacy business far into the future.

Pittsburgh native Todd Eury has dedicated the last 10+ years helping privately owned pharmacies. He started the Pharmacy Podcast Show in 2009 - the first audio blog about the Business of Pharmacy. The Pharmacy Podcast Show and IACP have partnered to bring the compounding side of pharmacy consistent programming specifically for compounders.

IACPRx.org/Publications | Spring 2015

MARKET WITH THESE UPCOMING OBSERVANCES

August

September

October

• National Breastfeeding Month

• Healthy Aging ® Month

• Health Literacy Month

• National Immunization Awareness Month

• Fruit and Veggies— More Matters Month

• National Breast Cancer Awareness Month

• Psoriasis Awareness Month

• Head Lice Prevention Month

• National Dental Hygiene Month

September 7 Labor Day

October 15 National Latino AIDS Awareness Day

August 1 - 7 World Breastfeeding Week August 8 Happiness Happens Day August 9 - 15 National Health Center Week

September 13 Rosh Hashanah Begins September 13 National Celiac Disease Awareness Day September 18 National HIV/AIDS and Aging Awareness Day September 26 Family Health & Fitness Day USA® September 22 Yom Kippur

THE PHARMER’S MARKET EXO We ordered EXO’s 4-Bar Sampler because we couldn’t help ourselves . . . Cricket Protein? In Chocolate? Well actually Cocoa Nut, Peanut Butter & Jelly, Blueberry Vanilla, and Apple Cinnamon! It’s our pick for the Pharmer’s Market because one of the ways to market your business is to be cutting edge. We think Cricket Protein fits the bill! Plus it’s packed with protein and good for the environment! MSRP: $14.00 to $36.00 https://www.exoprotein.com/wholesale The Pharmer’s Market brings you new ideas, products and services to your pharmacy. Have a suggestion for a future Pharmer’s Market profile? Email us at Scot@IACPRx.org

Spring 2015 | IACPRx.org/Publications

October 16 World Food Day October 18 - 24 National Healthcare Quality Week October 29 National Psoriasis Day October 31 Halloween

SAVE THE DATE FOR THESE UPCOMING PROGRAMS Learn More at http://tiny.cc/IACPRxCalendarSummer

Now, IACP is your one-stop shop for all things compounding! Compounder Calendar provides a comprehensive listing of compounding events and continuing education programs offered by IACP, state pharmacy associations, national pharmacy associations, IACP corporate partners and IACP affiliates.

OCTOBER 11 NASPA Fall Meeting

SEPTEMBER 17–19 ACA: 3-Day Fundamental Compounding & Calculations

OCTOBER 10–14 National Community Pharmacy Association Annual Meeting

SEPTEMBER 17 Freedom Pharmaceuticals Inc.: CPCSI Training Course

OCTOBER 2–3 ACA: Veterinary Compounding Essentials

SEPTEMBER 1 Pharmacy Compounding: Past, Present, and Future Webinar

Location: Denver, Colorado

SEPTEMBER

AUGUST AUGUST 14–16 ACA Fall Conference AUGUST 15 The Compound Conference AUGUST 17 Letco Medical: Compounding Options for Pain, Wound & Scar AUGUST 7–8 Fagron Academy: Bio-Identical Hormone Replacement TherapyFundamentals and Clinical Applications AUGUST 19–21 Fagron Academy: Modern Pharmaceutical Compounding AUGUST 19 Webinar: 2015 OSHA Training: Bloodborne Pathogens AUGUST 23–25 Fagron Academy: Modern Pharmaceutical Compounding AUGUST 21–22 Letco Medical: Veterinary Compounding Essentials AUGUST 21–22 Letco Medical: Veterinary Compounding Essentials

SEPTEMBER 18–19 Freedom Pharmaceuticals Inc. 4th Annual Seminar SEPTEMBER 19 IACP Denver, CO Regional Education Meeting SEPTEMBER 23–25 Fagron Academy: Modern Pharmaceutical Compounding SEPTEMBER 23 ACA: Compounding for Natural Hormone Replacement SEPTEMBER 28–30 ACA: 3-Day Comprehensive Sterile Compounding

OCTOBER

OCTOBER 16–17 Letco Medical: Compounding for Natural Hormone Replacement OCTOBER 21 Fagron Academy: Modern Pharmaceutical Compounding OCTOBER 24 MEDISCA NETWORK: Preparing for a State Board of Pharmacy Compounding Practice Inspection Pro

We are currently developing the 2015-2016 calendar. If you would like your compounding related events included, send an email to Macy Pruitt at macy@iacprx.org.

SEPTEMBER 29 NASP Annual Meeting & Expo

AUGUST 27 IACP AdvanCE Webinar: Hot Button Issues on the PBM’s Radar Screen

and practice accreditation. Plus our on-going regional education programs and self-study seminars in our IACPAdvanCE library are also available. That’s all available to you as an IACP member! Without our members, we can’t continue to grow and be successful and achieve our mission of defending, protecting, promoting and advancing pharmacy compounding. As IACP’s new Director of Membership, I realized you might not be aware of the great things that the Academy of accomplishing. So, I wanted to personally invite you to reinvest in your future by joining IACP or by renewing your membership to the only professional association in pharmacy that’s dedicated to compounders. We definitely need your membership, your voice, and your dues to help us continue to grow and achieve the things you need. Visit our website to join or renew your membership at www.iacprx.org or call our office at 281-933-8400 and we can help you over the phone. Let’s get you access to our website and the valuable information contained there. It only takes a few minutes, but it’s well worth your investment in time and in your dues. We hope you join us, because we can’t do it without you. Jennifer is responsible for IACP membership with goals to increase all levels of membership while maintaining retention with existing members. She coordinates with other IACP Events & Education and Communications & Publications staff to promote the visibility of IACP and the IACP Foundation.

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IACPRx.org IACPRx.org/Publications | Summer 2015

IACP NEEDS YOU! by Jennifer Petska, CPhT

Recently, IACP was successful in having four requirements added to the 2016 Appropriations bill that will direct the FDA to recognize and permit officeuse compounding as Congress intended, and to provide clear information on enforcement actions against the use of APIs that haven’t been reviewed by the Pharmacy Compounding Advisory Committee. As well as change the draft Memorandum of Understanding, and to back off from a very restrictive proposed guidance document on the repackaging of biologics like Avastin®.

First, we had the NECC tragedy of the deaths and sickening of more than 800 patients around the country from a contaminated sterile drug. Then we battled to protect our professional and business interests from overzealous federal legislation. All during 2014, we watched as both the FDA and state legislatures and Boards of Pharmacy introduced new regulations that left most of us feeling like there was nowhere to turn. And, of course, over the past several months our patients and our physician colleagues have seen unflattering media reports. Including claims that compounding pharmacists are ripping off the government and insurance companies with $15,000 and $20,000 billings for “snake oil.

for compounding oversight back where it belongs… in the hands of the State Boards of Pharmacy.

The past 24 months have been some of the most trying times ever for compounding pharmacists.

For the most part, it seems like it’s all doom and gloom. And, believe me, IACP knows how you feel. You’re on the front lines taking care of patients and keeping your practice surviving, and hopefully growing. IACP is on the front lines working to tackle those tough issues collectively in front of the FDA, Congress, and the DEA. But there’s hope! It’s not all “doom and gloom.” In fact, over the past six months IACP has been leading the charge to make things better for compounders. In early June, Senate Bill 1406 was introduced as part of our multi- organizational FIX DQSA coalition with medical and other pharmacy associations. That bill will codify that office-use compounding IS permitted. The bill requires the FDA to recognize it as such, and back off on the punitive inspections the agency has been conducting. It also makes major changes to the dreaded Memorandum of Understanding that puts the authority

IACP successfully lobbied to pass the first state legislation that addresses inappropriate physician ownership of compounding pharmacies and the undue influence of some who “pay for play” by providing financial compensation for prescriptions that they receive from prescribers they detailed. This bill is already being looked at as a model in other states as well. We aggressively defended compounding through extensive comments on more than six different FDA guidance documents and on the proposed revised USP <800> standards for compounding and handling of hazardous drugs. Oh, and we nominated more than 1,600 drugs to the FDA’s bulk drug list! In between all that, IACP has a new magazine Compounding Matters Quarterly, and the new IACPodcast, which is available weekly, that focuses on timely issues. Those are in addition to Pharmacy Marketing Quarterly, and our monthly on-line continuing education programs on topics ranging from FDA inspections, DEA inspections, third-party audits,

Summer 2015 | IACPRx.org/Publications

• June 5, 2005, the “Rx Mixer Visits the Beach” with Dan Fucarino as Chair • June 4, 2006, the “Rx Mixer Visits Mexico” with John Preckshot as Chair • June 8, 2007, the “Rx Mixer Visits Woodstock” with David and Diane Nicoletti as Co-Chairs • June 1, 2008, the “Rx Mixer Brings on Heroes & Heroines” with Bob and Barb Brensel as Co-Chairs • June 14, 2009 “The Seventh Inning Stretch” with Lizzie Dragon, John Preckshot and Jerrod Roberts as Co-Chairs

Last and certainly not least, we could not have this “Party with A Purpose” if it were not for the generosity of our corporate partners and the many donations made. Join us at next years Rx Mixer June 12, 2016, at the Renaissance Marriott Hotel in Washington, DC as Erin Michael and her team put together another – “Party With A Purpose” to raise funds for a good cause, having fun at the same time. The Rx Mixer Committee is in think tank mode for 2016’s theme! Also, in 2019 we will celebrate 15 years of Rx Mixer fundraising. Where will we time travel then?

• June 20, 2010 “Mardi Gras” with Chris Burgess as Chair • June 6, 2011 “Viva Las Vegas” with Chris Burgess as Chair • June 24, 2012 “Casablanca: A Night in Morocco” with Jim Paoletti and Wade Siefert as Co-Chairs • June 2, 2013 “Sunday Night Fever” with Brenda Pavlic as Chair • May 18, 2014 “The Roaring Twenties: The Compounding Age” with Erin Michael and Richard Harwood as Co-Chairs • June 7, 2015 “Rewind: Back to the 80’s” with Erin Michael and Richard Harwood as Co-Chairs

Lisa D. Ashworth, BS Pharm, RPh is the Compounding Specialist and Clinical Pharmacist at Children’s Health System of Texas. She is President of the IACP Foundation and has worked in the pharmacy industry for over 35 years. References: 2003 Annual Meeting & Compounders on Capitol Hill, An Official Publication of the International Academy of Compounding Pharmacists. 2003 Part I - History of the IACP Foundation. Compounding Matters Quarterly.

IACP_2015_CCH_IJPC_HalfPg_Ad_r_Layout 1 8/12/14 3:44 PM Page 1

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IACPRx.org/Publications | Summer 2015

PART II: HISTORY OF THE RX MIXER AND THE CELEBRATION OF 15 YEARS IN 2019 by Lisa D. Ashworth, BS Pharm, RPh

The history of how the IACP Board established the non-profit IACP Foundation in the Spring of 2003 was published in the Spring 2015 issue of Compounding Matters Quarterly. Of the $1.5 million raised in the Capital Campaign $500,000 was used to establish an endowment to support research and education for the profession of pharmacy, specifically compounding. With half a million dollars raised as seed money, the ultimate goal was to have $1 million in reserves to fund projects related to research and education related to compounding. Requests to fund projects before the application process was complete or a Request for Funding Proposal (RFP) was issued raising the question…”How do we continue to grow our money and fund projects at the same time?” While that group of around 40 pharmacists who met to establish the IACP Foundation in the summer of 2003 take their work as pharmacy owners and compounders seriously, they also like to have fun…what better way to raise money than to… Have a Party! A Party with A Purpose! And the Rx Mixer was born. In the last 11 years, hundreds of people have worked together to put on some fabulous parties to grow and sustain the endowment to fund research and educational grants. Even through some rough financial years, we have raised around $1.6 million dollars. Through the funding of over $275,000 in research and over $80,000 in educational grants; academicians, practitioners, students and patients have benefited. We are blessed to

have students attend both the Annual Compounders on Capitol Hill “CCH” meeting in Washington, DC and the Annual Educational Meeting “EduCon” which is held in conjunction with the American College of Apothecaries and American College of Veterinary Pharmacists. Students are our future, and we must train them as Yoda did with the young Luke Skywalker! In the spring issue of Compounding Matters Quarterly I stated the first “Rx Mixer“ was in 2004, actually, the planning started in 2004 with the first “A Party with A Purpose” in June of 2005. I have had the privilege to attend each of these fundraising events, purchase a few items all for a good cause - and have a good time. Leading a committee of dedicated volunteers to bring this fundraising party together is no small feat. In hotels in Washington, DC, we have time traveled to the beach, Mexico, Morocco, a baseball game, Mardi Gras, Las Vegas, celebrated Woodstock, the Roaring Twenties, the 80s, caught Sunday Night Fever and been rescued by Heroes and Heroines. A BIG THANKS TO ALL who have served on the Rx Mixer committee, helped with set-up and especially to those who have led the charge.

Summer 2015 | IACPRx.org/Publications

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Fer sure, fer sure it was the most rad Rx Mixer to date. It was like a party with 289 of dudes and betty’s from the really good part of Encino! It was solid! With your help, we raised $206,185 (worth about $92,462.50 in 1985 dollars!) You’re probably thinking “Shut up!” But I’m like No, totally.” And you’re like “SHUT UP!” And I’m like “ Seriously, it was a choice event!” Check out all the totally tubular photos online at http://tiny.cc/IACPRxMixer2015 and save the date for Rx Mixer 2016 on Sunday, June 12, 2016!

IACPRx.org/Publications | Summer 2015

THE UNITED VOICE OF COMPOUNDERS IS HEARD! by Dagmar Anderson

A special thanks to all the IACP members who participated either in person at Compounders on Capitol Hill, held, June 6-9, 2015 at the Renaissance Washington DC Downtown Hotel, or via our Virtual Hill Day -- your efforts made a HUGE impact. And a fast one as well. One of our key messages to Senators and Congressmen was that the U.S. Food and Drug Administration (FDA’s) interpretation of the 2013 Drug Quality & Security Act (DQSA) appears to ignore Congressional intent. Despite repeated invitations from IACP to speak with our CCH conference attendees, everyone at the FDA was again “unavailable” this year to attend and talk to those most impacted by the agency’s activities... and that was noticed by Congress.

they need. We are working closely with our Hill representation, federal regulatory agencies, and state boards of pharmacy to ensure that DQSA is enacted as it was intended by Congress.”

Dagmar Anderson, Vice President of Communications, oversees efforts to implement marketing strategic planning, developing and executing both internal and external communication programs that support brand positioning and the strategic goals of the organization established by the Board of Directors and IACP membership.

“Compounding pharmacists went to Washington to speak with their Senator and Congressional representatives about several issues that directly affect their patients,” says IACP President Dale Coker, RPh, FIACP. “We were particularly interested in discussing the Drug Quality and Security Act (DQSA) with our respective representation to ensure access to pharmacy compounding continues. We also emphasized the need for increased communications between the States and FDA as this legislation continues to go into effect.” IACP continues to educate patients, prescribers, pharmacists, patient advocacy groups, congressional offices, regulatory agencies, state pharmacy associations and state pharmacy boards about the vital importance of continued access to compounded medications. “These visits to Congress occurred at a particularly important time for compounding pharmacies across the country and for the patients whom they serve, says IACP Executive Vice President & CEO David G. Miller, RPh. “We believe it’s vital that patients and practitioners continue to have access to compounded medications prepared by licensed pharmacists who are following the necessary guidelines and who are helping patients and practitioners with personalized medication solutions each and every day. There currently are several issues with DQSA that we believe could detrimentally affect patients’ access to the compounded medications Summer 2015 | IACPRx.org/Publications

internal compliance team; or engage a professional licensing service company. Don’t choose the “let it slide” option – the risks are too high! The compounding industry, in particular, is under increasing scrutiny by regulators. To cure previous industry mistakes and address the public’s concerns regarding oversight, regulators will not look the other way when it comes to license compliance for compounders. Investigatory sweeps are occurring more frequently by state boards of pharmacy aimed at identifying unlicensed pharmacies operating within their states. The ramifications of a misstep when it comes to licensure can seriously impede operations. Aside from monetary penalties, cessation of operations, and potential criminal sanctions, citations also impair the morale of the businesses. These penalties can apply to both willful and ignorant violations. Compounding pharmacies have the option of establishing an internal compliance team to stay on top of their licenses or to outsource the work to licensing professionals. Many companies assign the process of obtaining business licenses to employees that have more important day-to-day duties. The licensing process can involve completing complex applications, gathering

supporting documentation from many different departments, and interacting with federal, state, and local bureaucracies. Outside licensing professionals can shepherd a business through its entire life cycle by assessing and advising on what licenses are required, aiding in the application for requisite licenses, managing and renewing the portfolio of licenses obtained and tracking changes to licensure requirements. Managing license compliance is a non-core function in most organizations despite its critical nature. The risk of something getting overlooked is significant, especially when the license management function is not housed in a specialized team. Outsourcing license compliance to a third party has proven to be a cost-effective, essential tool for a pharmacy’s back office. More stringent regulations are coming – make sure your compounding pharmacy has the right prescription for license compliance.

Shannon Kelly is an attorney and licensing professional at LicenseLogix in White Plains, NY. LicenseLogix helps companies, including pharmacies, streamline the process of securing and maintaining business licenses.

Summer 2015 | IACPRx.org/Publications

PAIN RELIEF FOR LICENSE COMPLIANCE by Shannon Kelly

Licensure is a mandatory and critical aspect of operating a compounding pharmacy. What used to be considered a niche service, compounding is now part of an expanding and heavily regulated industry. The federal government, along with state boards of pharmacy, has responded quickly to prevent another public health outbreak like we have seen in the past. Legislation has been pouring in at both the federal and state levels to correct inefficiencies in both the practices and oversight of compounding pharmacies.

consuming activity for pharmacies. Ongoing monitoring of regulatory changes is also a key function to license compliance. Compounding pharmacies are now presented with a few options for handling this ongoing compliance function: you can let it slide; establish your

Many states have also enacted additional licensure requirements for compounders. For example, Maryland and Florida have instituted the use of sterile compounding permits, requiring compounding pharmacies to obtain these permits before dispensing compounded sterile products to residents. These permits were set forth strict standards for cleanliness and sterility, such as safeguards for closed-system processing, waste disposal, employee hygiene, and air quality controls. A critical aspect of operating a compounding pharmacy is to ensure it maintains the necessary licenses and that it is operating within the scope of its licensure. This may seem like a straightforward task but with the many different licensing jurisdictions, as well as the lengthy and complex license applications, license compliance has now become a challenging and time-

IACPRx.org/Publications | Summer 2015

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IACPRx.org/Publications | Summer 2015

Here are two more: If an FDA-approved manufactured animal or human drug exists, the pharmacy may compound using bulk ingredients only if there is a change made to meet a specific individually identified animal patient under the veterinarian’s care and the pharmacist must document why the bulk compound is needed. That’s a brand new recordkeeping process that a pharmacy would need to establish and monitor. All prescriptions for a compounded preparation for which the pharmacist will use a bulk ingredient must be accompanied by a statement from the veterinarian stating that the compounded preparation produces a clinical difference for the individually identified animal patient with an explanation of what that difference is. In other words, the prescription or order you receive from a vet today may not be “valid” in the eyes of the FDA if this GFI is adopted. Even if your own state Board of Pharmacy defines a “valid” prescription without those statements and requirements. Once again, compounding pharmacists are put in the unenviable position of being between conflicting state and federal rules. It Says What? The proposed GFI document not only redefines how a veterinarian can issue a compounded prescription to a pharmacy, but it also includes sweeping new “decisions” by the FDA on other issues as well. Following its inaccurate interpretation of the DQSA on the human side, no compounder may provide an office-use preparation to a vet. Everything must be for an individually identified animal patient. Even though AMDUCA is completely silent on compounding and Congress never stated that office-use was prohibited. Pharmacists and veterinarians would be required to submit any and all adverse events associated with a compounded preparation to the FDA within 15 days. No enabling legislation from Congress authorizes that mandate and, for the first time, the traditional role of pharmacists and prescribers voluntarily submitted adverse event reports about drugs would now be compulsory. Is this FDA’s initial attempt to then apply that same mandate to the practice of compounding for humans? Perhaps the greatest example of regulatory overreach in the draft GFI is FDA’s decision to permit 503B outsourcing facilities to engage in the compounding and distribution of veterinary preparations. When

503B entities were created under the DQSA, they were specifically designed to be voluntarily registered compounders of sterile human drugs. Congress never intended nor included language in the law that permitted the compounding of any veterinary drugs by outsourcing facilities. The agency has taken a page from the DQSA and unilaterally decided to create a “list” of APIs that a 503B outsourcing facility may use in animal compounding. Without statutory authority, this list will be developed based upon nominations from practitioners and others and – though the “how” is not specified in the GFI – will be reviewed, published and enforced. So, while some APIs will be permitted for animal compounds, not all will be and not until the list is created. This is markedly similar to the DQSA approach for bulk ingredients that 503B outsourcing facilities may use for compounding. Congress never authorized that either. What’s Next? Because of the substantial policy implications of the guidance document, IACP requested that FDA and CVM extend the deadline for comments. That extension was granted formally on August 17, the same date the original comments were due. While the Academy continues to bring together pharmacists and veterinarians to respond to this troublesome GFI, every pharmacist who provides veterinary compounding services should speak up and submit comments to the public docket in November. Watch the IACP website for copies of our draft comments as well as key developments as the new November deadline approaches. Even once all the comments and input have been reviewed by the FDA, this GFI will still need to go through a finalization process that includes a subsequent publication in The Federal Register which affords another comment period before it becomes a required compliance document that pharmacists and veterinarians must follow. Already IACP has taken the concerns about the FDA’s attempts to circumvent the legislative process to Congress and it’s anticipated that both Representatives and Senators will intervene and demand answers as to how and why the agency believes it has this ability to regulate veterinary compounding practice without their authority and direction. As with the DQSA, the issuance of this veterinary compounding GFI means that collectively compounders will once again be subjected to an ongoing and lengthy process of monitoring, commenting, and adjusting their practices by the FDA. IACP will, as always, continue to aggressively defend its members’ ability to serve their patients – even the ones that woof, meow, or chirp.

David G. Miller, R.Ph., IACP’s Executive Vice President and CEO, works with our volunteer Board and leadership to set and execute the IACP agenda. Whether working on legislation on Capitol Hill, acting as compounding pharmacy’s liaison to other pharmacy and medical organizations, or defending against overzealous government regulation, his primary responsibility is always keeping the professional and proprietary business interests of IACP members first and foremost.

Summer 2015 | IACPRx.org/Publications

While that authority was granted, it came with several restrictions. Although vets were allowed to prescribe human drugs for extra-label drug use (ELDU), it required that such prescribing could only occur within the context of a valid veterinarian/client/patient relationship, that the animal’s health was threatened or that suffering or death would occur if no treatment were provided, and that the vet had to comply with FDA regulations eventually promulgated and published in 21 CFR 530. Additionally, the vet could not prescribe certain drugs that were placed by the FDA on a “do not use” list. Found in 21 CFR 530.41, the “do not use” list prohibits the use of certain medications in foodproducing animals and includes chloramphenicol, fluoroquinolones, and cephalosporins among others. The regulations developed by the FDA to carry out AMDUCA also included a section specific to compounding and described within 21 CFR 530.13. Essentially, FDA permits the ELDU compounding of drugs for animal use by a pharmacist or a vet if an approved animal or human drug isn’t available in the needed dosage form or strength, if state laws governing compounding are adhered to, and if the quantities compounded are “commensurate with the established need for compounded products (e.g., similar to that of comparable practices).”An additional requirement states that the compounder must also follow any guidance documents developed by the FDA on animal compounding. Reasonable? It seems so on the surface. Unfortunately, there was one clause within the regulations that creates problems for both veterinarians and pharmacists. That appears in 21 CFR 530.13(a) and says “[n]othing in this part shall be construed as permitting compounding from bulk drugs.” But Congress never addressed compounding in AMDUCA. The law itself is totally silent on compounding. The FDA created that prohibition in its regulation without direct authority. If that seems similar to the ongoing debate over Congressional intent within the Drug Quality and Security Act of 2013 on the ability of pharmacists to compound medications for office-use by prescribers and the FDA’s interpretation that DQSA prohibits office-use that’s because it is. It wasn’t until nine years later in July 2003 that FDA published a new Compliance Policy Guideline (CPG) for veterinary compounding. In that document, issued by FDA without first publishing a draft for public review and comment, the agency clearly stated that compounding from bulk ingredients for nonfood animals was prohibited. This is despite the fact that pharmacists and veterinarians had been and continued to need and use Active Pharmaceutical Ingredients (APIs) because of the wide variety of species and sizes of animals for which they care. While CPGs are technically internal guidelines, not laws, they are enforced by the FDA as if they were law. In June 2004, more than 70 members of Congress wrote the FDA, requesting either the withdrawal or the revision of the CPG after providing for an appropriate public comment period. The FDA responded by assuring the industry that a new CPG would be issued and subjected to public comment

and even announced that in September 2004 to the general public. The FDA never issued the document. In response to one year of inaction on the part of the FDA, 113 members of Congress signed letters requesting justification. Again, the FDA delayed action. In April 2010, the FDA filed a permanent injunction against a pharmacy in Ocala, Florida, for compounding veterinary prescriptions from pure drug chemicals, the first time the agency attempted to enforce its “guidance” on a compounder. In December 2010, Congress again asked the FDA for an explanation of its position and rationale for prohibiting bulk compounding as well as other concerns within the veterinary CPG and gave them a 60-day response deadline. The agency finally answered Congress in April 2011 saying “FDA continues to receive and consider input from stakeholders on the issues addressed in the CPG and is continuing to consider whether or not changes are warranted.” While the court in Florida ruled for the pharmacy, clearly stating that the FDA had exceeded its authority in prohibiting the compounding of veterinary drugs from bulk ingredients, that ruling was vacated pending an appeal. Because the pharmacy went out of business, the appeal never materialized, and the issue was never resolved. And until May of 2015, that’s where things stood. A CPG that Congress asked to be fixed multiple times over a decade. A prohibition by FDA that API compounded veterinary preparations were illegal. A court case that stated the agency did not have the authority to take that position. Guidance for Industry #230 – Big Changes On May 19, 2015, the FDA formally withdrew the old veterinary compounding CPG and released a new draft document called Guidance for Industry: Compounding Animal Drugs from Bulk Drug Substances to replace it. While FDA appears to have changed its mind on the use of APIs in veterinary compounding, it adds some new requirements and challenges for pharmacists and veterinarians. Under the GFI language, bulk ingredient compounding would be permitted but only for a specific individual non-food producing animal patient and dispensing may only occur after a valid prescription has been received by the pharmacy. This essentially eliminates any possibility of office-use veterinary compounding with bulk ingredients. Compounding with APIs for food-producing animals is still prohibited and the GFI would mandate that the vet provide via a prescription or documentation to the pharmacist for each patient a formal statement “This patient is not a food-producing animal.” If that statement doesn’t appear, then the prescription is not considered “valid.” Additionally, the pharmacist must label the medication with the following information the name of the animal patient, the name of the owner/caretaker, and the species of the animal. While that seems like a “win” – bulk compounding is at least permitted for individual patients so long as there are correct labeling and a statement on the prescription – it becomes even more complicated with additional new FDA documentation requirements.

IACPRx.org/Publications | Summer 2015

OLD DOGS, OLD TRICKS

FDA Proposes Sweeping Changes to Veterinary Compounding Practice by David G. Miller, R.Ph., Executive Vice President & CEO

In the middle of May, IACP and its members had just completed a series of lengthy comments to four Food and Drug Administration (FDA) proposed guidance documents issued for the implementation of the Drug Quality and Security Act. The final touches and review of an extensive opposition to the proposed FDA Memorandum of Understanding impacting the interstate dispensing and distribution of compounded preparations were almost complete. On the nineteenth of May 2015, FDAâ€™s Center for Veterinary Medicine (CVM), the department within the FDA that is charged with the oversight, review, and regulations of drugs used in animals, released a Guidance for Industry: Compounding Animal Drugs from Bulk Drug Substances that would drastically change veterinary compounding practice. This GFI impacts not only pharmacists but veterinarians as well and has the potential to adversely affect pet ownersâ€™ abilities to obtain the medicines they need. More importantly, as written, the Guidance sets down alarming precedents that could give FDA greater authority and new oversight ability that could eventually be applied to human compounding pharmacy practice.

How Did We Get Here? To understand where we are now, we have to understand how we got here. A little more than 20 years ago The Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) was enacted to achieve several different goals. Because of growing concern about the use of antibiotics and other drugs in food-producing animals like cows and poultry, an issue that is still of concern today, Congress defined specifically the role of the Food and Drug Administration (FDA) and the Department of Agriculture (DOA) in overseeing how farmers and veterinarians should use medicines in livestock. Additionally, recognizing that there are very few prescription drugs submitted for review and approval for use in animals, language was adopted to provide veterinarians with clear authority to make clinical decisions about when to use drugs already approved for humans for the treatment of animals by permitting extra-label drug use (ELDU). ELDU allowed the prescribing and use of a prescription drug for a species, indication, dose, or route of administration that was not part of the approved FDA labeling.

Summer 2015 | IACPRx.org/Publications

and all compounding pharmacists, she’s with her sweet dog Handsome, a rescue dog. I asked Cynthia what advice she’d give to a compounder speaking to a Senator or House member and her advice was practical and simple, just tell them your story. They want to hear what you have to say, and they want to know what solutions you have to solve the problems. That was one of the big takeaways from our chat. All of us have the ability to connect with the leaders in our government to make change happen. And at IACP we provide you with the tools you need to be your advocate. From updates in our Breaking News section to our Town Hall Teleconferences and our bi-weekly electronic newsletter Capitol Connections. And although Compounders on Capitol Hill is an amazing event with great speakers and a chance to visit the hill, it’s not the only time or opportunity to get engaged with our government.

YOUR PATIENTS ARE AT RISK. WE NEED YOUR HELP.

It was a pleasure getting to know Cynthia a little better. I walked into the restaurant as a colleague and walked out as a friend.

Scot Maitland is the Director of Communications and Publications at the International Academy of Compounding Pharmacists and Editor of Pharmacy Marketing Quarterly and Compounding Matters Quarterly.

Pharmacy Benefit Managers and Insurance Companies are cutting reimbursement for compounded medications. If they succeed, patients and doctors may have to base treatment decisions on money, not science. Help Patients and Physicians for Rx Access spread the word about maintaining this essential benefit. Join the coalition at SaveRxAccess.org

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CYN FOR THE WIN

IACP EMPLOYEE PROFILE by Scot Maitland

In early June, I headed down to Washington D.C. as I have for the past four years. It was Compounders on Capitol Hill time. But this year it was different for me. I was attending as an employee of IACP, not as an attendee. There are so many great things to share about my experiences at CCH, but the one I wanted to share with you is the lunch I had with my colleague, Cynthia Blankenship. Although I’ve been with IACP since October, I hadn’t had a chance to work with Cynthia directly. Due to an impromptu meeting by the FDA, Cynthia was unable to attend the Educational Conference. As our Vice President of Government Affairs, she’s up and down the hill from office to an event to a conference call. In fact, many of those calls have happened outside of someone’s office in the Senate or House of Representatives. Our website states that “Cynthia E. Blankenship, Esq., is the primary contact for Congress, federal and state regulatory agencies and other interests concerning IACP policies and activities associated with its advocacy efforts. Additionally, Ms. Blankenship manages the Political Action Committee (COMPPAC) for IACP and directly oversees compliance with the Federal Election Commission related federal election laws. Ms. Blankenship works with IACP governance committees and other internal groups to develop a comprehensive strategy and approach to addressing the legislative and regulatory issues and concerns to compounding pharmacists; and, continually strives to increase the involvement and awareness of IACP and its members in these areas. Ms. Blankenship also is IACP’s point of contact with outside organizations and affiliations on matters of policy affecting compounding pharmacists and their practices.” And while all of that is true, I had the opportunity to learn that she’s more than the sum of these words. For example, she is a Magna Cum Laude graduate of both the University of Central Arkansas and the University of Miami School of Law. And although she has an impressive CV that includes positions like Counsel and Senior Policy Advisor to Congressman Marion Berry and Counsel and Legislative Assistant to Congressman Tim Walz, her beginnings were quite humble. Like most successful people, she started at the bottom answering telephones and working her way up. I also learned that she’s quite close with her family back home in Arkansas and that she’s quite the foodie. In fact, our walk after lunch in Old Town was part history lesson of the area and a rundown of all the best places to eat! When Cynthia’s not at work protecting and looking out for the members of IACP Summer 2015 | IACPRx.org/Publications

compounding pharmacies. It is forward-thinking and we have proven that this model works – and we have high expectations for there to be other drugs distributed in this manner because it just makes sense.” More than 50 pharmacies from across the nation are now in the Makena distribution network. Juxtaposed from Johnson Compounding & Wellness on the East Coast is A&O Pharmacy in Salinas, California, headed by Dave Smith, PharmD. Smith read about John Walczyk’s experiences in an IACP blog post and decided to follow suit. Since both pharmacies had the ability to submit claims and both were PCAB-accredited, the credentialing process was straightforward. The relationship with Lumara is not something that either Walczyk or Smith would have entertained four years ago when Makena was introduced. Both were passionate and protective about dispensing 17P given the need the drug addresses and their commitment to support physician practices. “17P was rewarding to compound because you were addressing an important therapeutic area with no FDAapproved drug,” said Smith. “But the FDA told us to stop making it given the commercial availability. Now, we have a mutually beneficial relationship to dispense Makena.” In addition to partnering with compounders, Lumara made other efforts to make the drug accessible and

affordable, including offering discounts to payers and a strengthened financial assistance program for patients. According to Gates, for the pharmacies that formerly compounded 17P that are now dispensing Makena, their favorable experiences with this unlikely manufacturercompounder alliance may be the harbinger of an entirely new business model, one where compounders dispense FDA-approved specialty injectable drugs. “In health care today, practitioners and providers must evolve and adapt, or risk getting run over by broad systemic changes,” said Gates. “The new collaboration that we have created provides a model for compounding pharmacies to not only survive, but to thrive, in a dramatically changing healthcare environment.” IACP Members who are interested in dispensing Makena should contact: Alan Nedley, Gates Healthcare Associates Telephone: 978-646-0091 Email: alan.nedley@gatesconsult.com

Noah M. Pines is President of Think-Gen, a healthcare strategy firm based in Philadelphia, PA. A graduate of Haverford College, he has written extensively about topics in pharmaceutical marketing and distribution. AMAG Pharmaceuticals compensated Mr. Pines for this article. This article was reviewed by IACP prior to its publication.

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MANUFACTURER-COMPOUNDER ALLIANCE PROVIDES THE MODEL FOR A NEW TYPE OF NETWORK by Noah M. Pines

Johnson Compounding & Wellness in Waltham, Mass. looks like many other compounding pharmacies. It has large, bright, sterile and non-sterile compounding labs, a call center for handling prescriptions, and a broad range of homeopathic medications and supplements to meet the needs of patients. However, Johnson Compounding & Wellness has one thing that is different from many other compounding pharmacies: it has a direct contract with Lumara Health (a division of AMAG Pharmaceuticals) to dispense FDAapproved Makena® (hydroxyprogesterone caproate injection). Like many compounders, Johnson’s used to compound a version of this drug, commonly known as “17P.” So in addition to preparing many compounded medications, Johnson Compounding & Wellness operates, in essence, as a specialty pharmacy for patients prescribed Makena. “Strong relationships with physicians’ offices and a major focus on customer service made Johnson’s a perfect candidate for such a partnership,” said John Walczyk, PharmD, Pharmacy Manager. “Since Makena is commercially available and hasn’t been in a shortage situation, pharmacists shouldn’t compound it. We can get it quickly, keep it in stock, and we are successfully submitting claims for it. Additionally, Lumara helps patients who can’t afford the therapy and there have been several patients of ours we’ve helped access their prescription assistance program.” Just a short while ago, a partnership between any compounding pharmacy and the makers of Makena would have seemed improbable, if not impossible. When Makena was launched in 2011, its high initial price triggered a public outcry that led the US Food and Drug Administration (FDA) to exercise “enforcement discretion,” an unprecedented step that allowed

pharmacists to continue to compound 17P. This move was applauded at first by multiple professional societies, including the American College of Obstetricians and Gynecologists (ACOG). Typically, if a medication is FDA-approved and commercially available, compounding is limited to cases where the manufacturer’s product can’t meet the need for a particular patient (e.g., a different dose or formulation). FDA reversed its March 2011 position on Makena in June 2012, and returned to the customary FDA stance on the compounding of commercially available FDA-approved drugs, which restricts compounding of 17P to only those individual patients unable to take the approved drug. The longstanding relationship between pharmacists and the medical community regarding 17P led to Lumara seeking out partnerships with these pharmacists. Lumara has created a network of geographically dispersed compounding pharmacies that now dispense Makena. Lumara worked with Massachusetts-based Gates Healthcare Associates, a consultancy that has pioneered clinical and entrepreneurial advances in the field of pharmacy compounding, headed by Ernest P. Gates, Jr., RPh. A longstanding leader in the field and an expert on the regulation and accreditation of compounding pharmacies, Gates is seen as one of the people who helped lead compounding pharmacy back to a prominent place in the healthcare ecosystem. Gates also invented the lozenge mold, which is used by compounding pharmacies in daily practice across the nation. Gates and Senior Associate Bill Mixon, RPh, worked with compounding pharmacies to help them see the benefits of a potential partnership. “In the past, the traditional model was to push the compounder aside,” observed Mixon. “This is the first time I know of where a manufacturer has partnered with

Summer 2015 | IACPRx.org/Publications

YES! I want to contribute to IACP’s One Fund – and Preserve My Patients’ Access to Customized Medicines. Compounding pharmacists have the privilege to advance the quality of patient care, helping those who are underserved, and saving lives – one patient at a time. IACP’s One Fund provides you with a simple, convenient and powerful way to ensure that IACP can preserve your privilege to compound. So that you can continue serving your patients and practitioners. Contribute to One Fund today, and become part of a unified effort to preserve patient access to customized medicines.

Contribute to IACP’s One Fund, today! q I would like to make a semi-annual contribution of $500 per year for the next 2 years. I would like to make a monthly contribution in the amount of: q $250 q $200 q $100 q $50 q Other $ _______________ I would like to make a quarterly contribution in the amount of: q $5,000 q $1,500 q $1,000 q $500 q Other $ _______________ I would like to make a one-time contribution in the amount of: q $5,000 q $1,500 q $1,000 q $500 q Other $ _______________ Contact Name _________________________________________________________________________________ Pharmacy Name________________________________________________________________________________ Address ______________________________________________________________________________________ City _________________________________________ State _____________________ Zip __________________ E-mail _______________________________________________________________________________________ Phone ________________________________________ Fax ___________________________________________ Payment Method (Please direct payments to Missouri City, TX office) Check #_______________________ Please make checks payable to IACP. Charge our credit card: q Discover

q Mastercard

q Visa

q Amex

CC# _________________________________________

CVV Code: ____________________________________ Exp. Date: ____________________________________ Name on card:_________________________________ Total Amount: _________________________________ Signature: ____________________________________ Date:________________________________________ Billing Address: _____________________________________________________________________________ City _________________________________________ State _____________ Zip: _______________________ Please support IACP’s One Fund by contributing, today. This is the most important commitment you will make to your compounding profession all year. IACP’s mission is to Protect, Promote & Advance the Art and Science of Pharmacy Compounding. IACP Washington Headquarters 1321 Duke Street, Suite 200 n Alexandria, VA 22314 n 703-299-0796 n Fax 703-299-0798 IACP Corporate Headquarters 4638 Riverstone Blvd

Missouri City, TX 77459

281-933-8400

Fax 281-495-0602

A NOTE FROM THE PRESIDENT This year at Compounders on Capitol Hill, we announced an initiative for sustained giving to IACP for the future of Compounding. While we have an immediate goal of $2,000,000 contributed to ONE FUND between January 1, 2015, and December 31, 2016, the ultimate goal is to have ongoing, sustained giving to meet the challenges before us and beyond. Total giving to ONE FUND from January 1, 2015, to June 25, 2015, totals $292,288 with an additional $121,391 in pledges for the year, for a total of $413,679. This means we are less than halfway toward our goal for 2015, with seven more months to go. Don’t we want to add Topic-CLICK’s $25,000 donation in this story. Thanking them for helping to make a large impact upon the One Fund contributions? The IACP Board of Directors adopted a three-year strategic plan in October 2014, with a major emphasis of forming alliances with pharmacy, medical and consumer groups to achieve our goals and objectives. A direct and immediate result was the formation of the Fix DQSA (Drug Security and Quality Act) Coalition. This coalition already has resulted in Senate Bill 1406 being introduced by Senator David Vitter of Louisiana. A similar bill has a sponsor in the House of Representatives and is awaiting bipartisan support before being introduced. Another IACP Board strategic planning retreat is scheduled for the weekend of August 8 to fine tune our goals and objectives and to further align our financial, facilities and human resource needs with our fundraising efforts. You will hear much more about ONE FUND after the planning retreat. I hope you will be receptive to participating in this initiative for the sake of our businesses, for our patients’ access to critical medications, and for the future of pharmacy compounding, the very heritage of our profession.

Dale Coker, RPh, FIACP IACP President, 2015

Summer 2015 | IACPRx.org/Publications

IACP STAFF David G. Miller, R.Ph. Cynthia E. Blankenship, Esq. Dagmar Anderson Scot Maitland Jennifer L. Petska, CPhT

Contents 4 6

Ashlyn Grant Michelle McMahan Macy Pruitt

A NOTE FROM THE PRESIDENT MANUFACTURER-COMPOUNDER ALLIANCE PROVIDES THE MODEL FOR A NEW TYPE OF NETWORK by Noah M. Pines

CYN FOR THE WIN: IACP EMPLOYEE PROFILE by Scot Maitland

Teresa Roberts COMMUNICATION COMMITTEE Richard B. Moon, Pharm.D., R.Ph., FIACP, Chair

OLD DOGS, OLD TRICKS by David G. Miller, R.Ph., Executive Vice President & CEO

Lisa Ashworth, BS, Pharm.D., R.Ph. Kim Hansen, R.Ph. Robert Harshbarger, III, Pharm.D.

James Matthias, CPhT Linda McElhiney, Pharm.D., R.Ph., FIACP, FASHP

Lauren Onsa, BA Andy Ruiz, Pharm.D., MSc, FACA

Scott Wepfer, R.Ph., FIACP PHOTOGRAPHY

Scot Maitland DESIGN Dianne Stone

PAIN RELIEF FOR LICENSE COMPLIANCE by Shannon Kelly

THE UNITED VOICE OF COMPOUNDERS IS HEARD! by Dagmar Anderson

11TH ANNUAL RX MIXER PRESENTS: REWIND BACK TO THE 80s PART II: HISTORY OF THE RX MIXER AND THE CELEBRATION OF 15 YEARS IN 2019 by Lisa D. Ashworth, BS Pharm, RPh

22 24

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IACP NEEDS YOU! by Jennifer Petska, CPhT

SAVE THE DATE FOR THESE UPCOMING PROGRAMS

Compounding Matters Quarterly is published four times per year as Spring, Summer, Fall, and Winter. Compounding Matters Quarterly makes all attempts to publish accurate information; however, this publication may contain technical inaccuracies or typographical errors. The reader assumes all risk concerning the suitability and accuracy of the information within this publication. Compounding Matters Quarterly assumes no responsibility for and disclaims all liability for any such inaccuracies, errors or omissions in this publication and in other documents referred to within or affiliated with this publication.

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IACPRx.org/Publications | Summer 2015