2018 GEORGIA PHARMACY CONVENTION • JUNE 21-24 • NASHVILLE
THE NUMBERS ISSUE OUR ANNUAL ILLUSTRATED LOOK AT THE FACTS AND FIGURES THAT SHAPE YOUR WORLD
contents 15 BY THE NUMBERS It’s our annual roundup of the most interesting and informative facts and figures affecting the world of Georgia pharmacy — in living color!
2 prescript All about the numbers CEO Bob Coleman shares a few numbers of his own.
7 pharmacy school update
12 legislative update
News out of Georgia’s pharmacy schools
Read about the new laws, rules, and regulations coming out of this year’s legislative session
8 shout outs New members, who’s made it into the 100% Club and President’s Circle, and meet our president-elect
Who does what at GPhA — and how to reach us
24 the back page The lighter side of pharmacy and healthcare news
Investors in the future of pharmacy in Georgia
22 postscript Knowing the numbers GPhA President Liza Chapman on why numbers can be so important to pharmacists and their patients
3 quick hits What’s happening in the Georgia pharmacy world Surprising OTC painkiller news, the flu season (finally) wraps up, and much more
23 contact us
Georgia Pharmacy magazine is the official publication of the Georgia Pharmacy Association. Unless otherwise noted, the entire contents of this publication is licensed under a Creative Commons AttributionNonCommercial-ShareAlike 4.0 International license. Direct any questions to the editor at firstname.lastname@example.org.
Chief Executive Officer Bob Coleman President and Chair of the Board Liza Chapman President-Elect Tim Short Immediate Past President Lance Boles
Editor Andrew Kantor Director of Communication email@example.com Art Director Carole Erger-Fass ADVERTISING All advertising inquiries should be directed to Denis Mucha at firstname.lastname@example.org or (404) 419-8120. Media kit and rates available upon request.
Georgia Pharmacy is distributed as a regular membership service, paid for with membership dues. Non-members can subscribe for $50 per year domestic or $65 per year international. Single issues are $10 per issue domestic and $20 international. Practicing Georgia pharmacists who are not members of GPhA are not eligible for subscriptions.
Georgia Pharmacy (ISSN 1075-6965) is published bi-monthly by GPhA, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA, 30328. Periodicals postage paid at Atlanta, GA and at additional mailing offices. POSTMASTER: Send address changes to Georgia Pharmacy magazine, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA 30328.
PRESCRIPT From the CEO
All about the numbers Welcome to our annual numbers issue; a collection of numbers, charts, graphs, and factoids related to pharmacy in Georgia and nationwide. Please feel free to impress your peers, friends and family with your new found, in-depth knowlBOB COLEMAN edge! Seriously, this is always a fun issue to put together because it’s a learning experience for us as well. I promised our editor I’d find a way to work numbers into my prescript this time, so here goes: 4.7%. That’s the percentage decline in the nationwide number of independent community pharmacies in the US from 2009 to 2016. Why am I bringing that up? Because at a recent meeting of NCOIL (National Council of Insurance Legislators), Lauren Rowley, VP of state affairs for PCMA, made the claim that there are more independent community pharmacies today than eight years ago. Sorry, Ms. Rowley, the facts tell a different story. Out of the four categories tracked (independent, chain, supermarket, and mass merchant), the only category that experienced a decline in that period was independent pharmacy. Chains showed the most growth over the period at 8.2%, while mass market pharmacies grew at 5.8% and those in supermarkets grew at 0.1%. Ms. Rowley went on to tell the NCOIL members that PBMs are “about holding down the cost of prescription drugs.” and that PBMs faced negotiations with “highly sophisticated purchasers” in a “highly competitive market.” And, she added, “nobody has to contract with a PBM.” Again, the facts don’t support her statements. Anytime only three players control more than 85 percent of market share, it becomes a “take it or leave it” proposition. To position PBMs as poor, little, unsophisticated companies dealing with big, bad, sophisticated purchasers is just patently ridiculous. Arkansas state senator (and former NCOIL president) Jason Rapert — along with Scott Pace, 2
EVP & CEO of the Arkansas Pharmacy Association and Scott Brunner, senior VP of state and government affairs for NCPA — did an excellent job looking behind the curtain of PBM secrecy. The great news is NCOIL legislators, including Rep. Darlene Taylor and Rep. Richard Smith of Georgia, appear to agree. They decided to move forward with their investigation of PBMs, “in an effort to draft a piece of model legislation that amounts to fair and proper regulation.” More to come. 15. That’s the number of participants in the current LeadershipGPhA class. I recently had the opportunity to spend time with this incredible group of pharmacists teaching on the topics of leadership and management. I can’t get over what a great group this is and look forward to involving them (and past graduates) in more GPhA activities in the future. The future is bright for GPhA as these graduates become part of the leadership of GPhA. If you know someone that you think would be a good future candidate for the program, be sure to let us know. 6/21/2018-6/24/2018. OK, that’s a date, but it is made up of numbers. I hope you’ll join us as GPhA members take over the Omni in Nashville for the annual Georgia Pharmacy Convention. We have lined up an incredible selection of speakers for our general sessions, fantastic CE courses, and the President’s Bash band promises to be unbelievable. Check out GPhAconvention. com and be sure to watch the keynoter and band videos. Of course, there’s always Nashville! The convention is walking distance from Broadway and it’s actually connected to the County Music Hall of Fame so you can stroll over and visit between courses. See you there! As always, thank you for your membership. We appreciate it — and don’t hesitate to drop us an e-mail, letter, or phone call to share any ideas to make YOUR association better. Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
Bob Coleman is chief executive officer of the Georgia Pharmacy Association. April/May 2018
QUICK HITS “THE PREVALENCE OF EDL AMONG NSAID USERS IS NONTRIVIAL” In other words, about 15 percent of people take too much ibuprofen in a given week, according to a study published in Pharmacoepdemiology & Drug Safety. “Educating consumers about NSAIDs and their dosing directions could reduce excess dosing,” say the researchers.
FDA approvals: fast in 2017, slower this year The FDA reported that 2017 was a record year for generic drug approvals, “with 1,027 new generic drugs, 214 more than our previous record of 813 set in 2016.” But then comes 2018, when the agency started taking it a little more slowly. January saw a steep decline in the number of approvals for generic drugs when compared to the
three previous months (and all of 2017), and that trend continued into February, according to the latest activities report. Why the slowdown? The FDA says it might be due to new ‘elemental impurity guidelines’ — if new drugs aren’t pure enough, manufacturers won’t submit them, so there are fewer applications to approve.
If you give immunizations you MUST also give this letter to patients
ASPIRIN VS. XARELTO FOR CLOT PREVENTION Got patients taking Xarelto after knee surgery? Psssst: According to a study published in the New England Journal of Medicine, aspirin works just as well and “is an effective and safe alternative to rivaroxaban” at a tiny fraction of the price. April/May 2018
This is important: If you provide immunizations, you must provide your patients with a document from the Department of Public Health “on the importance of having and periodically seeing a primary care physician.” That document has been updated. You can download an editable copy in Word’s .docx format at GPhA.org/immunizationtemplate.
GEORGIA’S HEALTHY AND UNHEALTHY CITIES Atlanta ranked 26th out of 174 U.S. cities in terms of healthiness — a rating that looks at availability and cost of healthcare, good eating habits, physical activity, and other metrics. On the other end of the scale, though, are Columbus and Augusta,
ranked #158 and #172, respectively. Only Laredo and Brownsville, Texas were ranked lower than Augusta, which was rated worst in the country for “availability of green space.” But hey, Atlanta ranked third best for overall physical fitness. Georgia Pharmacy
FLU-SEASON WRAP-UP You might have noticed some dueling headlines during the flu season. “The Flu Vaccine Is Working Better Than Expected, C.D.C. Finds“ said the New York Times, while on the same day the AP reported, “Flu shot only 36 percent effective, making bad year worse.” So what’s the deal? They’re both right.
HOSPITAL PHARMACISTS: SKIP THE SALT Instead of using saline, an IV with balanced electrolytes (e.g., Ringer’s lactate*) seems to reduce mortality by a full percent. “[W]hile a 1% reduction may not sound large, the absolute impact would be highly significant given that more than 5 million people in the U.S. are treated in ICUs every year.”
1. There were multiple strains of the flu going around, as usual, and the most prevalent was the particularly nasty H3N2 variant. 2. The flu shot is more effective for certain age groups than others. 3. When determining effectiveness, the CDC compares what’s happening here with what
happened in Australia — same strains, same vaccine. So how did the vaccine do this year, according to the CDC? • Overall (against all strains): 39% effective • Against H1N1: 67% effective • Against H3N2 in adults: 25% effective (vs. 10% in Australia) • Against H3N2 in children (0-8 years): 51% effective And that’s why we have contradictory headlines — it all depends which of these figures you want to focus on. But the bottom line is that any vaccine is better than no vaccine, and it would be foolish not to reduce your chances of getting the flu by even 25 percent.
IT’S BAAAAAAAAACK A CDC committee recommended that the agency re-approve the FluMist nasal spray vaccine after a study showed that it works again.
Ova a barrel PEAKE WON’T RUN AGAIN Allen Peake, the state representative from Macon who has been leading the push to allow Georgians access to medical cannabis oil, says he won’t be running for office again. 4
Looking back, it seems that the flu vaccine made in cell cultures — as opposed to using hens’ eggs — was not only more effective in preventing the flu, it was 20 percent more effective. Of note: The egg-made vaccine is particularly weak against the H3N2 virus, and that’s what caused this year’s horrible no good very bad season.
Prescription opioids are no better than Tylenol A major new study published in JAMA found that, for people with chronic pain, prescription opioids are no better than OTC meds — and in fact are sometimes worse. “In patients with stubborn back aches or hip or knee arthritis, opioids worked no better than over-thecounter drugs or other nonopioids at reducing problems with walking or sleeping,” according to the study. “And they provided slightly less pain relief.” Yes, it’s that simple.
ALLERGY MEDS ARE IN AISLE 3
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If you enjoy being around an extra-high amount of pollen, we have some good news for you this year: Georgia is likely to have quite the active pollen season. Record-setting warmer weather overall combined with a cold and wet winter (giving trees some dormant time) mean lots of tree pollen coming this spring. Yay.
GET CPR CERTIFIED For four hours and just $60, you can get your CPR certification in GPhA’s comfy offices in Sandy Springs. Wednesday, May 2 Noon to 4:00 p.m. 6065 Barfield Road, Suite 100 Sandy Springs All you need to do is drop an e-mail to crystal@adaptivetrainingconsultants. com and let her know y0u’re coming. Then stay for the regional legislative briefing — get dinner, an update on new Georgia laws, and an hour of CPE to cap off the day! April/May 2018
Representing pharmacists and pharmacies before the Georgia Pharmacy Board, GDNA and DEA. AREAS OF PRACTICE Professional Licensing Medicare and Medicaid Fraud and Reimbursement Criminal Defense Administrative Law Healthcare Law Legal Advice for Licensed Professionals
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Healthcare costs vary based on usage as much as price If healthcare is more expensive in one state than another, we assume that’s because prices vary — for medication, for treatments, for hospitalization, etc. But a new analysis says, essentially, “Nuh-uh.” The Network for Regional Healthcare Improvement found that resource use was as big a driver of cost as price was. In some places, people just use more healthcare. (And no, that’s not because they’re sicker or more accident prone.) “These insights matter because if we want to do something about healthcare affordability we need to adopt strategies that reduce the total cost,” read the report. “There is no one-sizefits-all solution. If a region’s costs are driven primarily by high utilization, the right strategies may include engaging physicians to consider their referral patterns or use of testing and procedures. But, if the region’s total costs are largely driven by prices, different strategies involving purchasers or policymakers may be required.” So what about pharmacy? You can sit this one out: “Results showed variability in every category of care except pharmacy pricing, which is largely a result of the influence of a few, large pharmacy benefit managers and pharmaceutical manufacturers’ national pricing policies.” April/May 2018
School Updates PCOM SCHOOL OF PHARMACY
The sisters of Mercer’s Kappa Epsilon Alpha Delta took on community projects this past fall and winter.
MERCER UNIVERSITY COLLEGE OF PHARMACY Fall and winter 2017 were busy ones for the ladies of Mercer University’s Kappa Epsilon Alpha Delta chapter. We raised more than $1,000 to donate to research for our two nationally supported endeavors, breast cancer and ovarian cancer awareness. We held an extremely successful raffle of a pink Yeti cooler during September and October to celebrate life during our annual awareness campaigns. Another community project near and dear to our hearts is our involvement with the local Brookhaven Boys and Girls Club. To celebrate Halloween, Kappa Epsilon partnered with Mercer’s chapter of APhA-ASP for Operation OTC Medicine Safety to bring awareness regarding safe use of home medications. The children were able to participate in a fun game of “Candy versus Medicine” to demonstrate how difficult distinguishing medicine from candy can be and why medication only should be taken under adult supervision. For Christmas, the entire chapter came together to contribute holiday gifts for five children ranging in age from seven to 15. We not only were able to provide the gifts the children requested, we also raised $200 to donate to the Boys and Girls club for additional children in need. (Our chapter president, Katherine Key, was recently recognized nationally for her contributions to the chapter while upholding high academic standards by being awarded one of five Zada M. Cooper Scholarships.) —Keenya Riggins April/May 2018
With the theme “Believe in our Future,” the 40th annual Gwinnett Science, Engineering + Innovation Fair showcased the talent, creativity and capability of students in Gwinnett’s public and private middle and high schools at the Infinite Energy Center in Duluth. As the presenting sponsor, the PCOM School of Pharmacy was prominently featured at the Career Expo where about 700 middle and high school students visited the SOP’s table throughout the fair. The aroma of chocolate led students to the table where seven third- and fourth-year
PCOM student pharmacists helped expose high school students to the potential of pharmacy careers. pharmacy students waited with M&M’s, prescription pads, pill counting trays, and special red, blue and yellow prescription bottles. The pharmacy students instructed students in the art of filling a prescription, including how to count the “medication” and properly label the container. The younger students were happy to take their specially prepared prescription bottles with them as a souvenir of the experience. The pharmacy students also taught the younger students how to fill gelatin capsules with lactose powder — providing a small taste of what it’s like to be a pharmacist. — Jiehyun Lee Georgia Pharmacy
A S S O C I AT I O N
Congrats to Chris Thurmond of Athens, who was named by the GPhA Board of Directors as the association’s next president-elect. He’ll assume the duties of that office at the end of the 2018 Georgia Pharmacy Convention, and he’ll become president in 2019. Chris has been a member of GPhA since 2001, and served as Region 10 president where he won the Mal T. Anderson Award for his work. He currently serves as chair of the GPhA Audit and Investment Committee, and on both the AIP and GPhA boards of directors. He holds a PharmD from UGA, and owns or has interests in six independent community pharmacies in Georgia, including Village Drug Shop in Athens. You can read more about Chris at GPhA.org/christhurmond.
CL CIR E
Chris Thurmond named as GPhA president-elect
2017–18 These are the newest members of the GPhA’s President’s Circle — GPhA members who recruit their fellow pharmacists, technicians, academics, and others to become part of the association. Recruit a member and join!
3/21/18 1:02 PM
Robert Bazemore, Butler Nikki Bryant, Preston
Eastlake Pharmacy, Atlanta Owner: Thomas Jusu
A S S O C I AT I O N
A S S O C I AT I O N
These are the newest members of GPhA’s 100% Club — Georgia pharmacies where 100 percent of employees are GPhA members. Find out more at GPhA.org/100percent. GP.Logos.Final.indd 5
3/21/18 1:02 PM
Carter Clements, Rhine
Glenn’s Corner Pharmacy, Sylvester Owner: Glenn Parkman
David Clements, Sr., Griffin
Jennings Mill Drug Company, Watkinsville Owners: Cassie Hayes and Andy Ullrich
Rob Dykes, Cochran
Little Five Points Pharmacy, Atlanta Owner: Ira Katz
Martin Grizzard, Thomaston
McArthur’s Apothecary, Atlanta Owners: Nakia and T. Shaw
Bridget Hogan, Macon
Adams Family Pharmacy, Preston Owners: Nikki and Terry Bryant
McDaniel Pharmacy/Cochran, Cochran Owner: Trent McDaniel
Bedingfield Pharmacy, Pembroke Owners: Nelson Bedingfield and Teresa Smith
Newnan Pharmacy, Newnan Owner: Jan Smit
Wes Chapman, Vidalia
Ben Cravey, Hawkinsville Matt Frazier, Macon Amy Galloway, Blue Ridge Kimberly Grubbs, Bogart Thomas Jusu, Atlanta Stephanie Kirkland, Rhine Trent McDaniel, Cochran Glen Parkman, Sylvester
Northside Drugs, Thomaston Owner: Martin Grizzard
Becky Powell, Buena Vista Ken Rogers, Eastman
Chapman Healthcare Pharmacy, Vidalia Owner: Wes Chapman
Premier Specialty Pharmacy, Johns Creek Owners: Buffy Gougelmann and Andy Tran
Crowley Drug Co., Calhoun Owner: Will Crowley
Smith’s Pharmacy, Butler Owner: Robert Bazemore
Jan Smit, Newnan
Dykes Pharmacy, Cochran Owner: Rob Dykes
Victory Pharmacy, Hampton Owner: Jack Mbadugha
C&C Pharmacy, Dallas Owner: Kim B. Curl
Jeff Richardson, Ball Ground Charles Scott, Dawson Wade Scott, Macon Teresa Smith, Pembroke
PCOM names Shawn Spencer its new dean of pharmacy PCOM has chosen Dr. Shawn Spencer as the new dean of its School of Pharmacy’s Georgia campus in Suwanee. He’ll take over the duties March 26, 2018. “Dr. Spencer brings to PCOM more than 23 years of combined experience in pharmacy practice and education, and has held a wide variety of academic leadership roles,” according to the university. Spencer earned a Ph.D. in pharmaceutical sciences from Temple University in Philadelphia, and most recently served as associate dean of institutional improvement at Florida A&M University.
The big five-oh Congratulations to Nelson Bedingfield and the rest of the folks at Bedingfield Pharmacy in Pembroke, celebrating 50 years in business this month!
New Members PHARMACISTS Nevin Abuabdou; Johns Creek Bart Anderson; Atlanta (AEP) Ed Bagwell; Douglas (AEP) Melissa Bagwell; Auburn (AEP) Sonal Bains; Louisville, Ky. Tadesse Belachew; Washington Kimmie Bell; Macon (AEP) Katherine Bell; Ocean Springs Avinash Bhatia; Atlanta (AEP) Ray Black; Cleveland (AEP) Shennae Blackwood; Tucker (ACHP) Yolanda Brown; Harlem Summer Bryan; Buford (AEP) Letitia Burage; Atlanta Abigail Case; Athens (AEP) Claire Clark; Vidalia (AEP) Kevin Coggin; Auburn Varun Dalwadi; Decatur (AEP) Kimberly Dorto; Hixson Jeffery Felton; Smyrna (AEP) Tricia Francetich; Grayson (AEP) Bobby Gay; ALbany (AEP) Lindsay Guttuso; Aiken (AEP) Sarah Harrison; Orlando, Fla. Kevin Harrison; Orlando, Fla. Nisha Hull; San Antonio, Tex. Mark Hurley; Senoia (AEP) Chidi Ifedi; Suwanee Cecilia John; Lawrenceville (AEP) Sade Jones; Atlanta (AEP)
Donald Korkis; Augusta Otilia Layfield; Auburn Jenny Layson; Greensboro (AEP) Christopher Lieu; Peachtree Corners Walter Massey; Decatur (AEP) Deanna McEwen; Watkinsville (AEP) Amanda Moon; Savannah (AIP) Melissa Olsen; Atlanta Marie Orff; Marietta (AEP) Ankit Patel; Byron Ami Patel; Duluth Giraben Patel; Fort Myers Caroline Randall; Roswell (AEP) Rodney Ransom; St. Augustine Doree Richardson; Greenville Laura Rogers; Yulee Kendrick Rosenthal; Brookhaven (AEP) Alicia Ross; Olympia Fields Janet Royals; Atlanta (AEP) Christa Russie; Atlanta (AEP) Erika Rylee; Atlanta (AEP) Nikita Smith; Norcross (AEP) Kim Strain; Lawrenceville (AEP) Alan Voges; Lookout Mountain (AEP) Nicole Winston; Evans Barclay Wiseman; Kennesaw (AEP) Yancy Witt; Atlanta (AEP) Gwen Young; Cochran (AEP) Edward Zwick; Richmond Hill (ACHP)
TECHNICIANS Sara Beth Bazemore; Butler Samantha Blymire; Glenwood Colter Cochran; Ball Ground Michelle Curl; Vidalia Lydia Daniel; Dallas Trang Duong; Norcross Jessica Fordham; Cochran Tina Foskey; Chester Chandra Frazier; Atlanta Kay Goodman; Tifton LaJuan Harris; Butler James Hays; Monticello Santrean Holmes; Locust Grove Melissa Jones; Norcross Amber Klein; Stockbridge Ashley Mullis; Cochran Hollie Murphy; Butler Donna Norfleet; Vidalia Nikki Normile; Canton Leah Paradis; Cochran Tennille Rider; Rockmart Tara Ruff; Dallas Alnieska Shine; Cochran Jennifer Story; Dallas Johnda Ulm; Sumner Judy Vaughn; Canton Samantha Wainwright; Rupert Renata Williams; Tifton Nikcy Willis; Butler
JUNE 21-24 • OMNI NASHVILLE
The 2018 Georgia Pharmacy Convention is the biggest gathering of Georgia’s pharmacy professionals all year. Hundreds of pharmacists, pharmacy owners, technicians, and students from across Georgia will come to Nashville to grow, play, and connect. Be sure to check out all the courses and events — and the ways to have fun. We’ll see you in the Music City!
Lively general sessions The anchors of the 2018 Georgia Pharmacy Convention are our three general sessions, flanked by hours and hours of CPE. Grow with... n
otivational speaker and humorist M Brad Montgomery
A PhA’s Randy McDonough on transforming your pharmacy practice
ercer College of Pharmacy Dean Brian M Crabtree on value-added services
CPE and more CPE Bottom line: You can easily acquire 15 hours of CPE, choosing from the more than 48 hours we're offering. These are topics you want and need — we know because we asked. Build a better pharmacy team. Learn smarter diabetes counseling and med sync. Find out about the newest treatments. Get updated on the latest technology. Hear about new Georgia pharmacy law. And more — lots more. All this, all in one place, all up to date. You won't get that anywhere else. Every course is ACPE accredited for both pharmacists and pharmacy technicians.
Grow. Play. Connect.
What’s Happening WEDNESDAY LeadershipGPhA Retreat GPhA Board of Directors Meeting Council of Presidents Dessert Reception
THURSDAY Lean In: Quality Improvement in the Highly Efficient Pharmacy Instructor: Joe Ed Holt 2018 New Laws Update Instructor: Greg Reybold Pharmacogenomics Instructor: Amy Ham THURSDAY GENERAL SESSION Keynote: Funny Business with Brad Montgomery Lilly Product Theater Luncheon PharmPAC Board Meeting (working lunch) Diabetes Adherence Counseling + Med Sync/Care Planning Instructor: Carlie Traylor Leadership/Management: Effective Meetings, RACI, Problem Solving, and Team Building Instructor: Austin Mudd Value Based Purchasing and Quality Measurement Instructor: Adrienne Mims Expo Grand Opening with Reception
FRIDAY Naloxone: Dispensing and Patient Training Instructor: Tracy Frame OTC Dermatology: Rash, Burns, Blisters, Bruises, Scrapes and more Instructor: Melanie DeFusco Quality Measures in Clinical Service Models Instructor: Jake Galdo New Drug Update 2018: A Formulary Approach
Instructor: Rusty May Using PDMP to curb opioid problems Instructor: Drew Miller Alzheimer’s and Dementia Care Instructor: Adrienne Mims What’s Changed: Treatment Updates for 2018 Instructor: Jake Galdo Women’s Health Update Instructor: Kendra Manigault Transforming Community Pharmacy Practice Instructor: Randy McDonough Lilly Product Theater Luncheon FRIDAY GENERAL SESSION Keynote: Motivational Interviewing: A Required Skill for Pharmacy Practice Transformation Randy McDonough Expo Open with Reception Student & Student Sponsor Reception PharmPAC Investors Reception & Legislative Victory Party
SATURDAY AIP Compounding Pharmacy Section Breakfast (AIP Compounding Section members only)
SBIRT/Opioid Risk Assessment/ Health Education Instructor: Matt Perri 2018 Federal Issues Update Instructor: Greg Reybold
Immunization Roundtable Instructor: Libby Massiah Technician Skills: Documenting Patient Health Information Instructor: Carlie Traylor Precepting Successes for Residents, Interns and Host Sites Instructor: Angela Clauson GENERAL MEMBERSHIP MEETING 10:15 – 11:00 a.m. SATURDAY GENERAL SESSION Keynote: Dr. Brian Crabtree, Dean of Mercer College of Pharmacy Academy luncheons (AIP, ACHP, AEP) A Visit with GDNA and the Board of Pharmacy Moderator: Greg Reybold Opportunities and Challenges Regarding Integration of Pharmacists as Medical Providers Instructor: Micah Cost PRESIDENT’S BASH 7:00 – 10:00 p.m.
SUNDAY Travel Immunizations within Community Pharmacy: Opportunities for Enhanced Patient Care with Revenue Benefits Instructor: Jonathan Marquess GPhA Region Presidents Orientation GPhA Board of Directors Orientation
Performing at the President’s Bash:
The Downtown Band!
2018 Legislative Session Wrap-Up Regretfully, this Greg’s final column for Georgia Pharmacy. Greg has accepted an offer within the healthcare industry and we wish him all the best in his new endeavor. He wanted readers to know how grateful he is for the opportunity and privilege to advocate on behalf of the GPhA membership, and he thanks all Georgia’s pharmacists for their support. As a reminder, nothing in this column constitutes legal advice. If you have a legal issue or question, consult your attorney.
The 2018 legislative session is over, at least for the General Assembly, and that meant the end of the line for many healthcare related bills while others went on to the governor’s desk for consideration. (Governor Deal GREG REYBOLD has 40 days to consider, sign, or veto those bills that passed. The bills he signs or ignores become law, typically on July 1.) This year two bills passed that will have a signficant and positive impact on pharmacists and their patients. We’ve spoken about one during the session, but the other passed quietly as part of the state’s budget. And it’s a very big deal. The former is legislation significantly expanding the ability of pharmacists to assist patients with point-of-care testing. The latter is language in the budget that brings greater transparency to PBM practices in connection with state health benefit plan and managed care prescription drug claims. More on both in a moment. It’s worth noting that this year’s legislature considered many healthcare-related bills, most of which did not pass; see the box on page 14. Scan through that list. It helps put into perspective just how hard it can be to pass legislation — and thus how effective pharmacists are when we engage and lead.
SB 422 This bill, introduced by Senator Unterman and carried by Representative Cooper in the House, 12 Georgia Pharmacy
updates the law to allow pharmacists to perform all tests approved by the FDA for home use to screen for disease risk factors and drug use. (Pharmacists can currently perform capillary blood tests, i.e, finger prick tests, to screen for disease but are restricted from performing simpler less invasive tests such as saliva testing.) This updated bill will also help pharmacists provide their patients with improved care by assisting with education, and it will allow pharmacist testing to evolve with technology: It does not limit pharmacists to any particular test method, but rather is tied to tests approved for home use, regardless of testing method.
HB 684 — BUDGET PBM transparency is a major issue in Georgia and nationwide. That’s why language passed in this year’s budget is so important. One recommendation made by the House Rural Development Council was to seek transparency in connection with PBM models. That’s why the House included language in the budget bill regarding state health benefit plan contracts and managed care contracts in connection with pharmacy claims. Plan sponsors will now be required to annually report all pharmacy claims and itemization of all administrative fees, rebates, or processing charges associated with each claim. The Department of Community Health will then provide a report (with aggregated data) to the chairs of the House and Senate Appropriation committees. This is a major step toward transparency. While there are some ambiguities, these reporting requirements will be the first time plan sponsors in Georgia have been required to report on all pharmacy claims. Once again, Georgia finds itself ahead of the curve when it comes to shining a light on PBM practices. While opposition was fierce and some changes were made — the language in the final budget includes first-of-its-kind requirements for reporting pharmacy claim information to DCH. Finally, while this language is incredibly significant, we believe this is just the first step in bringing transparency to PBM practices and GPhA April/May 2018
Other legislation that passed
HB 65 — LOW-THC OIL This bill creates the Joint Study Commission on Low-THC Medical Oil Access for the purpose of studying in-state access of medical cannabis and lot THC oil. The bill also adds to the list of conditions eligible to possess low-THC oil in Georgia.
There were several resolutions that passed, each creating a study committee. HR 1160 / SR 832 Introduced by Representative Brooks, this resolution creates a House study committee on risks associated with kratom. Senator Mullis introduced a similar resolution for the Senate.
HB 769 — MICRO-HOSPITALS AND PHARMACISTS
HR 1194 Brought by Representative Knight, this resolution created a study committee on the issue of retrospective emergency room policies instituted by insurers.
Also coming from recommendations of the House Rural Development Committee, this bill, sponsored by Representative Jasperse, takes several steps hoping to improve rural healthcare. First, it establishes micro-hospitals — rural healthcare institutions that contain two to seven beds, and that are open 24 hours a day and seven days a week). With regard to pharmacy, this bill updates and improves the ability of hospital pharmacies to use remote order entry. It allows remote order entry when (1) a licensed pharmacist is not physically present in the hospital, the hospital pharmacy is closed, and a licensed pharmacist will be physically present in the hospital pharmacy within 24 hours or the next business day; or (2) when there is at
SR 489 Introduced by Senator Ligon, this resolution creates a study committee on prescribing patterns for antidepressants and other psychotropic medications, and would include a pharmacist on the committee.
looks forward to working with DCH and House leadership to ensure that the proper information is reported, information is put in the appropriate context, and further steps are taken to shine a light on PBM practices.
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Georgia Pharmacy 13
2018 HEALTHCARE-RELATED BILLS THAT FAILED TO PASS ✖✖ HB 519 (step therapy override) *
✖✖ HB 868 (low-THC OIL eligible condition expansion)
✖✖ HB 927 (APRN bill increasing supervising physician to
✖✖ HB 872 (insurer selection standards for provider network
APRN ration) * ✖✖ HB 678 (surprise billing) * ✖✖ SB 184 (creation of Integrated Health Data Project) * ✖✖ SB 325 (Interstate Medical Licensure Compact) * ✖✖ SB 334 (remove Board of Nursing from Sec. of State to DCH) * ✖✖ SB 352 (creating Commission on Substance Abuse and implementing new anti-kickback prohibitions) * ✖✖ SB 359 (surprise billing for emergency medical providers) * ✖✖ HB 716 (Georgia Pre-Arrest Diversion for Drug and Mental Health Treatment Act) ✖✖ HB 747 (unrestricted access to medications for hemophilia patients) ✖✖ HB 755 (pre-exposure prophylaxis drug assistance to at-risk people pilot program)
participation) ✖✖ HB 873 (PBM prior authorization regulation) ✖✖ HB 875 (requiring payors to reimburse providers for services reimbursable under federal/state plans) ✖✖ HB 895 (ID checks for most OTC cough syrups) ✖✖ HB 943 (requiring reimbursement for less addictive opioids) ✖✖ SB 300 (healthcare premium assistance) ✖✖ SB 322 (imposing certain requirements in connection with sale of personal assistive mobility devices) ✖✖ SB 344 (creation of Georgia retail marijuana code) ✖✖ SB 346 (repeal of low THC registry) ✖✖ SB 471 (mandatory e-prescriptions) * Crossed over but still did not pass
least one licensed pharmacist physically present in the hospital (does not have to be in the hospital pharmacy). Additionally, pharmacists performing remote order entry no longer have to be located within the state so long as they are licensed in the state and the pharmacy with which they are employed or contracted with hold either a license in this state or a nonresident pharmacy permit in this state. This bill was not without controversy, but GPhA worked with stakeholders and the bill sponsor to ensure that the Georgia Board of Pharmacy has appropriate oversight of these activities. (We appreciate all the work those stakeholders did, as well as Representative Jasperse. This bill will not only bring Georgia into line with the rest of the nation, it will allow smaller rural hospitals and their patients to access critical pharmacy care services.
code with regard to controlled substances and dangerous drugs.
HB 818 — REIMBURSEMENT
SB 407 — PDMP REVISIONS
Introduced by Representative Lee Hawkins, this bill seeks to bring transparency to the insurance reimbursement process and to give healthcare providers (including pharmacists) the ability to choose to be reimbursed via check as opposed to electronic credit cards.
This bill makes certain narrow revisions to Georgia’s PDMP as recommended by the Department of Public Health, which administers the program. This looks to ease requirements in connection with prescriber and dispenser delegation (e.g., delegates no longer have to licenses or registrations) while at the same time allowing DPH to share PDMP info with other state PDMPs as well as prescriber or healthcare facility electronic medical record systems.
HB 830 — ANNUAL DRUG UPDATE Introduced by Representative Harden, this is the annual drug update bill that updates the Georgia
SB 321 — FALSE CLAIMS ACT Senator Blake Tillery’s bill revises penalties for Medicaid false claims to bring those penalties in line with federal penalties for civil False Claims Act violations.
SB 357 — HEALTHCARE COORDINATION Senator Burke’s bill creates the Healthcare Coordination and Innovation Council in order to improve coordination of the state’s healthcare system. The bill would create and 18-member council that must include a pharmacist. (The initial bill did not specifically require a pharmacist, but GPhA worked with the legislators to ensure that pharmacy have a voice on the council.)
Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
Use of this article, or the information it contains, does not constitute any legal advice, does NOT establish any attorney-client relationship, and does NOT create any legal duty on the part of the author or the Georgia Pharmacy Association. When making a decision that may have legal consequences, readers should consult with qualified legal counsel. 14 Georgia Pharmacy
Tomorrow. Imagine That.
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BY THE NUMBERS
ll year long we’re bombarded with numbers — survey results, demographics, how many are doing this, how many are doing that. So every year we like to take some of our favorites and illustrate them (a picture being worth 1,000 words and all). This year we have a bit of a focus on economics: where the jobs are, where the growth is, where the money is going. (We know that pharmacists, especially our student members, keep a sharp eye on the future ... where it may take them and where to meet it.) But obviously that’s not all. Pharmacy is all 2500 about health, and we can see where Georgians need the most help. And we’d be remiss not to recap the long and difficult 2017–18 flu season. 2197
CURRENT GPhA MEMBERS AIP PHARMACY OWNER/ CO-OWNER
LICENSED EMERITUS ACADEMICIANS 2% 8% 6% NON-LICENSED ACADEMICIANS 1%
TECHNICIANS 5% 12% 24%
CURRENT GPhA MEMBERS
AIP PHARMACY OWNER/ CO-OWNER
LICENSED EMERITUS ACADEMICIANS LICENSED 2% PHARMACISTS 8% 6% NON-LICENSED ACADEMICIANS 1%
TECHNICIANS 5% 12%
Finally, there are some numbers we throw in 24%
for theOVER simple reason that, well, they’re interestGPhA MEMBERSHIP TIME 47%
ing. It’s a shame we don’t have more room. STUDENTS —Andrew Kantor
GPhA MEMBERSHIP OVER TIME
2197 1000 2000
■ Individual Pharmacist ■ Emeritus ■ Affiliate ■ Academician ■ Pharmacy Technician ■ Student Pharmacist * 2014: No data
Source: Mary Ritchie
■ Individual Pharmacist ■ Emeritus ■ Affiliate ■ Academician ■ Pharmacy Technician ■ Student Pharmacist Source: Mary Ritchie
16 Georgia Pharmacy
* 2014: No data April/May 2018
PHARMACY EMPLOYMENT 2016 AND 2026 PROJECTED PHARMACIST EMPLOYMENT (IN THOUSANDS)
■ STANDALONE AND LTC PHARMACIES ■ HOSPITALS ■ SUPERMARKET AND MASS MERCHANTS WITH PHARMACIES ■ PHYSICIANS’ OFFICES
■ ■ ■ ■
OUTPATIENT CARE CENTERS MAIL-ORDER PHARMACIES HOME HEALTHCARE SERVICES OTHER (GOVERNMENT, WHOLESALE, EDUCATION, ETC.) Total: 312,500
2016 Total: 330,100
WAGES JOB GROWTH 2016-2016 All occupations
The U.S. average wage for pharmacists is
$120,270 In Georgia
All healthcare workers
The U.S. average wage for pharmacy technicians is
The "South Georgia nonmetropolitan area" is the FIFTH BEST PAYING REGION in the country for pharmacists, with an avevage annual wage of $140,800 Source: U.S. Bureau of Labor Statistics, Employment Projections program
Georgia Pharmacy 17
HEALTH & WELLNESS THE 2017–18 FLU SEASON 4,064: Americans killed by the flu or pneumonia in one week in 2018
GEORGIA FLU DEATHS, 2017-18 FLU SEASON*
118: Georgia deaths from the flu itself 1,895: Georgia deaths from the flu and pneumonia, which are closely related 2,409: hospitalizations in Georgia due to influenza so far this season * These are minimum numbers as of press time
Sources: CDC, Georgia DPH
HEALTHY GEORGIANS? 36.2%
% OF GEORGIANS WHO ARE OBESE
% OF GEORGIANS WITH HYPERTENSION
% OF GEORGIANS WHO ARE PHYSICALLY INACTIVE
% OF GEORGIANS WHO SMOKE
Heart disease is the leading cause of death for people over 45. For children it’s motor vehicle accidents. For younger adults it’s motor vehicle accidents, suicide, and poisoning (e.g., overdoses) Source: Kaiser Family Foundation
OVERDOSES IN GEORGIA, 1999-2016 1500
TOTAL DRUG OVERDOSE DEATHS
900 PRESCRIPTION OPIOID OVERDOSE DEATHS ONLY
HEROIN OVERDOSE DEATHS
NUMBER OF DEATHS PER YEAR
1999-2016 TOTALS TOTAL DRUG OVERDOSE DEATHS: 15,873 PRESCRIPTION OPIOID OVERDOSE DEATHS: 5,654 HEROIN OVERDOSE DEATHS: 536
Source: Georgia Department of Public Health
18 Georgia Pharmacy
AND THE REST
PHARMACY MARKET SHARE DIPLOMAT 1.1%
CIGNA 0.7% COSTCO 0.6% PHARMERICA 0.6% AHOLD DELHAIZE 0.5% PUBLIX 0.5%
INDEPENDENT AND OTHER PHARMACIES 26%
ALBERTSON’S 1.2% HUMANA 1.5%
CVS RETAIL 14.4%
KROGER 3.2% RITE AID 3.8% WALMART/ SAM’S CLUB 5.0%
CVS MAIL ORDER/ SPECIALTY 9.4%
OPTUM RX 5.0%
Source: Drug Channels Institute
EXPRESS SCRIPTS 10.9%
A Pharmacy Index (With apologies to Harper’s) Minimum number of municipalities suing opioid manufacturers for their part in the opioid epidemic: 355 Percentage of U.S. women who smoked cigarettes during pregnancy: 7.2 Of women aged 20–24: 10.7 Of women in Georgia: 5.3 U.S. life expectancy in 2015 in years: 78.7
In 2018: 78.6 Minimum number of annual drug overdose deaths in the U.S.: 63,600 In Georgia: 1,394 Percentage of U.S. adults with diagnosed hypertension: 29.0 Of those aged 60 and over: 63.1
Number of independent pharmacies in the U.S. in 2016: 22,041 In Georgia: 684 Number of chain pharmacies* in the U.S. in 2016: 39,442 In Georgia: 1,374 Average number of fulltime-equivalent employees in an independent pharmacy: 8.1
Number of those who are pharmacists: 1.6 Who are technicians: 3.1 Percentage of prescriptions that were for generic medication in 2012: 77 In 2016: 84 Average annual sales per pharmacy location in 2007: $3,604,000 In 2016: $3,619,000
* Includes standalone stores and those in supermarkets and mass merchants Sources: CDC, NCPA
Georgia Pharmacy 19
INVESTING IN PHARMPAC IS INVESTING IN YOUR PRACTICE. 2018 PHARMPAC INVESTORS The following pharmacists, pharmacy technicians, students, and others have joined GPhAâ€™s PharmPAC for the 2017 calendar year. The contribution levels are based on investment through February 28, 2018.
Diamond Investors ($4,800 or $400/month)
RALPH BALCHIN Fayetteville
CHARLES BARNES Valdosta
MAC McCORD Atlanta
SCOTT MEEKS Douglas
FRED SHARPE Albany
Titanium Investors ($2,400 or $200/month)
DAVID GRAVES Macon
LON LEWIS St. Simons Island
BRANDALL LOVVORN Bremen
DEAN STONE Metter
David Graves, Macon, PharmPAC chairman 20 Georgia Pharmacy
2018 PHARMPAC INVESTORS Platinum Investors ($1,200 or $100/month)
Gold Investors ($600 or $50/month)
BRUCE BROADRICK THOMAS BRYAN, WILLIAM CAGLE HUGH CHANCY KEITH CHAPMAN WES CHAPMAN DALE COKER BILLY CONLEY BEN CRAVEY BLAKE DANIEL AL DIXON JACK DUNN ROBERT HATTON CASSIE HAYES MARSHA KAPILOFF IRA KATZ
JAMES BARTLING WILLIAM BREWSTER LIZA CHAPMAN BARON CURTIS MARSHALL CURTIS MAHLON DAVIDSON SHARON DEASON BENJAMIN DUPREE KEVIN FLORENCE KERRY GRIFFIN JOHNATHAN HAMRICK MICHAEL ITEOGU STEPHANIE KIRKLAND GEORGE LAUNIUS EUGENE MCDONALD BOBBY MOODY
Silver Investors ($300 or $25/month)
Nelson Anglin Michael Azzolin Claude Bates James Carpenter Michael Crooks Ed Dozier Gregory Drake Marshall Frost
JEFF LUREY IVEY MCCURDY AMY MILLER DREW MILLER WALLACE PARTRIDGE HOUSTON ROGERS JOHN SANDLIN TIM SHORT TERESA SMITH CARL STANLEY DENNIS STRICKLAND CHRIS THURMOND DANNY TOTH ALEX TUCKER TOMMY WHITWORTH
Joe Holt Susan Kane Willie Latch Tracie Lunde Hillary Jack Mbadugha Donald Piela, Jr. Terry Shaw Jonathan Sinyard Renee Smith Marie Tomblin
SHERRI MOODY SUJAL PATEL DARYL REYNOLDS ANDY ROGERS JAMES THOMAS WILLIAM TURNER CHUCK WILSON H.D. WILSON MIKE TARRANT â€” INTEGRATGED FINANCIAL GROUP
Phil Barfield Bryce Carter Mathew Crist Larry Harkleroad Phillip James Brenton Lake Micheal Lewis Amanda Stankiewicz
Marla Banks Bryan Keen Laird Miller Melissa Olsen Tri Phan Gina Roland George Sanders Austin Tull James White
($150 or $12.50/month)
(up to $150)
HELP US REACH OUR GOAL FOR 2018! Visit GPhA.org/PharmPAC to find out more.
*As of February 28, 2018
David Graves, Macon, PharmPAC chairman April/May 2018
Georgia Pharmacy 21
POSTSCRIPT From the President
Knowing the Numbers Reflecting upon the personality profile of many pharmacists, we are typically extremely analytical — black and white in our decision making, always searching for the facts, and excited about statistics. I know this LIZA CHAPMAN description has me pegged to a tee. I am always seeking the truth and appreciate numbers to help defend my decisions and opinions. Numbers help by empowering our confidence and increasing knowledge about the efficacy of the medications that we
GIVING PHARMACISTS THE ABILITY TO PERFORM RAPID INFLUENZA AND STREP TESTS WOULD BE AN INCREDIBLE BENEFIT dispense and counsel our patients about every day in practice. Our counseling and providing education enables patients to be empowered about their health and medical conditions. As a patient, “knowing the numbers” enables more accountability for one’s self and knowledge of personal health. In addition to pharmacists’ counseling efforts, some community-based practitioners have been offering specific health screenings and providing patients with blood glucose, hemoglobin A1c, and cholesterol results as these are CLIA- (Clinical Laboratory Improvement Amendments) waived tests. Pharmacists practicing in ambulatory care clinics are managing patients’ anticoagulation therapy by measuring INR levels with a simple finger stick (another CLIA-waived test). Providing patients with their screening results allows for “knowing the 22 Georgia Pharmacy
numbers” and equips both patients and pharmacists to communicate with prescribers if therapy changes are needed. Patients can have a better understanding of their medications and how adherence to therapy and lifestyle modifications can improve their numbers. During the 2018 Georgia legislative session, the passage of senate bill 422 means pharmacists’ scope of practice has been expanded to include additional OTC point-of-care tests — and that allows for additional numbers pharmacists will be able to share with both the patients and physicians and mid-level providers. Giving pharmacists the ability to perform rapid influenza and strep tests is an incredible benefit for both patients and the healthcare community. Just think how many patients would have been able to receive care at their local community pharmacy rather than visiting emergency departments and urgent care clinics if pharmacists could have performed influenza tests and dispensed anti-viral therapy under a physician-authorized collaborative practice agreement. Pharmacists in states that have legislation allowing point-of-care testing and collaborate practice agreements have proven success caring for patients. Through the legislative efforts of GPhA members and staff, our scope of practice has been expanded in a small but meaningful way. Sir Francis Bacon said, “Knowledge is power.” Providing patients with real-time screening and testing results allows for more meaningful and powerful counseling opportunities. If we can empower our patients to have improved health outcomes, then as pharmacists we must do our diligence to provide such services to allow patients to “know the numbers.” Let us be proactive and be ready when expansion of scope of practice occurs as it may be very soon. Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
Liza Chapman is GPhA’s 2017-2018 president and pharmacy clinical sales manager for Kroger’s Atlanta division. February/March2018
Keep in touch
REACH US AT 404.231.5074 OR GPhA.ORG
GPhA LEADERSHIP President & Chair of the Board LIZA CHAPMAN, Dawsonville firstname.lastname@example.org President-Elect TIM SHORT, Cumming email@example.com Immediate Past President LANCE BOLES, Hartwell firstname.lastname@example.org Directors ASHISH ADVANI, Atlanta email@example.com WES CHAPMAN, Bishop firstname.lastname@example.org SHARON DEASON, Newnan email@example.com AMY MILLER, Gainesville firstname.lastname@example.org FRED SHARPE, Albany email@example.com JONATHAN SINYARD, Cordele firstname.lastname@example.org KEVIN FLORENCE, Athens email@example.com CHRIS THURMOND, Athens firstname.lastname@example.org Chief Executive Officer BOB COLEMAN email@example.com
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Georgia Pharmacy A S S O C I AT I O N
Georgia Pharmacy 23
Fighting superbugs ... with platypus milk You read that right. “A team of Australian researchers has found that platypus milk contains novel antimicrobial properties that could help scientists battle the global superbug threat.” Why? A unique protein in the milk that may have evolved as a way to protect the young from bacterial contamination “in ways that are simply not an issue for mammals.”
Say it with pictures The Unicode Consortium — the group that sets the standards that phone and icon makers follow — has released its list of 2018 emojis. Of note to medical and science types, the new emoji list includes a microbe, lab coat, Petri dish, test tube, and DNA helix. Oh, and a mosquito. Coming soon to a phone near you.
SURPRISE FACTS “March Madness” is the busiest time of year for vasectomies
In fact, they increase by about 30 percent. Probably because some men need a few days to recover, and that might as well be in front of the television.
The flu increased orange juice sales. For the first time in nearly five years, OJ sales went up from December through January according to Nielsen — and yes, that’s thanks to the rougher than normal flu season.
24 Georgia Pharmacy
There are now more people working in the legal cannabis industry than there are dental hygienists in the U.S. Estimates say there were about 230,000 people employed in the U.S.’s legal cannabis industry in 2017, compared to about 201,000 dental hygienists. And, according to ZipRecruiter, cannabis-industry job postings increased 445% in 2017.
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Georgia Pharmacy A S S O C I AT I O N
GEORGIA PHARMACY FOUNDATION, INC. 6065 Barfield Road NE | Suite 100 Sandy Springs, GA 30328
SUNDAY, APRILOPEN15, 2018
BLACK & WHITE
SAVE THE DATE GLOSS/GRADIENT
MACON MARRIOTT & CENTREPLEX
AIP SPRING MEETING FLAT COLOR
Events and programs include: • Network with colleagues • Nomination of AIP officers • Meet with partners • CE opportunities • Medicaid/CMO roundtable Plus • Legislative Update • Continental breakfast and lunch provided
All non-AIP members who own independent pharmacies are welcome to attend AT NO CHARGE.
SHOW YOUR SUPPORT — ATTEND THIS YEAR’S AIP FALL MEETING Registration: Please fill out and fax back to (404) 237-8435 Member’s Name: Nickname: Pharmacy Name: Address: E-mail Address (please print): Will you be joining us for lunch (Noon – 1:00PM)? q Yes q No How many total will be attending? Names of Staff/Guests:
The April/May 2018 issue of Georgia Pharmacy magazine