IPA Journal Jan/Feb/Mar 2021

A Peer-Reviewed Journal | Vol. LXXVI, No. 1 | JAN.FEB.MAR. 2021

INSIDE:

COVID-19 Vaccine PharmaCE Expo Recap Deans’ Columns

TABLE OF CONTENTS 8515 Douglas Avenue, Suite 16, Des Moines, IA 50322 Phone: 515.270.0713 Fax: 515.270.2979 Email: ipa@iarx.org | www.iarx.org

PUBLICATION STAFF Allison Hale, Managing Editor Kate Gainer, PharmD Anthony Pudlo, PharmD, MBA Casey Ficek, JD Amanda Abdulbaki, PharmD Sharmi Patel, PharmD, MBA

COVER STORY COVID-19 Vaccine pg. 6

OFFICERS

CHAIRMAN Connie Connolly, RPh, BCACP – DeWitt PRESIDENT Diane Reist, PharmD, RPh – Cedar Rapids PRESIDENT-ELECT Christopher Clayton, PharmD, MBA – Manchester TREASURER CoraLynn Trewet, PharmD – Des Moines SPEAKER OF THE HOUSE Kristin Meyer, PharmD, CGP, CACP, FASCP – Marshalltown VICE SPEAKER OF THE HOUSE Deanna McDanel, PharmD, BCPS, BCACP – Coralville

TRUSTEES

REGION #1 Wes Pilkington, PharmD – Waterloo REGION #2 Shane Madsen, PharmD, BCPS – North Liberty REGION #3 Candace Jordan, PharmD, BCPS, MBA – Winterset REGION #4 Gary Maly, PharmD – Sioux City AT LARGE Emily Beckett, PharmD, BCPS – Johnston Nancy Bell, PharmD – West Des Moines Bill Doucette, PhD, RPh – Iowa City John Hamiel, PharmD – Waterloo HONORARY PRESIDENT Dan Murphy, RPh - Davenport PHARMACY TECHNICIAN Tammy Sharp-Becker, CPhT, CSPT – Des Moines STUDENT PHARMACISTS Courtney Temple – Drake University Alexis Clouse – University of Iowa The Journal of the Iowa Pharmacy Association is a peer reviewed publication. Authors are encouraged to submit manuscripts to be considered for publication in the Journal. For author guidelines, see www.iarx.org/journal.

“The Journal of the Iowa Pharmacy Association” (ISSN 1525-7894) publishes 4 issues per year: January/February/March issue; April/ May/June issue; July/August/September issue; and October/November/December issue by the Iowa Pharmacy Association, 8515 Douglas Avenue, Suite 16, Des Moines, Iowa 50322. Periodicals postage paid at Des Moines, Iowa and additional mailing offices.

POSTMASTER: Send address changes to: The Journal of the Iowa Pharmacy Association, 8515 Douglas Ave., Suite 16, Des Moines, IA 50322. Published quarterly, The Journal is distributed to members as a regular membership service paid for through allocation of membership dues. Subscription rates are $100 per year, single copies are $30. Printed by ColorFx; Graphic design done by the Iowa Pharmacy Association.

PharmaCE Expo Recap pg. 8

Legislative Day Recap pg. 21

FEATURES

COVID-19 Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 PharmaCE Expo Recap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Deans’ Columns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Legislative Day Recap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Member Forums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Annual Meeting 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

IN EVERY ISSUE

President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Iowa Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Practice Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Technician Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Members Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 IPA in Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Mission Statement The Iowa Pharmacy Association empowers the pharmacy profession to improve the health of our communities.

JAN.FEB.MAR. |

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PRESIDENT’S PAGE

PROCURE SOME TOILET PAPER WHEN IT IS NEEDED!

I

Diane Reist, PharmD, RPh IPA President Cedar Rapids

t has been a long and bumpy road for the past year or so, hasn’t it? There have been so many changes to our lives due to the global coronavirus pandemic that it almost leaves one speechless. Professional changes, personal changes, political changes, community changes – All can seem overwhelming. Yet I find on reflection that this is certainly not the first time I have felt overwhelmed by factors around me that I didn’t have control over. I have never lived through a global pandemic before, (still refuse to call it an “unprecedented” event), but I do recall having some of the same angst and concerns over other issues in my life in the past. Each time, I took the appropriate amount of time to fuss and fume, then grieve, then plan my revenge, and then come to my senses and move forward, taking the lessons that I learned and the frustrations that I felt to build something new and almost always better.

Several times in the past year I have heard colleagues of mine say, “Never let a good crisis go to waste.” What great advice! I always attributed it to Jay Currie and Gary Milavetz. Little did I realize that it is originally attributed to Winston Churchill back in the 1940s, very likely when he was talking with Stalin and Roosevelt after World War II, and the idea of the United Nations was being kicked around.

“The United Nations is an international organization founded in 1945 after the Second World War by 51 countries committed to maintaining international peace and security, developing friendly relations among nations and promoting social progress, better living standards and human rights.” www.un.org The concept of using adversity and chaos to create something better has been a common theme throughout the history of the world in all aspects and venues of humanity, including being portrayed in the movie Operation Petticoat, which takes place during WWII. An American submarine base in the Philippines is bombed, and the boat’s crew is trying desperately to make repairs so they can get away. But even during this desperate time, the bureaucracy that lies above them hinders their efforts to get the supplies they need to repair the damages. During an air raid, an officer shouts, “In confusion there is profit!”

He then utilizes that crisis to procure the supplies they need the most: including toilet paper!

We can all learn from the TP raid (although the hoarding of TP in 2020 still baffles me a little) that in times of crisis, chaos, or air raids, there is an opportunity for great

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leaders to rise to the occasion in ways they wouldn’t be able to in normal times.

Even Bud Light’s Super Bowl 55 commercial highlighted the fact that the year 2020, or as they refer to it ‘the year that shall not be named,’ was a “lemon of a year,” and what do we do with lemons when life gives you nothing but lemons? Make lemonade! (Not so sure about Lemonade Seltzer though…)

Where am I headed with all of these serious and silly references to making the best out of bad situations? We are a profession of doers, of helpers, of kindhearted, educated healthcare providers that can take the bad situations and make them better, but certainly not alone. Just as the UN started with 51 different nations, all with diverse goals, languages, needs, and peoples, and worked tirelessly to make a positive difference in the world, we too as health care providers have had to work together in times of uncertainty. Do they always get it right? Do we? No – No one does, but we keep trying. Progress can be made from chaos. We have had plenty of chaos this past year, and that signals us to take that situation and make something better.

Our association and members have been front and center with public health, local government, and other healthcare providers in coming up with solutions to COVID vaccine distribution and administration. Our association, together with our Board of Pharmacy, is squeezing lemons and using them to rewrite the Iowa Pharmacy Practice Act to create a practice environment and rules base that will allow us to do what is needed to improve the care of our patients in a new way.

This will allow us to be, as NCPA CEO Doug Hoey said during PharmaCE Expo 2021, recognized not as part of the “provider creep” that physicians talk of, but qualified providers that are reimbursed for professional services.

Scott Knoer, APhA CEO, also shared at Expo that he believes “the future is bright,” and we are being recognized for our rightful place in providing medication services, not just medications. Chad Worz, ASCP CEO, encouraged that we need to have the confidence to position ourselves to provide solutions to problems, whether it is in a healthcare institution or doctor’s office in addition to our more traditional practices. Paul Abramowitz, CEO of ASHP, offered his time and team to help sweeten that lemonade by focusing on Iowa specific issues.

As we all see daily, there are a lot of people who have received more lemons than ourselves. Simply being aware that these issues exist does not get us any closer to helping alleviate the poor health outcomes that they cause.

Rather, that chaos and adversity give us a place to start.

Doug Hoey, CEO, NCPA

Paul Abramowitz, CEO, ASHP

I am so excited that we focused education at this year’s PharmaCE Expo on how to truly assess, come face to face with, and address the social determinants of health and structural racism that our patients live with every day. Even though it seems like another chaotic mess of adversity, by working together we can make a positive dent in this situation too. Squeezing those lemons or grabbing that toilet paper is our responsibility, our expertise, our privilege! Lemonade tastes awfully good and well….TP is necessary.

If any of these charges sound familiar, think back to the words we spoke when we graduated from pharmacy school:

“I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow: I will consider the welfare of humanity and relief of suffering my primary concerns.

I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.

I will respect and protect all personal and health information entrusted to me.

I will accept the lifelong obligation to improve my professional knowledge and competence.

I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical, and legal conduct.

I will embrace and advocate changes that improve patient care.

I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists.

I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.”

JAN.FEB.MAR. |

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COVID-19 VACCINE

COVID-19 VACCINE DISTRIBUTION IN IOWA

T

he FDA issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine on December 11, 2020 and for the Moderna COVID-19 vaccine on December 18, 2020.1,2 However, planning for vaccine distribution in Iowa began long before December 2020. The Iowa Department of Public Health (IDPH) internal planning group began officially meeting in mid-August 2020 and reached out to partner organizations, including the Iowa Pharmacy Association and the Iowa Board of Pharmacy, in mid-September.3 IDPH communicated with partner organizations through weekly webinars and shared documents through the Iowa Health Alert Network (HAN).3 These communication strategies have remained throughout the vaccine rollout.

On December 2, 2020, the Advisory Committee on Immunization Practices (ACIP) released their recommendations for priority groups to receive vaccine. On December 4, IDPH announced that an Infectious Disease Advisory Council (IDAC) would be convened to provide clinical guidance for determining priority populations for vaccination in Iowa.3,4 Members of IDAC were intended to represent multiple perspectives with clinical and ethical expertise from across the state.3 Phase 1A in Iowa, as recommended by IDAC, aligned with ACIP recommendations to vaccinate healthcare personnel and residents of long-term care facilities.5 The first doses of Pfizer-BioNTech vaccine arrived at Iowa hospitals on December 14, and healthcare workers began receiving their first doses.6,7 David Conway, RN, an emergency room nurse at the University of Iowa Hospitals & Clinics, was the first Iowan to receive the vaccine.7 Long-term care residents began receiving their first doses of vaccine on December 28.8 Vaccinations of long-term care residents and staff in Iowa were provided through the Federal Long-Term Care Pharmacy Partnership Program using the Pfizer-BioNTech vaccine.9 The program assigned long-term care facilities to Walgreens, CVS, or Community Pharmacy to provide vaccinations to current staff and residents.9 IDPH has utilized a localized approach in working with local county public health agencies to directly allocate and distribute vaccine within each county. Each local county public health agency has autonomy to identify local partners for vaccine administration. To identify providers who wish to administer the COVID-19 vaccine, IDPH utilized a REDCap survey that was accompanied by the

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CDC’s COVID-19 Vaccination Program Provider Agreement.3 Vaccines providers had to be enrolled within the state’s immunization registry, which was a primary tool for capturing and reporting doses provided.

Over 500 pharmacies in 96 of Iowa’s 99 counties are state-approved and able to administer COVID-19 vaccines.

On February 1, 2021, IDPH activated Phase 1B of vaccine distribution.11 Phase 1B will include individuals aged 65 years and older, and a tiered-approach for first responders, PreK-12 school staff and childcare workers, individuals living in congregate settings other than college dormitories, government officials, health and safety inspectors, and correctional facility staff.11 Since the number of eligible Iowans has exceeded the number of available vaccines, these populations were further divided into five tiers to accommodate continued short supply of vaccine.11 The vaccine rollout has brought criticism into the federal process as Iowa has received some of the smallest vaccine allocations in the nation.12 As the new Biden Administration announced plans to secure 200 million additional doses of vaccine, IDPH has reported that Iowa’s vaccine allocation would slowly begin to increase beginning in February.12 Given the increased population that will become eligible for vaccination in Phase 1B and anticipated increased vaccine supply, the Federal Retail Pharmacy Program is expected to be activated sooner than expected to improve vaccine distribution utilizing additional community pharmacy partners with direct allocation from the federal government.

IPA continues to work directly with IDPH and other key stakeholders across the state to ensure equitable and efficient distribution of the COVID-19 vaccine to all Iowans. Stay tuned to IPA communications for the latest information.

SOURCES:

1. Pfizer-BioNTech COVID-19 Vaccine. FDA. January 12, 2021. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine.

2. Moderna COVID-19 Vaccine. FDA. January 6, 2021. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccine.

3. Iowa COVID-19 Vaccination Strategy Working Draft Version 2.0. Iowa Department of Public Health.

December 4, 2020. https://idph.iowa.gov/Portals/1/userfiles/61/covid19/vaccine/V%202%20IOWA%20 COVID-19%20VACCINATION%20STRATEGY%2012_4_20_FINAL.pdf.

4. Infectious Disease Advisory Council (IDAC) COVID-19 Vaccine and Therapeutics Priority Distribution Framework. IDPH. December 4, 2020. https://idph.iowa.gov/Portals/1/userfiles/61/covid19/vaccine/ IDAC_Framework_Dec2020.pdf.

5. Vaccine Shortage Order. IDPH. December 14, 2020. https://idph.iowa.gov/Portals/1/userfiles/61/ covid19/vaccine/Vaccine%20Shortage%20Order%20Phase%201-A%20FIN.pdf.

6. COVID-19 vaccine arrives in Iowa, first doses administered. KCCI Des Moines. December 14, 2020. https://www.kcci.com/article/first-doses-of-pfizer-covid-19-vaccine-arrive-in-iowa/34962755.

7. Pfizer-BioNTech vaccine delivered to UI Hospitals & Clinics. UIHC. December 14, 2020. https://uihc. org/pfizer-biontech-vaccine-delivered-ui-hospitals-clinics.

8. Stein E. Vaccinations begin in long term care facilities in Iowa. KCRG Cedar Rapids. December 29, 2020. https://www.kcrg.com/2020/12/30/vaccinations-begin-in-long-term-care-facilities-in-iowa/.

9. COVID-19 Vaccine Update. Leading Age Iowa. https://www.leadingageiowa.org/lai-covid-19news---12-7-2020.

10. Iowa COVID-19 Vaccine Doses Administered Report. IDPH. January 25, 2021. https://idph.iowa. gov/Portals/1/userfiles/61/COVID19%20Vaccine%20Administration.pdf?utm_medium=email&utm_ source=govdelivery.

11. Phase 1-B Supplemental Vaccine Shortage Order. IDPH. January 21, 2021. https://idph.iowa.gov/ Portals/1/userfiles/61/covid19/vaccine/COVID%20Vaccine%20Shortage%20Order%20Phase%201-B%20 FINAL_1_21_21%20%281%29.pdf.

12. Price D. Iowa’s COVID-19 Vaccine Supply Will Increase Next Week, health Department Confirms.

WHO13 Des Moines. January 26, 2021. https://who13.com/news/coronavirus/iowas-covid-19-vaccinesupply-will-increase-next-week-health-department-confirms/.

COVID-19 VACCINE

BE PREPARED FOR QUESTIONS:

T

HOW DOES THE MRNA VACCINE TECHNOLOGY WORK?

wo messenger RNA (mRNA) vaccines for COVID-19 have been granted emergency use authorization in the United States. These vaccines work by a novel mechanism, though mRNA technology has been studied for its potential application in healthcare for over thirty years. The first report of successful use of synthetic mRNA in mice was published in 1990.1 Instead of using a dead or weakened version of the virus to illicit an immune response, as traditional vaccines would, the mRNA vaccines instruct cells to produce a piece of the spike protein SARS-Cov-2 that enters cells to prompt the body to recognize that protein and produce antibodies to the virus.2 The mRNA vaccines are injected intramuscularly into the deltoid muscle on the upper arm. The mRNA is encapsulated in a layer of lipid nanoparticles to protect it from degradation as it makes its way to the lymph nodes near the injection site. Once in the lymph nodes, the mRNA enters the cytoplasm of dendritic cells and macrophages where it is transcribed to produce spike proteins. The dendritic cells and macrophages then break down the mRNA and display the spike proteins on their cell surfaces to activate T-cells and initiate antibody production. The mRNA never enters the cell’s nucleus and does not affect the patient’s DNA. It is also important to note that the vaccines do not provide instructions for the body to produce the full virus, and it is not possible to become infected from COVID-19 through the mRNA vaccines.2 Exogenous mRNA tends to cause a significant immune response, which leads to efficacy in providing protection from the virus but may also lead to adverse effects. Both the mRNA-1273 SARS-CoV-2 vaccine, produced

by Moderna, and the BNT162b2 mRNA Covid-19 Vaccine, produced

by Pfizer and BioNTech, reported high rates of efficacy in their phase 3 trials at 94.1% and 95%, respectively.3,4 In Moderna’s trial, no severe COVID-19 infections were reported in the vaccine group, compared to 30 severe infections including one fatality in the placebo group.3 Pfizer reported one severe COVID-19 infection in the vaccine group and nine in the placebo group following the first dose of vaccine.4 This data indicates that both vaccines are effective in preventing mild and/or symptomatic COVID-19 infections.

Trials for both vaccines reported local and systemic adverse effects.

Injection site pain was the most common local adverse effect reported in both trials, though redness and swelling were also reported.3,4 The pain was typically reported as mild to moderate in intensity. Data from Moderna’s trial shows an incidence rate of >80% for injection site pain and patients reported that the pain resolved over 2-3 days.3 Pfizer’s trial found an incidence rate of >70% for injection site pain, and patients reported that pain resolved within 1-2 days.4 Headache and fatigue were the most common systemic adverse effects caused by both vaccines, though these effects were reported by a slightly higher percentage of the patients in the Moderna trial than the Pfizer trial.3,4 In both trials, systemic adverse effects were more pronounced after the second dose than after the first dose of vaccine and were more commonly reported by younger patients than older patients.3,4 In the Moderna trial, the incidence of patients in the vaccine group reporting headache was 32.7% after the first dose and 58.6% after the second dose. 37.2% of patients receiving Moderna vaccine reported fatigue after the first dose, and 65.3% reported fatigue after the second dose.3 34-47% of patients receiv-

ing the Pfizer vaccine reported fatigue after the first dose, and 51-59% reported fatigue after the second dose.4 25-42% experienced headache after the first dose, compared to 39-52% after the second dose.4 Muscle and joint pain, chills, and gastrointestinal effects were also reported to a lesser extent with both vaccines.3,4 Despite these adverse effects, the Food and Drug Administration (FDA) considers both vaccines to be safe and effective based on the available data.

Both have been granted emergency use authorization and are being administered across the country. While they are both intramuscular injections, there are a few important differences in storage, stability, and administration. Pfizer’s vaccine requires ultracold storage at -80 to -60°C and must be diluted before use.4,5 It is only stable for five days in the refrigerator and must be used within six hours once brought to room temperature.5 Patients aged 16 years and older receive two doses of 0.3 mL 21 days apart.4 The Moderna vaccine remains stable at higher temperatures than the Pfizer vaccine for greater lengths of time.6 For longer periods of storage, it should be kept in a freezer between -25 and -15°C, but it may be stored in the refrigerator for up to 30 days.6 Patients aged 18 years and older receive two doses of 0.5 mL 28 days apart.3 The widespread use of these two vaccines is the result of significant progress in the evolution of mRNA vaccine technology. Though the vaccines present some challenges, they are highly effective in preventing symptomatic COVID-19 infections.

SOURCES:

1. Pardi N, Hogan MJ, Porter FW, Weissman D. mRNA Vaccines – A New Era in Vacinology. Nature Reviews. Drug Discovery. 2018; 17(4): 261.

2. Understanding and Explaining mRNA COVID-19 Vaccines. Centers for Disease Control and Prevention. Last reviewed November 24, 2020. https://www.cdc.gov/vaccines/covid-19/hcp/mrna-vaccine-basics.html.

3. Baden LR, El Sahly HM, Essink B, Kotloff K, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. NEJM. 2020. DOI: 10.1056/NEJMoa2035389.

4. Polack FP, Thomas SJ, Kitchin N, Absalon J, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. NEJM. 2020; 383: 2603-2615.

5. Pfizer-BioNTech COVID-19 Vaccine Storage and Handling Summary. Centers for Disease Control and Prevention. December 22, 2020. https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/ downloads/storage-summary.pdf.

6. Moderna COVID-19 Vaccine Storage and Handling Summary. Centers for Disease Control and Prevention. December 20, 2020. https://www.cdc.gov/vaccines/covid-19/info-by-product/moderna/ downloads/storage-summary.pdf.

Both Written By: Maureen Martin, PharmD Candidate Class of 2021, University of Iowa College of Pharmacy

JAN.FEB.MAR. |

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PHARMACE EXPO

LEARN. CONNECT. BE INSPIRED. PharmaCE Expo took on a new name and virtual format in 2021 but continued to provide high-quality CE and networking opportunities for pharmacy professionals across the state of Iowa and country. This year’s event spanned one week, February 1-7, with a clinically intensive debate on a pharmacotherapy topic released each morning and lunch networking hours throughout the work week. Primary programming took place on Saturday, February 6 and Sunday, February 7.

Debate topics included cardiology, immunizations, oncology, diabetes, and iron, procalcitonin and hypertension. Faculty from Arizona to Iowa and Texas to Illinois participated in these debates that were well-praised by event attendees. National pharmacy executives, including Chad Worz, CEO of ASCP, Scott Knoer, CEO of APhA, Doug Hoey, CEO of NCPA, and Paul Abramowitz, CEO of ASHP, also joined the week’s agenda during VIP lunch hours.

Vibhuti Arya Amirfar, PharmD, MPH, kicked-off Saturday morning’s session with her presentation on addressing structural racism, intentional and unintentional, in healthcare. After a short break, panelists of 25 Ways: Top 5 Ways Pharmacists and Pharmacy Technicians Can Influence Social Determinants of Health in 5 Categories each gave a ten-minute preview on a particular social barrier to patient health, including maternal care and inequity; grief, depression and loneliness; patients in rural areas or transportation issues; obesity and food insecurity; and aging patients and affordable housing. Attendees then chose the breakout session they wished to learn more about.

After lunch, Dr. Christina Madison started the afternoon’s session with an overview of the pharmacist’s role in the COVID-19 pandemic, as well as the concept of pandemic preparedness. Dr. Geoffrey Wall then provided an in-depth clinical view of COVID-19 therapies, vaccines and its affect on pharmacy. Following GameChangers: COVID-19 Edition, attendees participated in a facilitated breakout session to further discuss each topic.

Joe Strain, PharmD, kicked-off the “Annual Favorite” programming Sunday morning with an update on newly approved medications and integrating them into practice. David Brushwood, RPh, JD, then presented a case to evaluate workplace liability in pharmacist-administered immunizations. To close PharmaCE Expo 2021, Lisa Wilhelm, BSPharm, RPh, described how meditation can be used to improve patient safety and personal well-being.

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PHARMACE EXPO

MISSED IT LIVE?

11.5 hours of CE for pharmacists and 9 hours of CE for pharmacy technicians are available through PharmaCE Expo On-Demand.

Scan the QR code below to purchase!

JAN.FEB.MAR. |

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HEALTHCARE HOT TOPICS

ADA UPDATES STANDARDS OF MEDICAL CARE FOR PATIENTS WITH DIABETES

In December, ADA released 2021 Standards of Medical Care based upon the latest scientific diabetes research and clinical trials. Updates include evidence for diabetes treatment for people also managing chronic kidney disease and heart failure, the use of technology for diabetes management and individualized care, as well as recommendations for continuous glucose monitoring (CGM) for people with diabetes-based on therapy, important information on addressing social determinants of health in diabetes and barriers to, and critical times for diabetes self-management education and support (DSMES).

OVERDOSE DEATHS ACCELERATING DURING COVID-19

Data collected by the CDC suggest that the COVID-19 pandemic has accelerated the trend of increasing overdose deaths in the United States.

Synthetic opioids, especially illicitly manufactured fentanyl, are the primary driver of this trend but deaths related to cocaine and psychostimulants, such as methamphetamine, have also increased. On December 17, 2020, the CDC issued a health advisory recommending expanded distribution and use of naloxone and overdose prevention education, increased awareness and availability of and access to treatment for substance use disorder, early intervention for individuals at highest risk for overdose, and improved detection of overdose outbreaks to facilitate a more effective response.

HHS RELEASES ADVISORY OPINION CLARIFYING THAT 340B DISCOUNTS APPLY TO CONTRACT PHARMACIES

Under the 340B program, drug manufacturers are obligated to provide discounts to covered entities, including safety net hospitals, community health centers, and other institutions that serve vulnerable populations.

In some instances, drug manufacturers have been refusing to provide 340B discounts to pharmacies contracted with covered entities to supply the drugs to patients. On December 30, HHS stated in an advisory opinion that contract pharmacies should receive the same discounts as covered entities under the 340B program when acting as an agent of a covered entity to provide services.

FDA ENCOURAGES INCREASED DIVERSITY IN CLINICAL TRIALS AND MEDICAL PRODUCT DEVELOPMENT Lack of diversity in clinical trials and medical product development contribute to health care disparities. Racial and ethnic minorities, older adults, individuals with comorbid conditions, those with disabilities, and patients at weight extremes are some examples of populations that tend to be underrepresented in clinical trials but likely to use the drug

or medical product being studied. To address this concern, the FDA issued guidance in November addressing how sponsors can increase enrollment of underrepresented populations in their studies. These recommendations include reducing patient burden for participation by decreasing the number of required visits, offering flexibility in visit windows, and using electronic communications, if appropriate, and early engagement with patient advocacy groups who may help the sponsors better understand what changes would make patients more able or willing to participate.

MANY HEALTH PLANS MUST NOW COVER PREP

The United States Preventative Task Force (USPSTF) gave Preexposure prophylaxis (PrEP) an “A” rating in June 2019, meaning that USPSTF recommends the service due to high certainty of substantial net benefit.

Under the Affordable Care Act (ACA), services that receive and “A” or “B” rating from USPSTF must be covered by most private health plans without cost sharing. A recent study suggests that fewer than 10% of people eligible for PrEP are currently taking it, which may be related to the expense of the service. While the ACA requires that the drugs be covered without cost sharing, it is unclear if the necessary monitoring services, such as office visits and lab work, also need to be provided at no cost to the patient.

RECORD AMOUNT OF MEDICATIONS COLLECTED DURING NATIONAL PRESCRIPTION DRUG TAKE BACK DAY

October 24 was National Prescription Drug Take Back Day. This year, the DEA and its partners collected nearly a million pounds of unused, expired, or unwanted medications at 4,587 different sites across the country, setting a record for the ten-year-old program. Since the program started, the DEA has collected 13.7 million pounds of medications. Unused, expired, or unwanted medications can also be disposed of throughout the year at any of 11,000 DEA authorized collectors. A list of these sites can be found on the DEA website, and additional information on safely disposing of medications at home can be found on the FDA and EPA websites.

CDC UPDATES TREATMENT GUIDELINES FOR GONOCOCCAL INFECTION

Due to increasing concern for antimicrobial stewardship, the CDC has updated its recommendations for treatment of sexually transmitted diseases (STIs) caused by Neisseria gonorrhoeae. The CDC previously recommended treatment with a single 250 mg IM dose of ceftriaxone and a single 1 g oral dose of azithromycin for uncomplicated gonococcal infections of the cervix, urethra, and rectum. New guidelines recommend a single 500 mg IM dose of ceftriaxone for uncomplicated urogenital, anorectal, and pharyngeal gonococcal infections. If chlamydial infection has not been ruled out, concurrent treatment with 100 mg of doxycycline twice daily for seven days is also recommended.

JAN.FEB.MAR. |

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FROM THE DEAN

DILIGENT AND RESILIENT: ALL IN THIS TOGETHER

A Renae Chesnut, EdD, MBA, RPh Dean Drake University College of Pharmacy & Health Sciences

s we reflect on the past several months and the numerous changes made due to the pandemic, we are proud of the pharmacy profession in the state of Iowa for coming together and being resilient and diligent in providing a high level of patient care. We are also appreciative of the numerous preceptors who continued to provide our students outstanding educational experiences, even though it often meant additional work. The dedication shown to our students’ education has been nothing short of inspiring.

While the pandemic also had an impact on our campus courses and operations, we continued to deliver on our mission of preparing today’s learners to be tomorrow’s health care leaders. Our faculty and staff transitioned to virtual instruction and mentoring last spring and created hybrid learning experiences this fall. Our experiential department dealt with hundreds of changes in experiential education schedules and devoted additional time, ensuring students fulfilled their requirements. Our students demonstrated their resilience, patience, agility, and openness to new ways of learning. As a result of all of these efforts, the College swiftly adapted to the circumstances while serving our community.

One such effort was the organization and completion of COVID-19 tests for 1,400 students before the start of the fall semester, along with ongoing testing of approximately 100 students each week to support the surveillance efforts.

Students, faculty, and staff will continue these efforts prior to and during the spring 2021 semester as well. The College has also partnered with Hy-Vee, allowing our faculty and students to administer COVID-19 vaccinations to eligible community members at the new Harkin Institute building on Drake’s campus.

A few of the other partnerships, new educational opportunities, and highlights from the past year: • A Master of Science in Health Informatics and Analytics program launched this past fall semester.

This 30-credit hour online degree can be completed as a stand-alone program for practicing professionals, or along with the PharmD for current students.

• We celebrated the one-year anniversary partnership with Tabula Rasa HealthCare® (NASDAQ: TRHC) that created a clinical intelligence center and new opportunities for our students to provide additional patient care services.

• In the latest U.S. News and World Report’s “Ameri-

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ca’s Best Graduate Schools,” the pharmacy program advanced to 4th place among private programs, an advancement from 5th place in 2017.

Our students continue to excel in obtaining residencies, highly competitive fellowship positions, and other post-graduate positions. Several students were also the recipients of national honors: • Leah Bishop (P2) was one Leah Bishop of five pharmacy students in the nation among 689 applicants to receive a CVS Health Minority Scholarship.

• Jesse Upton (P4) was accepted into the AACP Walmart Scholars Program.

• Nevin Radechel (P3) was accepted as a student scholar for the Academia-CPESN Transformation (ACT) Pharmacy Collaborative Midyear Meeting.

• Drake’s chapters of Phi Delta Chi and Kappa Psi both ranked in the top 10 chapters of their respective fraternities’ national chapter awards.

Recent recognitions and awards for the faculty include the following: • Sarah Grady received the national Phi Delta Chi Chapter Advisor of the Year.

• Sally Haack was elected the AACP Council of Faculties Secretary of Knowledge Management.

• Renae Chesnut was installed as Chair-elect of the AACP Council of Deans and joined the AACP Board of Trustees.

• Several grants and contracts were received, including Pramod Mahajan, who was awarded a $345,013 grant for the SoapyCilantro® STEM Scale Up Program.

• Ron Torry was the recipient of the 2020 Drake Madelyn M. Levitt Teacher of the Year.

Congratulations as well to national pharmacy leader, Charlie Porter, PH’70, who received the 2020 Lawrence C. and Delores M. Weaver Medal of Honor, the highest honor given by the College.

As a result of all the work of our faculty, staff, preceptors, alumni, and students that led to these collaborations and accomplishments, the Drake University College of Pharmacy and Health Sciences continues to live up to its mission and take an active role in overcoming COVID-19.

To all the IPA members who support our College and assist us in these endeavors, thank you for your diligence and resilience! ■

FROM THE DEAN

I

THE CALM IN A TUMULTUOUS STORM

n a recent communication to our Hawkeye Pharmacy family, I noted that I had run out of adjectives to describe the events of 2020. Indeed, let us hope humankind never again is called upon to endure another year like it!

It would be easy for me to wax on about the many accomplishments of our faculty, staff, and students this past year despite the tremendous challenges imposed by the pandemic. Instead, I would urge readers to view recent issues of HawkScripts, our College’s publication, that nicely captures many of those successes.

In honor of those who have been on the front lines, I prefer to devote this column to pharmacists and pharmaceutical scientists both domestic and across the globe.

On countless occasions, they have been the ‘calm in a tumultuous storm,’ responding to the medication needs of patients in ways too numerous to mention. Creativity, resilience, and perseverance abound.

All spectrums of the profession have been on full display, from acute care to ambulatory care, from rural to urban, from logistics and operations to patient-specific therapy, from bench-to-bedside, and from the classroom to the emergency room. No aspect of our profession has been spared the challenges imposed by this pandemic.

Throughout it all, pharmacists and pharmaceutical scientists utilized their intellect, talents, and skills to bring to the fore feats that many believed unattainable.

New methods of care delivery were established, and new drugs and vaccines were developed in an unimaginable timeframe, all serving as testament of a profession that goes about its business with little to no public recognition for its efforts, yet its overwhelming impact upon humankind deserves such recognition. In this regard, I was touched deeply by a simple yet poignant recent social post by one of our faculty, Professor Laura Knockel, who

simply noted: “This is what we do…we plant the seed and watch them grow,” in referencing the powerfully important interface between student and faculty. No fanfare – Just going about one’s business…The Calm!

Laura Knockel

I would be remiss if I didn’t also note the vitally important role that IPA has played throughout the past year.

From delivering high quality education, to relentless advocacy, to serving as the master weaver of our professional fabric, whose efforts to interlace us through an ongoing virtual social interface has never been more important as pharmacists across the State have often felt isolated and overwhelmed. I know I speak for many in offering a heartfelt salute to our IPA colleagues for their dedication and resolute commitment to the profession!

Donald Letendre, BS Pharm, PharmD, FASHP Dean University of Iowa College of Pharmacy

While there are rays of sunshine and glimmers of hope emerging almost daily, the storm is far from over. Our profession will continue to be challenged in ways currently unimaginable. However, as we continue to strive to defeat this relentless adversary, one thing is clear: Pharmacy…practitioners, scientists, educators, and the many others who comprise our profession…is at its best when faced with a common foe. We pull together, we support each other, and we serve as the one profession which represents calm in times of turmoil. ■

JAN.FEB.MAR. |

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PRACTICE ADVANCEMENT ADDRESSING SOCIAL DETERMINANTS OF HEALTH THROUGH IMPLEMENTATION OF HIV AND HCV SCREENINGS

January 2021 marked the two-year anniversary of the launch of the HIV screening project in collaboration with the Iowa Department of Public Health’s Bureau of HIV, STD, and Hepatitis. Over the two years, 12 community pharmacies from across the state have been offering free HIV screenings for their communities.

The five-year grant provides funds to deliver technical assistance and marketing materials for participating pharmacies as well as INSTI HIV1/HIV-2 Antibody Test Kits. The INSTI Test is a rapid in vitro qualitative test for the detection of antibodies to HIV virus Type 1 and Type 2 in fingerstick blood. The test yields results in as little as one minute and makes it easy to include in a variety of workflow models.

To participate in the project or to learn more, please contact Kellie Staiert, IPA’s lead project manager at kstaiert@iarx.org.

Social determinants of health, such as socio-economic status, education, neighborhood, employment, access to healthcare and mental health services, can contribute to infectious-disease-related health disparities that impact minority communities. As an example, communities of color in the state of Iowa experience significantly higher rates of HIV and STDS than white Iowans. IDPH works to achieve health equity in a variety of ways including data analysis and program activities and outreach. The Data Management & Health Equity Program within IDPH provides stakeholders (such as IPA) technical assistance as it relates to stigma and misinformation around HIV.

Studies have shown that the INSTI Test is extremely accurate and has a greater than 99% specificity. The INSTI Test is a screening test and is not a final confirmation of HIV infection, therefore a confirmatory test is required if a positive result is given. In the event of a positive result, participating pharmacies utilize collaborative practice agreements or collaborate with their local public health departments to refer their patients for confirmatory tests.

In addition to HIV screenings, the project also includes HCV screenings. A pilot site for HCV screenings was identified in the fall of 2020 and started offering screenings in December 2020.

The OraQuick HCV Rapid Antibody test used in the project is a single-use immunoassay for the detection of antibodies to Hepatitis C in fingerstick blood specimens from individuals 15 years or older. The test results are interpreted after 20 minutes utilizing a developer solution vial. In the event of a positive or reactive test result, the pilot pharmacy is collaborating with their local public health department to refer their patient for a confirmatory test.

IPA is working to add additional pharmacies to both the HCV and HIV project. With the goal of 40 sites, IPA is looking to gain more interest in offering HIV testing in the following counties: Palo Alto, Pocahontas, Calhoun, Webster, Humboldt, Kossuth, Clarke, Decatur, Wayne, Lucas, Monroe, Appanoose, Wapello. These are areas of the state that the Iowa Department of Public Health considers focus areas, based on their epidemiology reporting.

IPA PARTNERS WITH IMS, PCA, AND IHA ON RURAL HEALTHCARE WORKFORCE

IPA has partnered with the Iowa Medical Society (IMS), Primary Care Association (PCA), and Iowa Hospital Association (IHA) to facilitate and execute on a strategic vision and comprehensive planning to address rural health workforce issues in Iowa. Through a collaboration with the Iowa Department of Public, this stakeholder group will identify current and anticipated healthcare workforce shortages in Iowa, convene

regional meetings and leadership stakeholder meetings in order to prepare an Iowa Healthcare Workforce Strategic Plan.

Most regional meetings have occurred throughout 2019 and 2020, while leadership stakeholder meetings will occur in 2021. This stakeholder meeting will utilize results of a survey from Iowa practitioners and members of the public with ideas, concerns, and considerations for the strategic plan. The final strategic plan will be submitted to the Iowa Department of Public Health in the summer of 2021.

JAN.FEB.MAR. |

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PHARMACY NEWS

INSULIN SLIDING SCALES COULD COST YOU BIG MONEY From our partners at Pharmacy Audit Assistance Service (PAAS) National

Insulin continues to be one the most targeted medication for audits.

Having an insulin prescription with a sliding scale attached can be easy prey for auditors. Anytime there is a sliding scale on insulin, a daily maximum number of units must be on the prescription in order to calculate an accurate days’ supply. Let us look at a few examples of some written instructions that an auditor could flag: 1. Use as Directed 2. Per Sliding Scale 3. Inject 30 units in the morning, 20 units at night and as per sliding scale

a. Auditor will not assume maximum daily dose is 50 units 4. Inject 35 units once daily. If blood sugar greater than 130, increase by 3 units every three days until lower than 130

a. Auditor will not assume maximum daily dose is 35 units

» Document a clinical note on the hard copy (who you spoke with and their title, date and time, maximum number of units clarified and your initials) • Clarify the maximum number of units per day prior to the first fill » Be sure to include the maximum daily dose on the patient label » PBMs may mark the prescription discrepant if the directions are not on the patient label or clarified after dispensing • You must obtain a maximum number of units per day even if you are dispensing the smallest package size (i.e. 1 vial or 1 box of insulin pens) PAAS National® is committed to serving community pharmacies and helping keep hard-earned money where it belongs. Contact us today at (608) 8731342 or info@paasnational.com to see why membership might be right for you.

By Trenton Thiede, PharmD, MBA, President at PAAS National®, expert third party audit advice and FWA/HIPAA compliance. © 2021 PAAS National® All Rights Reserved

PAAS TIPS:

• Call the doctor’s office to obtain an estimated maximum number of units per day when the instructions are written for “use as directed” or anytime a sliding scale is attached

UPDATED COVID-19 RESOURCES In light of the ongoing changes and key issues regarding COVID-19, IPA utilizes its COVID-19 Resources webpage as the most timely source of information on testing, therapies, vaccines and government activity, as well as IPA’s COVID-19 Progress Tracker, workforce assistance and continued Connecting Over COVID-19 webinars.

IPA encourages members to familiarize themselves with the updated www.iarx.org/covid19 webpage. If you have additional questions and are unable to find the answer, as always, please do not hesitate to reach out to IPA staff.

NEW PAGE FEATURES: - IPA COVID-19 Progress Tracker - Resources for media interviews and COVID talking points - State and national testing guidance - Anticoagulation protocols - Fact sheets per vaccine developer for healthcare providers and recipients - And MORE!

Access resources, view workforce volunteers and register for upcoming webinars at www.iarx.org/covid19

PUBLIC AFFAIRS

BOARD OF PHARMACY: REGULATORY UPDATE The Iowa Board of Pharmacy convened for virtual open session on November 26 and January 12 to discuss multiple requests, reports, and several proposed rules.

ADOPTED REGULATIONS

EXECUTIVE DIRECTOR UPDATE

The Board voted to adopt a proposed rule-making that clarifies that patient information which is needed for a pharmacist to conduct drug utilization reviews shall be obtained and that the collection of such information can be delegated to a pharmacy technician. The rule-making also provides that an electronically transmitted prescription must include the telephone number where the prescriber can be contacted and updates a reference.

Iowa Board of Pharmacy Executive Director Andrew Funk provided an update to the Board on current member terms. Jason Hansel will be finishing his second term on the Board in the spring of 2021. Ed McKenna will be wrapping up his third and final term with the Board in the spring of 2021.

Funk also discussed the Opioid Naloxone Education (ONE Rx) Program. NABP approached the Iowa Board of Pharmacy about the possibility of rolling the program out in Iowa. The program reimburses pharmacies $20 for screening individuals who may be at risk for opioid abuse.

FDA COMPOUNDING MEMORANDUM OF UNDERSTANDING

Universal Practice Standards and Electronic Data and Automated Systems

Nuclear Pharmacy Practice

The Board voted to adopt a proposed rule to amend Chapter 16, “Nuclear Pharmacy Practice,” in the Iowa Administrative Code. The proposed amendment would include a requirement that nuclear pharmacies comply with the minimum standards identified in the United States Pharmacopeia General Chapter 825 which applies to radiopharmaceuticals and will be effective December 1, 2020.

On October 26, 2020, the FDA announced the availability for signature of the standard Memorandum of Understanding (MOU) Addressing Certain Distributions of Compounded Human Drug Products between state boards of pharmacy or other state agencies and the FDA. The purpose of this memorandum is to protect public health through collaboration with individual states. This goal would be accomplished through improved communication, maximization of both federal and state resources, and expanded information sharing between the FDA and various state agencies regarding compounded human drug products distributed interstate. The Board solicited public comment and feedback and decided to sign on to the MOU.

Controlled Substances

LANDMARK CASE DECIDED IN FAVOR OF PHARMACY

benefit plans, preempts the states from regulating the amount that PBMs pay pharmacies to dispense prescription drugs that are covered by an employer-sponsored health plan. SCOTUS held that rate-regulation and mechanisms to enforce rate regulation, like those under the Arkansas law at issue, fall outside of ERISA preemption.

The Supreme Court of the United States issued its landmark ruling in Rutledge v. Pharmaceutical Care Management Association (PCMA), determining whether community pharmacies are protected from abusive payment practices.

The unanimous (8 to 0) decision ruled in favor of the interests of patients and community pharmacies, who have been fighting for years to regulate pharmacy benefit managers (PBMs), the controversial middlemen that manage prescription drug benefits for health insurers, Medicare Part D drug plans, and large employers. With this ruling, states will have greater authority to protect their local businesses and their patients from PBM overreach.

At issue was the extent to which the federal Employee Retirement Income Security Act of 1974 (ERISA), which regulates private employee

The Board also voted to adopt a proposed notice of intended action to amend Chapter 10, “Controlled Substances,” of the Iowa Administrative Code. The proposed amendments make temporary amendments to the Iowa Code for scheduling action in the Iowa Controlled Substances Act to match similar action taken by the federal Drug Enforcement Administration. The proposed amendments add one substance (synthetic opioid) to Schedule I and remove FDA-approved cannabidiol products containing less than 0.1 percent tetrahydrocannabinol (THC).

Iowa has now introduced PBM legislation and will use the SCOTUS decision as support to enforce the need for stricter PBM regulation at the state level.

JAN.FEB.MAR. |

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PUBLIC AFFAIRS

THANK YOU DONORS

IPPAC

LDF

The Iowa Pharmacy Political Action Committee (IPPAC) is a fund used to strategically strengthen relationships with legislators that are supportive of pharmacy interests. The IPPAC is funded by contributions from individual pharmacists, pharmacy technicians, or student pharmacists, as well as member PACs of other organizations.

IPA’s Legislative Defense Fund (LDF) consists of contributions from corporate sponsors. Since corporations are prohibited from contributing to candidates (and therefore, the IPPAC), these funds are used to pay for advocacy activities, which include IPA’s Legislative Day and Capitol Screenings, contracted lobbyists and external consultants, and IPPAC administration and fundraising costs.

IOWA PHARMACY POLITICAL ACTION COMMITTEE

Learn more at www.iarx.org/ippac.

2020 IPPAC Donors

LEGISLATIVE DEFENSE FUND

Learn more at www.iarx.org/ldf.

2020 LDF Donors

Amanda Abdulbaki

Gary Maly

Brent Bovy

Michael Andreski

Kristin Meyer

David Bainbridge

Robert Nichols

Matt Hummel

Cheryl Clarke

Matt Osterhaus

Kyra Corbett

Marilyn Osterhaus

Wes Pilkington

Steve Firman

Nathan Peterson

Drake Reiter

Bob Greenwood

Lisa Ploehn

Charles Hartig

Anthony Pudlo

Diane Heiken

Susan Shields

Jennifer James

Stevie Veach

Erik Maki

Kristin Williams

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Hy-Vee

2021 LEGISLATIVE PRIORITIES & POLICY POSITIONS The Iowa Pharmacy Association’s Legislative Committee and Board of Trustees have established the following legislative priorities for 2021.

LEGISLATIVE PRIORITIES

POLICY POSITIONS

INCREASE ACCESS TO CARE

IOWA MEDICAID

• • • •

Immunizations Test and Treat Collaborative Practice COVID-19

Allowing healthcare providers to practice at the top of their training is an essential component to expanding patient access to care and addressing the COVID-19 pandemic. Pharmacists are trained to provide an array of clinical services, but excessive regulation and red tape prevent them from being able to serve their patients and communities to the fullest. IPA supports increasing access to patient care services by allowing pharmacists to test and treat, administer immunizations to all age groups, and utilize collaborative practice agreements.

ENSURE PHARMACY VIABILITY • PBM Regulation

Pharmacists and pharmacies are vital to meeting public health needs.

During the COVID-19 pandemic, some of Iowa’s rural communities’ lost access to all medical providers except the local pharmacy that remained open. Financial sustainability is critical to ensuring that they can meet patient and community needs across Iowa. Following the landmark decision in 2020 from the U.S. Supreme Court in Rutledge v. PCMA, Iowa now has clear legal authority to pass legislation that will ensure effective regulation of PBMs.

PROVIDER STATUS

Decades of research have proven the value of including pharmacists on healthcare teams. Improved health outcomes, lower costs, and increased access to care could be a reality for Iowans if pharmacists were fully recognized as patient care providers. While pharmacists already provide patient care services through collaborative practice agreements and statewide protocols, reducing barriers that prevent pharmacists from billing for those services is necessary to create sustainable access to care.

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IPA supports laws, regulations and policies that ensure prescription drug reimbursement under Medicaid is sustainable, predictable, and transparent. This includes maintaining patient access by paying pharmacies at average acquisition cost, plus a cost of dispensing fee set by bi-annual survey.

SUPPORT THE UNIQUE NEEDS OF EVERY IOWAN • 340B Program Integrity IPA supports allowing medically underserved patients in Iowa to obtain care and services from pharmacists, which can significantly decrease costs for patients and government programs. Ensuring the 340B Drug Pricing Program remains protected and enforced according to current laws and regulations is essential to preserving access to care. Additionally, allowing pharmacists to bill for telehealth services within their scope of practice can help increase access to care for many Iowans living in rural areas.

MODERNIZE THE IOWA PRACTICE ACT

Since the Iowa Pharmacy Practice Act was last completely updated 30+ years ago, the practice of pharmacy has undergone a drastic transformation. All pharmacists now graduate with a doctorate degree and the training to perform a vast array of clinical services. IPA supports modernizing the Iowa Pharmacy Practice Act and reducing licensing regulations to match the evolving practice of pharmacy to improve patient care delivery and outcomes.

PUBLIC AFFAIRS

LEGISLATIVE DAY GOES VIRTUAL Although virtual, IPA’s 2021 Legislative Day, the cornerstone of the association’s legislative and public policy efforts, was a great success. On Wednesday, January 27, nearly 150 pharmacy professionals and student pharmacists logged on for virtual programming and grassroots efforts.

The day began with a casual coffee hour to allow attendees to network, engage, and contact their legislators before the event began. Iowa DHS Director Kelly Garcia kicked off formal programming with her opening keynote presentation.

IPA’s Vice President of Public Affairs, Casey Ficek, and IPA lobbyist Matt Eide then provided a briefing on legislative priorities for pharmacy this year, including PBM legislation, COVID-19 policies relating to testing, vaccination and pharmacy technician roles, and Board of Pharmacy priorities.

Following the legislative briefing, IPA presented its 2021 IPA Legislative Champion awards. This year’s honorees were Steve Firman, Chief Executive Officer of Pharmacy Marketing Group, and Randy Edeker, Chief Executive Officer and President of Hy-Vee. To close formal programming, Casey Ficek was joined by a panel of legislators, including Representative John Forbes, Representative Joe Mitchell, and Senator Pam Jochum. These legislators thanked IPA members and pharmacy professionals across the state for their continued efforts during the COVID-19 pandemic and explained how to best advocate for the profession.

In the weeks leading up to Legislative Day, IPA hosted its first ever Polar PAC Plunge fundraiser for the Iowa Pharmacy Political Action Committee (IPPAC). We far surpassed our goal of raising $5,000 for IPPAC, so both Casey Ficek and IPA’s Vice President of Professional Affairs, Anthony Pudlo, took an icy plunge in a dunk tank!

Thank you to those who donated and helped us raise over $6,000 for our political action fund. If you missed it, you can still watch the dunk tank footage on our Facebook page!

Tune in to IPA’s BOP: What, Why & How podcast following each Iowa Board of Pharmacy meeting to recap the board’s actions and earn Pharmacy Law CE! Each episode will focus on WHAT actions were taken by the Board of Pharmacy, WHY the BOP took the actions it did, and HOW BOP action will impact practice in Iowa.

IARX.ORG/BOP_PODCAST

JAN.FEB.MAR. |

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Patient safety.

Professional practice.

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View PTCB’s full suite at ptcb.org/credentials

Compounded Sterile Preparation Technician® (CSPT®) Certification

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TECHNICIAN CORNER

TECHNICIAN SPOTLIGHT: KIMERLY METCALF, CPHT-ADV

T

he role of pharmacy technicians in Iowa has been evolving and expanding with the initiation of technician product verification, and now with technicians being trained to administer vaccinations. To perform these tasks, pharmacy technicians must complete a certificate program offered through the Pharmacy Technician Certification Board (PTCB). PTCB offers a total of six certificates and three certifications. The highest credential offered by PTCB is the certification of Advanced Certified Pharmacy Technician (CPhT-Adv). Advanced Certified Pharmacy Technicians must have at least three years of work experience as a pharmacy technician within the last eight years and have completed at least four of the assessment-based certificate programs, or three certificate programs and the Compounded Sterile Preparation Technician (CSPT) Certification. Kimerly Metcalf was the first, and is currently the only, pharmacy technician in Iowa to receive the designation of CPhT-Adv! Kimerly began working as a pharmacy technician in 2011 when the pharmacist at the retail store where she worked asked if she would like to have a few shifts in the pharmacy. She became a Certified Pharmacy Technician in 2012. As a pharmacy technician in the community pharmacy setting, Kimerly completes data entry and product dispensing, answers the phone, and maintains pharmacy inventory, but what she enjoys most is interacting with patients. She provides amazing customer service and takes the time to help patients find a discount card if they cannot afford their medication or do not have insurance. Kimerly enjoys having the opportunity to brighten someone’s day, mentioning that sometimes the simple things, like asking patients “How is your day?” can make a huge difference.

In 2016, Kimerly joined the staff at UnityPoint Health – Allen Hospital. In the hospital setting, Kimerly delivers medications, compounds IV medications such as antibiotics, performs technician product verification, and completes medication reconciliations, among other duties. She has found that community and hospital pharmacy offer different opportunities, but interacting with and helping patients is the most rewarding part of her job in both settings. In Kimerly’s own words, “In the hospital, when performing medication reconciliation with a pharmacist, we are able to provide the best list of medications the patient is taking so the providers know exactly what medications the patient is taking, the strength, dose and frequency of them as well. By running STAT meds, I am helping ensure the patient is getting what they need as soon as it is possible.”

Kimerly Metcalf, CPhT-Adv

Pharmacy Technician UnityPoint Health Allen Hospital

Kimerly is a relatively new member of the Iowa Pharmacy Association, only in her second year of membership, but she has enjoyed the opportunities she has discovered through IPA. An email from IPA led her to become an item writer for the PTCB’s technician product verification and hazardous drug management certificate exams.

This role allowed her to meet people from all over the country and travel to Alexandria, VA and Denver, CO. These experiences helped motivate her to pursue the CPhT-Adv Certification. Currently, the new certification has not changed her duties as a pharmacy technician. In the future, she would like to see pharmacy technicians have opportunities to play a greater role in MTM, pain management, diabetes, and oncology (outside of the IV room). ■

FREE TECHNICIAN CPE IPA Pharmacy Technician members receive a FREE subscription to CEimpact’s Pharmacy Technician CE Service with access to 1 hour of learning each month on various topics needed for recertification.

Log in to your IPA account at www.iarx.org/cei_libraries to take advantage of your membership benefit and ACTIVATE your subscription.

JAN.FEB.MAR. |

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TECHNICIAN CORNER

USP CHAPTER 800 HIGHLIGHTS: PART 1 From IPA’s November 2020 Tech Tidbits newsletter The United States Pharmacopeia (USP) officially released General Chapter 800 Hazardous Drugs – Handling in Healthcare Settings on December 1, 2019. The Iowa Board of Pharmacy endorsed USP 800 and required compliance by 12/1/2019 with some exceptions. USP 800 provides standards for safe handling of hazardous drugs to minimize the risk of exposure to healthcare personnel, patients, and environment. The hazardous drugs are identified by the National Institute for Occupational Safety and Health (NIOSH). Drugs are considered hazardous if they exhibit any of the following characteristics in humans/animals: • • • • • •

Carcinogenicity Teratogenicity (developmental toxicity) Reproductive toxicity Organ toxicity at low doses Genotoxicity Structure and toxicity profiles of new drugs that mimic existing hazardous drugs

prepare, administer, transport, or otherwise come into contact with hazardous drugs and the environments in which they are handled.

HAZARDOUS DRUG MANAGEMENT CERTIFICATE NOW AVAILABLE

For pharmacy technicians looking to demonstrate their competency in USP 800, the Pharmacy Technician Certification Board (PTCB) created a certificate for Hazardous Drug Management. This certificate program offers educational resources for competency in USP 800 topic areas and can allow for progression towards becoming an Advanced CPhT. By completing this certificate program, technicians are given the opportunity to practice at the top of their licenses.

SOURCES:

1. Pharmacy Services: What is USP <800>, https://www.prsrx.com/ usp800-the-independent-pharmacists-guide-part-1/ 2. PTCB: Hazardous Drug Management Certificate, https://www.ptcb.org/ credentials/hazardous-drug-management-certificate 3. USP General Chapter 800, https://www.usp.org/compounding/general-chapter-hazardous-drugs-handling-healthcare

USP 800 addresses requirements for personnel handling hazardous drugs. These standards apply to all healthcare personnel who receive,

USP CHAPTER 800 HIGHLIGHTS: PART 2 From IPA’s December 2020 Tech Tidbits newsletter TECHNICIANS AS HDC MANAGERS

Pharmacy technicians can play a role in the compliance program at each pharmacy by being designated as the Hazardous Drug Compliance (HDC) Manager. Clinical understanding of hazardous drugs is not necessary for the HDC Manager. Instead, there are three major activities that the HDC Manager oversees. These activities include:

IDENTIFYING HAZARDOUS DRUGS

Every pharmacy should have its own list of hazardous drugs. Any hazardous drug must be clearly labeled to ensure employees can easily determine the group of the hazardous drug. NIOSH created three different groups: Antineoplastic Drugs, Non-Antineoplastic Drugs, and Drugs with Reproductive Risk. *Any hazardous drug may have reproductive risk.

IDENTIFY EXPOSURE POINTS

Hazardous drugs can enter the body through skin absorption, inhalation, injection, and ingestion. The pharmacy must have policies and procedures in place for different activities that involve hazardous drugs including receipt, dispensing, or administration of medications, compounding, patient-care activities, spills, transport, and waste disposal.

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PERSONAL PROTECTIVE EQUIPMENT (PPE)

USP 800 defines PPE as “gloves, gowns, respirators, goggles, face shields, and others that protect individual workers from hazardous physical and chemical exposures.” To limit the changes each pharmacy needs to make, the HDC Manager can perform an “Assessment of Risk” for specific hazardous drugs and dosage forms within the pharmacy. This allows the HDC Manager to keep employees protected in alternative ways. All employees must be trained on when and how to use PPE when dealing with hazardous drugs.

SOURCES:

1. Pharmacy Services: What is USP <800>, https://www.prsrx.com/ usp800-the-independent-pharmacists-guide-part-1/ 2. USP General Chapter 800, https://www.usp.org/compounding/general-chapter-hazardous-drugs-handling-healthcare

TECHNICIAN CORNER

NEWLY CERTIFIED IOWA TECHNICIANS OCTOBER 1, 2020 – DECEMBER 31, 2020 Congratulations to the following pharmacy technicians on becoming PTCB-certified!

Jason Barnes Kayla Behrens Tyler Bertling Tess Bjorklund Jessica Boots Erin Botterbrodt Shaylee Cooper Tiffany Cotten Angela Cross Amanda Davis Jaeden Davis Jessica DuVal Kyle Dyson Mattie Early Jessica Ennis Ella Erickson Elisabeth Erickson

Ciara Feltner Christina Gassman Alixzander Gradin Brianna Grant Alexa Grimm Courtney Gunderman Brea Hanson Sandra Hayes Jill Hayton Carolyn Healy Mandy Hellman Alexis Helmer Connie Hose Harrison Howard Elma Ibrahimovic Hayley James Marissa Jenkins

Tiffany Kayl Tessa Kemp Danielle Kent Kelly Lee Jennifer Lemen Karen Lewis Avery Liss Gabriella Liviero Taylor Lloyd Nathan Lopez Jessica Maxheimer Tonia McBride Sydney McFarland Erica Meyer John Meyer Amanda Missavage Alejandra Montenegro

Alvin Nguyen Will OBrien Emra Oglecevac Sarah Olson Susan Palmer Kimberly Papstein Samantha Pedek Nathalie Pena Valerie Porter Korey Rife Marvina Roebuck Grace Ronnfeldt Rebekah Sanford Rachel Scott Allison Servellon Christine Short Jordan Singer

Abbigail Sird Maria Smirnova Emma Snyder Laura Stinson Kerry Strum Makayla Tibbetts Stefan Torres Aaron Van Vark Susan VanderLinden Asha Verma Crystal Ward Justin Watson Tayler Watts Abigail Weedman Jessica Welter Roxanna Wendel Ziling Xia

TECHNICIAN CORNER

COVID-19 VACCINES VS MONOCLONAL ANTIBODY (MAB) THERAPY From IPA’s January 2021 Tech Tidbits newsletter There have been questions with the differences between novel COVID-19 monoclonal antibody (mAb) therapies and vaccines. Both are therapies based around enhancing the immune system’s normal function, specifically against SARS-CoV-2, the virus that is the culprit for COVID-19.

So, what is the difference? They are all treatments for COVID-19, right? Kind of.

The mAb therapies from Eli Lilly (bamlanivimab) and Regeneron (casirivimab/imdevimab) are both providing man-made antibodies to fight COVID-19. Both therapies are for patients who are likely to progress to severe COVID-19 and/or require hospitalization. The vaccines from Pfizer and Moderna are intended to prime an individual’s immune system so that when encountered, the virus is neutralized before it can cause a problem and antibodies can be naturally produced to recognize future encounters with the virus. It is important to keep in mind that these antibodies may only last for a few months.

So, what is the difference? Both are antibodies for SARS-CoV-2, right? Kind of.

While both therapies allow the immune system to act against the virus, they work on two different parts of the immune system. The mAb therapies are to engage the innate immune system, while the vaccines are to engage the adaptive immune system.

So, what is the difference? Both are activating the immune system, right? Kind of.

The two parts of the immune system are both very good at different things. The innate immune system is the quick, non-specific, relatively weak arm, whereas the adaptive immune system is the slow, specific, strong arm. The innate immune system is our first defense and handles everything we encounter daily. It attacks what it encounters that is not part of “us” or foreign to our body. The issue is that it is not hard to overwhelm it, and that is the reason for our adaptive immune system.

If something gets through the innate immune system, our adaptive immune system kicks in and recognizes how much non-self-material is present and causing harm. This is where we start producing our antibodies that neutralize the pathogen so they cannot do damage, and

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then get cleared by the body. Sounds great right? The thing about the adaptive immune system is that it is very slow, and the infection has to get severe enough where we are experiencing symptoms to really engage it in fighting the infection off. Enter: vaccines. They work by convincing the adaptive immune system that there is enough of the pathogen around to mount this response. This is done by providing either a piece of the pathogen, an attenuated (i.e. designed to be weaker) version, or a very small dose of something that the pathogen produces. This “fake infection” convinces the adaptive immune system to make “plasma cells” which creates antibodies for the “infection” but also make “memory cells” which remain dormant. The immune system remains ready to engage much more quickly and just as potently if that pathogen comes back.

SO. What is the real difference between mAb therapies and vaccines?

In short, monoclonal antibodies therapies provide temporary antibodies that last around 11-30 days1, whereas vaccines can produce immunity from months to as long as a lifetime, depending on the pathogen and vaccine. Thus, ongoing studies for COVID-19 therapies and vaccines are warranted due to the uncertainty that exists for how long immunity can be maintained.

SOURCES:

1. Ovacik M, Lin K. Tutorial on Monoclonal Antibody Pharmacokinetics and Its Considerations in Early Development. Clin Transl Sci,2018. Nov;11(6):540552. PMID: 29877608 2. Bamlanivimab EUA: https://www.fda.gov/media/143603/download 3. Casirivimab/Indevimab EUA: https://www.fda.gov/media/143892/download

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Learn more at www.medicationsafety.org or call us at (866) 365-7472.

The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO).

IPA FOUNDATION

THANK YOU FOR SUPPORTING THE IPA FOUNDATION IN 2020!

The Iowa Pharmacy Foundation sincerely thanks those members who made a contribution to the future of the profession by supporting the efforts of the Foundation…these contributions truly make a difference!

The following list of contributors is for January 1, 2020-December 31, 2020.

PLATINUM LEVEL ($1,000+) Sharon Cashman Carl Chalstrom Renae Chesnut Connie Connolly Kate Gainer Robert Greenwood Tom Halterman Rick Knudson Donald Letendre Randal McDonough Gary Milavetz Brand Newland Lisa Ploehn Anthony Pudlo Diane Reist Al Shepley Susan Winckler

GOLD LEVEL ($500-$999) Bill Baer William Baker Tim Becker Cheryl Clarke Ed Cohen Jay Currie Jennifer Fix Greg Hoyman Julie Kuhle Lloyd Matheson Stephen Mullenix Susan Shields Farah Towfic Stevie Veach

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SILVER LEVEL ($250-$499) Jeff Aden John Daniel Michele Evink Steve Firman John Hamiel Morgan Herring June Johnson Carson Klug Kimberly Lintner Craig Logemann Shane Madsen Alex Mersch Kristin Meyer Matt & Marilyn Osterhaus Heather Ourth Wes Pilkington Matt Pitlick Michael Pursel Shannon Rudolph Michael Schnackenberg Terrel Wiedenfeld

BRONZE LEVEL ($100-$249) Emily Beckett Nancy Bell Michelle Bottenberg Neal Daley Ashley Dohrn William Doucette Peter Fay Jessica Frank Allison Hale Charles Hartig

Sandra Johnson TJ Johnsrud Candace Jordan Gene & Susan Lutz Edward Maier Erik Maki Gary Maly Deanna McDanel Dana McDougall Sharon Meyer Phyllis Olson Bob Osterhaus Charles Phillips Andy Stessman John Swegle Tom Temple CoraLynn Trewet Jillanne Wall Sara Wiedenfeld Bill Wimmer

BUSINESS PARTNER CONTRIBUTIONS Main at Locust Pharmacy McKesson NuCara Pharmacies Network for Good Osterhaus Pharmacy

IPA FOUNDATION

SUMMER EVENTS IPA is looking forward to safely hosting in-person events this summer, including the Eggleston-Granberg Golf Classic. After great success last summer, we will plan to host a 2021 STEP, CYCLE, SWING for Student Scholarships fundraiser as well.

We are closely watching announcements from RAGBRAI to know if RAGBRAI XLVIII will take place and the Foundation team will be able to assemble.

Please stay tuned to communications from IPA for details on all summer events as the dates near.

ODE TO THE CRITICAL ACCESS PHARMACIST Jack of all trades and master of all, 340B, oncology, USP, and IT technician – We have a ball.

Emergency, MedSurg, and Skilled, Better make sure all meds get billed.

P&T, Policies, and Med Error sheriff, our badge may be invisible, But through it all, we are invincible.

Our army of ONE wears all of these hats that are worn by many at an acute site, But in spite of this challenge, we don’t lose the fight.

24/7 what’s a holiday, Often without any on-call pay.

Now comes 2020.

Remdesivir, bamlanivimab and COVID vaccine, Policies, procedures, and documentation we achieve.

We cannot remove our many hats because if you are getting the gist, We are the lone pharmacist!

Poem by IPA member Kathy Stone, PharmD, BCSCP

JAN.FEB.MAR. |

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MEMBERS SECTION

PHARMACIST SPOTLIGHT: RACHEL OTTING, PHARMD

A

n open mind and a willingness to say yes to new opportunities have helped shape many pharmacists’ career pathways. This has certainly been true for Rachel Otting.

Rachel Otting, PharmD Clinical Pharmacist MercyOne Pharmacy

Written By: Maureen Martin, PharmD Candidate Class of 2021 University of Iowa College of Pharmacy

The Charles City native came to pharmacy school as a nontraditional student. She completed her undergraduate degree in Neuroscience at Kenyon College in Gambier, Ohio, spending four years as a member of the varsity swim team. Following graduation, she returned to Charles City, unsure what she wanted to do next. Her father told her she just had to pick something, so she chose pharmacy. In January 2007, she began working as a pharmacy technician at Connor’s Pharmacy, an independent pharmacy in Charles City at the time, and completing prerequisite courses for pharmacy school. She graduated from the University of Iowa College of Pharmacy in 2013 with her PharmD. As a fourth-year pharmacy student, Rachel completed one of her advanced pharmacy practice experiences with the Medical Assistance Center at the University of Iowa Hospitals and Clinics. She enjoyed working with the patients, often from underserved populations, to find ways to make their medications more affordable.

When considering her options after graduation, she remembered this experience and searched for residency programs that would allow her to continue working with underserved patient populations. Rachel completed the PGY-1 community residency program at Mercy Family Pharmacy in Dubuque. During her residency, Rachel gained experience managing chronic disease states through a collaborative practice agreement, working with hospital staff to increase patient safety during transitions of care and managing anticoagulation therapy, among other valuable experiences including an elective with the Iowa Pharmacy Association.

After successfully completing her PGY-1 residency, Rachel entered her current role at MercyOne Pharmacy as a clinical pharmacist. One of the many things she loves about her position is the variety of her responsibilities.

There is always something new. Her current role focuses on transitions of care, but she also works with long term care and palliative care and precepts pharmacy students as well as the MercyOne PGY-1 Pharmacy resident.

Rachel works closely with the interdisciplinary team on the inpatient psych unit to facilitate transitions of care for those patients by monitoring their medications for other disease states and preemptively completing prior authorizations before patients are discharged. Though her role has changed from what she experienced in her residency, Rachel has enjoyed gaining experience in new areas and having the opportunity to continue working

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with the medically underserved patient population that initially drew her to MercyOne in Dubuque. She is able to follow her patients as they transition between inpatient and outpatient, which she has found to be a unique and rewarding experience.

When she is not at the pharmacy, Rachel enjoys spending time with her husband and two children, catching up with friends, and being involved in the Rotary Club. Son Atticus and daughter Etta keep Rachel busy with various activities, including sledding in the winter and visiting the pool in the summer. Rotary Club provides a refreshing chance to meet other members of the community and collaborate on projects unrelated to pharmacy. Rachel enjoys the local connections she has made within the Rotary Club.

Building and maintaining local connections is important in pharmacy as well, which is one of the reasons Rachel is also an active member of the Iowa Pharmacy Association.

IPA helps foster connections between pharmacists in the state and offers opportunities and resources for pharmacists to learn how to advocate for the profession. To move the profession forward, Rachel believes pharmacists must educate the public about what we do. When she entered pharmacy school, Rachel had no idea how many different services pharmacists are trained to provide or the variety of different settings in which pharmacists work. Now, after seven years as a pharmacist, Rachel has had the opportunity to provide services she never would have imagined when she was in school. IPA is appreciative of Rachel’s ongoing commitment to the profession and looks forward to all the success that lies ahead of her! ■

MEMBERS SECTION

WELCOME NEW IPA MEMBERS! OCTOBER 1, 2020 – DECEMBER 31, 2020 Sulafa Adam Victoria Adrian Logan Akason Ashraf Amadou Anna Amos Blake Anderson Savannah Anderson Andjela Andric Bryce Andry George Appleseth Christina Balow Ali Barakat Tess Bjorklund Eric Boel Jordyn Boge Karlee Boyle Kelly Brock Shawna Brooks Shelbie Brotherson Sophia Brown Patrycja Buch Jacob Bulger Brittany Bullock Caden Burkamper Marcus Burrow Sara Carr Ryan Christensen Connie Chu Lauren Collier Alyssa Conaway Annika Cook Tyler Cooksley David Cromer Ashley Cunningham Chyan Decker Mitchell DeKeyrel Nick Deveza Alison DeVore Yue Dong

Kevin Dong Brooke Doohen Callie Doohen Sarah Dumachi Lauren Duncalf Jack Dykema Kelsey Fausel Robin Fenton Dawn Fitzgerald Kathryn Fitzpatrick Lindy Flatau Fabiola M Gallardo Brittni Gerdts Timothy Giesen Emily Gilbertson Caleb Ginn Zachary Glanz Delayne Glassgow Nevena Glavas Noah Goebel Ali Goldensoph Austin Grossman Jill Guetersloh Laurel Gunnerson Jilene Haas Lisa Handley Sean Harms Nathan Harold Emilie Heggen Spencer Heggen Sarah Hennessey Melissa Highness Gabrielle Hiner Makayla Hoing Nicole Hunter Yusuf Ibrahim Stacey Jackson Kylie Juenger Andrea Ketcham

Jonathan Klauke Kayli Kruser Paige Kuennen Lauren LaPointe MacKenzie Lasnek Nathan Liberty Keegan Lilly Jennifer Lin Hsin Lan Lin Duachee Lo Alisha Lyons Cristina Markham Jennifer Mayer Grace McCollum David Miller Elijah Miller Hannah Minor Megan Mitchell Davina Monson Michelle Moon Ann Morley Sohida Muslem Ariba Naeem Mark Nagel Rakhshan Naseeb Kendal Newman Brittany Nguyen Lan Anh Nguyen Zachery Nunemaker Carlos Nunez Aguillon Dominic Ortega Bhavesh Patel Kalpana Patel Minh Pham Lucas Philip Faith Poelker Natalie Polich Ryann Powell Amanda Powers

Destanie Pringle Isaac Ramos James Rardin Don Reed Savannah Reicks Samantha Ritter Emma Robasse Jacob Roher Caitlin Rohrbaugh Sydney Ross Colby Rueschenberg Melanie Ryan Jerrianne Sanger Gracie Schnell Jozey Seaton Paige Setchell Ali Shishter Kelly Smith Emma Smith Emily Sotelo Sharon Spaans Edward Stoll McCaffery Townsend Tin Tran Tracy Tran Kailee Turner Hannah Ungurean Tessa Vagasky Vanessa Van Holland Melia Van Meter Sidney Vancil Morgan VanZante Kim Vo Abigail Wagner Eric Weetman Destiny Welt Kindra Welter Samantha Whitcomb Karen Wood

JAN.FEB.MAR. |

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MEMBERS SECTION

STUDENT SPOTLIGHTS: BOARD OF TRUSTEES EDITION

O

riginally from Winterset, Iowa, Alexis Clouse is currently a P3 student at the University of Iowa College of Pharmacy. She was inspired to go to pharmacy school after spending time working at the independent pharmacy in her hometown, Montross Pharmacy, in high school. There, she saw first-hand the impact pharmacists have in the community, and she wanted to do the same.

Within the college, she currently serves as the president of the Student Leadership Council.

She is also involved in the pharmacy student ambassador network, Rho Chi, Kappa Psi, UI-SSHP, and graduate and professional student government.

Alexis Clouse

PharmD Candidate 2022 University of Iowa IPA Board of Trustees

Within IPA, Alexis serves on the IPA Board of Trustees as the University of Iowa College of Pharmacy student representative and on the Student Advisory Committee. When asked about her career goals, she mentioned her interest in family medicine, geriatrics, and acute care, and how eager she is to start exploring different areas on her P4 rotations starting this May. After rotations, Alexis plans to complete a residency and become board certified while also continuing involvement within pharmacy organizations and being an ongoing advocate for the pharmacy profession.

Besides pharmacy, Alexis enjoys interior design and looks forward to designing her own dream home one day. In her free time, she loves to listen to podcasts, workout, and shop.

When asked to share a fun fact about herself, Alexis mentioned that she was a state champion in softball her freshman year of high school! ■

C

ourtney Temple, P3 student at Drake University College of Pharmacy, is originally from Newell, Iowa. Interested in science since childhood, Courtney knew she wanted to work in the healthcare field.

Having many family members with type 1 diabetes (As well as herself!) and a brother born with a congenital heart defect, she quickly became familiar with medications and their uses and realized she found this area of healthcare fascinating.

Courtney Temple

PharmD Candidate 2022 Drake University IPA Board of Trustees

At Drake, Courtney is involved in the Drake Pharmacy Unified Group of Students (DRxUGS) and Kappa Psi Pharmaceutical Fraternity, where she serves as pledge trainer, philanthropy chair, and pledge class fundraising co-chair.

Within IPA, Courtney serves on the IPA Board of Trustees as the Drake University College of Pharmacy & Health Sciences student representative and on the Student Advisory Committee.

When asked about her future, she said she plans to work in an ambulatory care setting that will allow her to work primarily with patients who have diabetes and utilize her Spanish language knowledge.

In her free time, Courtney enjoys reading, being outdoors, and spending time with friends and family. ■

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MEMBERS SECTION

MEMBER TIP: CEimpact Subscription Activation To obtain CE in 2021, ENGAGED Pharmacist and Pharmacy Technician members must activate two separate CE subscriptions: one for CEimpact’s Course Catalog and one for BOP: What, Why & How podcasts as well as select 2/2/2 webinars. This is new this year.

Both subscriptions can be easily activated from www.iarx.org/accesscpe when logged into your account. You will see step-by-step instructions for doing so after clicking the “Activate My Subscription” button.

With this change, CONNECTED and INFORMED Pharmacist members will soon be able to purchase CE packages for the year’s BOP podcasts and accredited 2/2/2 webinars. Stay tuned for details. Accreditation pending.

Watch for additional Member Tips in upcoming IPA Journals! If you have suggestions, feel free to submit your Member Tip ideas to Allison Hale at ahale@iarx.org.

IPA MEMBER BENEFIT Have You Accessed Your FREE Continuing Education Benefits Yet? WWW.IARX.ORG/ACCESSCPE

IPA ENGAGED Pharmacist and Pharmacy Technician members receive a FREE subscription to CEimpact’s Pharmacist or Pharmacy Technician Course Catalog, which includes all required CPE for pharmacist relicensure and pharmacy technician recertification for FREE. In addition, you also receive FREE continuing education credit for IPA’s BOP: What, Why & How podcast series and select 2/2/2 webinar recordings!

JAN.FEB.MAR. |

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MEMBERS SECTION

MEMBER MILESTONES Congratulations to Kimerly Metcalf for becoming the first technician in Iowa to receive Advanced Certified Pharmacy Technician (CPhT-Adv) with PTCB.

Congratulations to Mark Branum as he becomes the new Pharmacist-in-Charge at Donlon Pharmacy in Decorah!

Read more under her Technician Spotlight!

IN MEMORIAM It is with sad news that we share the passing of Robert Miller on December 20, 2020. A graduate of Drake University, Bob was a licensed and practicing pharmacist for more than 50 years, owning Rowe Drug Store on Ottumwa’s south side before finishing his career at NuCara Pharmacy.

Lastly, we sadly share the passing of Gene Carlson on February 4, 2021.

Gene earned his BS Pharm from Drake University in 1957. He and his wife Kay moved to Ottumwa in March of ‘57, where he worked for Southside Drug until purchasing the business in 1967. Gene was a longstanding member of IPA.

IPA GOES LOCAL Due to COVID-19, IPA Goes Local programming was impractical in 2020. Stay tuned for plans in 2021!

Resources from previous Goes Local events, including MedPharm’s presentation on medical cannabis in Iowa during IPA’s 2020 Annual Meeting, are still available at www.iarx.org/goeslocal.

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With a heavy heart, we also share the passing of Dan Newton on January 21, 2021. Dan’s career in pharmacy began when he was just 14 years old, working as a clerk at the Corner Pharmacy in Newton. A 1975 graduate of the University of Iowa College of Pharmacy, Dan worked at hospital pharmacies in Osage, Waterloo and Maquoketa before returning to Newton in 1991. He then spent the majority of his career as a pharmacist at Skiff Medical Center (MercyONE Newton).

THREE NEW WAYS TO JOIN IPA

Get it all and fully engage in your profession at the ENGAGED level of membership!

This tier offers pharmacists the greatest value and full access to all membership benefits.

Benefits include: CONNECTED + free CPE with CEimpact’s Pharmacist Library, eligibility to serve on IPA Committees, exclusive discounts and communications, free IPA Journal print subscription, and more!

Don’t need free CPE but seeking a higher level of involvement in your profession?

Stay connected with the latest pharmacy news and advance your practice with resources at your fingertips!

Benefits include: INFORMED + full access to IPA’s webpage resources, discounted registration to IPA events, free IPA Journal e-subscription, exclusive professional communications, and more!

Not sure about membership just yet? The INFORMED tier is being offered to keep you up-to-date with the latest pharmacy news and trends as you consider a higher-level IPA membership.

Benefits include: Weekly TOP5 emails, Advocacy Alerts, access to IPA Podcasts, 2/2/2 & Connecting Over COVID-19 Webinars, and more!

PLATINUM BUSINESS PARTNER

Elevate the level of care you provide your patients.

www.iarx.org/platinum PLATINUM BUSINESS PARTNERS receive all the benefits of a standard business partner PLUS access to higher level of services and resources from IPA. Here’s what some of our Platinum Business Partners have to say: “Although IPA is well positioned to address many of our hospital pharmacy concerns, one area we really needed their assistance was with getting a pharmacy residency program started. IPA customized our platinum business partner membership to meet our specific needs and created a detailed proposal for us that included planning for accreditation, staffing, and budget requirements for us to present to our executives for final approval. IPA’s help has been instrumental in providing us with insight and resources for us to foster innovation to across our pharmacy department and further drive the mission and vision of our institution.”

“Our company joined as a Platinum Business Partner with IPA approximately one year ago. Not only do we feel more connected to what’s going on in the industry, legislature, and within the organization, we also have a direct line of communication for any questions/concerns or help on matters that affect our business. One example is the help that we received from IPA in bridging some communication problems we were having with the MCO’s regarding DME billing. Thanks to the contacts they have established with members of those organizations, we were able to get the assistance we needed for billing claims. We gain a lot of information through our quarterly touch-base phone calls and also appreciate the discounts on various resources thanks to our PBP membership!”

– Doug Wetrich, Director of Pharmacy Mary Greely Medical Center

– Heather Storey, Pharmacy Manager, Clinical Consultant Lewis Drug

IPA IN ACTION 2020-2021 IPA MEMBER FORUMS

New this year, IPA Member Forums are an added membership benefit for ENGAGED Pharmacist, Pharmacy Technician, and Student Pharmacist members to come together to learn, network and engage with the profession. To date, IPA has hosted two Member Forums: the Health-System Leadership Forum on October 21, 2020 and the Long Term Care Pharmacy Forum on January 20, 2021.

During the Health-System Forum, 38 pharmacists, technicians and students registered to take part in this event highlighting topics pertaining to individuals in health-system management and leadership roles.

Panelists John Hamiel, PharmD, Brian Benson, PharmD, and Mike Brownlee, PharmD, MS, FASHP, kicked-off the first session discussing development of a contingency plan, including considerations for staffing, PPE, supply chain and more. Attendees then selected a breakout session under the topics of drug shortages, staying engaged in a virtual world, or an update on ASHP priorities. Lastly, attendees came back together for a session on ensuring APPE students have meaningful experiences during the COVID-19 pandemic.

Make sure to save the date for our upcoming Member Forums! Register and learn more at www.iarx.org/forums.

PAYMENT FOR PHARMACY SERVICES FORUM April 14, 2021

SPECIALTY PHARMACY FORUM May 19, 2021

INDEPENDENT AND COMMUNITY PHARMACY PRACTICE FORUM June 16, 2021 (Tentatively)

HEALTH-SYSTEM LEADERSHIP FORUM October 20, 2021

PHARMACY TECHNICIAN FORUM November 10, 2021

SAVE THE DATE 24 IPA members registered to take part in the Long-Term Care Pharmacy Forum last month. Lindsey Ludwig, BS, Executive Director of CPESN-IA, and Chad Worz, PharmD, BCGP, CEO of ASCP, led the first session on Operation Warp Speed and COVID-19 vaccine development and distribution. Kim Bergen Jackson, PhD, RN-BC, LNHA, then gave her experiences on the impact of COVID-19 on residents at Oaknoll Retirement Residence in Iowa City. Mark Branum, PharmD, BCGP, Mark McMullen, BS Pharm, BCGP, and Kristin Meyer, PharmD, CGP, CACP, FASCP, led the last session on the future of long-term care.

IPA ANNUAL MEETING SEPT. 23-24, 2021 DES MOINES, IA

JAN.FEB.MAR. |

37

CALENDAR OF EVENTS

UPCOMING IPA EVENTS Find additional details to these events and more at www.iarx.org. Click on “Calendar of Events” under the Events tab.

MARCH 2021 5

Insight to Advocacy Webinar Series:

First Funnel Update – What Bills are Still Alive?

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Connecting Over COVID-19 Webinar

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Lunch & Learn with Amag Pharmaceuticals

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Lunch & Learn with Puma Biotechnology

APRIL 2021 5-9

Public Health Conference in Iowa

13

2/2/2 Webinar – Topic TBD

14

IPA Payment for Pharmacy Services Forum

16

Insight to Advocacy Webinar Series: Practice Act Task Force Update

MAY 2021 11

MPJE-NAPLEX Virtual Review Course

14

Insight to Advocacy Webinar Series: 340B – Updates and Advocacy

19

IPA Specialty Pharmacy Forum

Currently scheduled events are subject to change due to COVID-19. Please continue to watch IPA communications regarding any updates.

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PHARMACY TIME CAPSULE

19 57

Issues & events that have shaped Iowa pharmacy (or are fun to remember!)

JANUARY:

Eli Lilly and Company standardized all of their dispensing equipment, scales, balances, and other measuring devices from the avoirdupois system (ounces and pounds) to the metric system, stating, “We hope a mass conversion to metric will be stimulated and hastened in both the pharmaceutical and fine chemicals industries.”

FEBRUARY:

The 78th Iowa Pharmaceutical Association Convention was held February 17-19.

Max W. Eggleston, the leader whom the IPA Executive Internship was named after, was elected to his first Iowa Pharmaceutical Association position as 2nd Vice President.

Louis C. Zopf, Dean of the University of Iowa College of Pharmacy, and Byrl E. Benton, Dean of Drake University College of Pharmacy, proposed plans to implement a five-year pharmacy program by the fall of 1960.

APRIL:

Dr. Robert P. Fischelis accepted the American Druggist “Man of the Year 1956” Award and discussed his visions for a Doctor of Pharmacy degree with a minimum educational requirement of 5-6 years.

The Journal of the American Medical Association (JAMA) estimated the average prescription price was $2.51. (This is the same buying power as $23.37 in 2021).

Dr. Robert P. Fischelis

JUNE:

Robert G. Gibbs was inaugurated as IPA’s 79th President. He would later serve as IPA’s Executive Officer from 19591979, and the Distinguished Pharmacist Award was established in his name in 1979.

Sister Mary John accepted the 1957 Harvey A. K. Whitney Lecture Award at ASHP’s Annual Meeting.

AUGUST:

Controversy arises in response to the Durham-Humphrey Law which defined categories of medications as either prescription or over-the-counter. Robert E. Abrams, executive secretary of the American College of Apothecaries, suggested that “all drug products… be required to be sold under professional supervision.”

DECEMBER:

William Paul Briggs accepted the 1957 Remington Medal on December 2, 1957.

Harvey A. K. Whitney

Harvey A. K. Whitney, the namesake of ASHP’s most prestigious award, passed away on December 15, 1957.

The Iowa Pharmacy Association Foundation is committed to the preservation of the rich heritage of pharmacy practice in Iowa. By honoring and remembering the past, we are reminded of the strong tradition we have to build upon for a prosperous future for the profession.

JAN.FEB.MAR. |

39

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