Michigan Pharmacist – Jan./Feb./March 2024

MICHIGAN T H E O F F I C I A L J O U R N A L O F T H E M I C H I G A N P H A R M A C I S T S A S S O C I AT I O N

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2024

2 024 ANNUAL

CONVENTION & EXPOSITION Friday, Feb. 23 — Sunday, Feb. 25

PROFESSIONAL AFFAIRS

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

A look at the 2024 ACIP recommendations on immunization schedules. (p. 12)

MichiganPharmacists.org

CSPM FOCUS

Examining various pharmacy benefit manager reforms and future proposals. (p. 14)

ALS PRESENTATION Sign up for an inspiring CE on ALS featuring MPA member Michael Tiberg. (p. 27)

IN THIS ISSUE FROM THE FOUNDATION

ACE 2024

MEMBERSHIP UPDATE

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3 P resident’s Platform

4 C EO Corner

16 CSPM Board Update

18 S tudent Focus

25 Legal Insights

29 Agency Update

MPA's 140th President Sarah Hill details the association's areas of focus for 2024.

Why attending ACE 2024 is a must for pharmacy students.

CEO Mark Glasper gives a sneak peek of our 2024 award winners who will be honored at ACE.

A closer look at the bill that repealed Michigan's Drug Product Immunity statute.

Matthew McTaggart, board chair, takes a closer look at drug shortages.

Winter can be a perilous time for your home's roof; a few ideas how you can protect yourself from snow and ice damage.

CEO: Mark Glasper; EDITOR: Ryan Weiss; PUBLISHER: Bryan A. Freeman Michigan Pharmacist (ISSN 1081-6089) is the official journal of the Michigan Pharmacists Association, published four times a year at 408 Kalamazoo Plaza, Lansing, MI 48933. Publication Number: USPS-345-600.

Phone: (517) 484-1466, Fax: (517) 484-4893 Website: MichiganPharmacists.org, E-mail: MPA@MichiganPharmacists.org, Advertising Information: Visit MichiganPharmacists.org/news-publications/advertising-opportunities or contact Bryan Freeman, MPA marketing and communications director, at (517) 377-0257 or BryanFreeman@MichiganPharmacists.org

2 MichiganPharmacists.org

All opinions expressed in Michigan Pharmacist are not necessarily official positions or policies of the Association. Publication of an advertisement does not represent an endorsement. Michigan Pharmacist is subject to the standards established by the Association. Michigan Pharmacist is distributed as a regular membership service, paid for through allocation of membership dues. © Michigan Pharmacists Association, 2024

— PRESIDENT’S PLATFORM —

PRESIDENT HILL

OUTLINES VISION FOR 2024 As I begin my role as the 140th president of the Michigan Pharmacists Association, I am filled with a profound sense of responsibility and excitement. It is an honor to serve an association that has been at the forefront of advocating for our profession's growth and resilience for so many years. I am thrilled to share my vision for the coming months, which revolves around fortifying and expanding the pivotal role of pharmacy professionals in Michigan.

BY SARAH HILL,

Pharm.D.; president, Michigan Pharmacists Association

"It is an honor to serve an association that has been at the forefront of advocating for our profession's growth and resilience for so many years. I am thrilled to share my vision for the coming months, which revolves around fortifying and expanding the pivotal role of pharmacy professionals in Michigan."

In the evolving landscape of health care, pharmacy professionals are uniquely positioned to play an increasingly integral part in patient care. While patients have long rated pharmacists among the most trusted members of the health care team, the way pharmacy professionals stepped up during the pandemic, shined a spotlight on how critical our services are to the communities we serve. As we move into the new year, MPA will continue to focus on harnessing that momentum and solidifying pharmacists’ and technicians’ places as crucial health care professionals, deeply integrated into the fabric of our communities.

One of MPA’s key focuses for this year will be advocating for fair reimbursement for both medication dispensing and cognitive services. Recognizing the multifaceted contributions of pharmacy teams, we understand the need for fair compensation for the vital services we provide. Dispensing medications remains integral to our commitment to community health. It is essential to secure our ability to serve our communities without the looming concern of negative reimbursements influencing the daily decisions we make in supporting them. Cognitive services, including medication therapy management, immunizations, and point-of-care testing, are important components of the comprehensive care pharmacists provide. Pharmacists should be compensated appropriately for the dedication and expertise they bring to these services. For pharmacy professionals hoping to integrate cognitive services into their practice model, it is imperative that the opportunities exist for them to achieve financial success in their endeavors.

By championing fair compensation, we empower pharmacists to invest more time in patient care, facilitating better health outcomes and fostering a stronger health care system. Achieving these goals requires a collaborative effort. MPA will actively engage

with policymakers and other stakeholders to ensure that our advocacy efforts are heard and understood.

As a member, you have a role too! Members are crucial to grassroots advocacy efforts. We urge you to add your voice to MPA’s efforts by joining our Pharmacy Advocacy Response Team (PART) in sending emails to your legislators and by participating in Pharmacy Day at the Capitol (PDAC) in Lansing this fall! By working together, we strengthen the voice of pharmacy and we can work towards aligning reimbursement structures with the evolving role of pharmacy professionals, creating a health care system that values and compensates us fairly.

In addition to our advocacy initiatives, we will continue to prioritize educational programs and resources that empower our members to stay at the forefront of advancements in the field. MPA has a rich tradition of delivering compelling and cutting-edge educational programming. Our goal is to offer educational content that keeps you abreast of our continually evolving profession and equips you with practical insights that can be implemented immediately upon learning.

By investing in continuous learning and professional development, we equip our members with the knowledge and skills necessary to thrive in an ever-changing health care landscape. We hope that you will join us for this year’s Annual Convention & Exposition which will be held one final time at the Renaissance Center in Detroit. This will undoubtedly be an amazing experience packed to the brim with networking, educational programming and bidding fond farewell to the end of an era before we take ACE on the road in 2025!

As we move forward this year, let us do so with unity, purpose and a shared vision for the future. Together, we can elevate the profession of pharmacy, ensuring that pharmacy professionals across Michigan continue to be valued and recognized for their indispensable contributions to the communities they serve. I am excited about the possibilities that lie ahead and am confident that, with your support, we will make significant strides in protecting and advancing our profession.

Here's to a year of growth, advocacy, and empowerment as we work together to shape the future of pharmacy in Michigan!

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— CEO CORNER —

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AWARDING EXPERIENCE Ok, so maybe the headline of this column should read “A Rewarding Experience,” but I couldn’t help the play on words. There’s no greater and enjoyable activity I do in my role at MPA than to inform members of the honors they’ll receive as recipients of MPA’s yearly awards at the Annual Convention & Exposition (ACE).

BY MARK GLASPER, chief executive officer, Michigan Pharmacists Association

It’s a great way to end one year and begin another by having these conversations with members who have no idea of why I’m calling. But it only takes a few short congratulatory words from me for them to be on cloud nine. Their reactions range from complete surprise to one of humbleness for receiving such recognition from their peers. No matter the reaction, it quickly sinks in that they will forever be remembered in the long and distinguished history of MPA, now at 140 years old and counting.

A Sneak Peek Word of these honors travels fast, so I’m not naïve to think many of you will already know who our annual awardees are by the time you read this column. But I also don’t want to completely spoil the surprise for those who attend ACE and don’t know the names of our awardees until the night of the annual awards banquet.

That’s why I’m going to give away the names of just a few of this year’s awardees now because their responses to my words of congratulations were so precious.

“I’m over the moon happy with this honor, just completely speechless,” said Doug Samojedny, recipient of the 2024 Bowl of Hygeia Award. Anyone who knows Doug realizes what it must take to make him speechless! I might add that Doug was one of the first members to invite me for a tour of his workplace, Henry Ford Pharmacy Advantage. He was a terrific host and I’ll always remember his hospitality.

“I’m truly humbled and honored to be recognized by my peers,” said Mike Toscano, the 2024 Executive Board Medal Award recipient. The award is presented annually to recognize leadership efforts during years of dedication and distinguished service while working with or for MPA. And, from what I’ve learned about Mike, this description fits his personality and commitment to MPA. May you enjoy your retirement, Mike, in Jupiter, Florida!

Then there’s my immediate predecessor, Larry Wagenknecht, recipient of the 2024 Pharmacist of the Year Award. There was a look of complete surprise and astonishment on Larry’s face as I reached across our table LARRY WAGENKNECHT at lunch to congratulate him.

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“I’m totally humbled with the news. … You caught me off guard!” Larry and I have had quarterly lunches since his retirement, so I knew I had to give him the good news in person. His knowledge and insight have been priceless for me. There’s no finer and more deserving recipient of this lifetime achievement award than Larry.

Honorable Mention I would be remiss if I didn’t call attention to a special MPA member who delivered exceptional service to the pharmacy profession at the national level during 2022-2023 – Ilisa Bernstein. Ilisa served as interim EVP/ CEO of the American Pharmacists Association (APhA) at a critical time for APhA. Her work on the national stage put a spotlight on MPA and demonstrated how an MPA member can have a profound impact on not just Michigan, but on the nation as well. Ilisa has settled back into her regular position at APhA as Senior Vice President of Pharmacy Practice and Government Affairs, but we are so appreciative of her service!

We will have a complete wrap-up of MPA’s 2024 awards in the second quarter issue of the Michigan Pharmacist, but you can get a front row seat at the annual awards banquet on Saturday, Feb. 24, during ACE at the Marriott Renaissance Center in Detroit. There’s still plenty of time for you to register and get your ticket to attend the banquet!

Happy 140th Anniversary MPA Don’t forget that we’re producing a pharmacy flashback video commemorating MPA’s 140th anniversary to air at the 2024 Annual Convention & Exposition. You can contribute to the video by sending us photos or a short video wishing MPA a happy 140th anniversary. Just send your photos and/or videos (up to one minute) to MPA@MichiganPharmacists.org.

— EVENTS CALENDAR —

EVENTS CALENDAR

MPA events, as well as health observances, are included below. For the most up-to-date information, please visit our online calendar at www.MichiganPharmacists.org/events.

JANUARY 2024

1-31

Monday, Jan. 1 – Wednesday, Jan. 31

1-31

Monday, Jan. 1 – Wednesday, Jan. 31

3-5 11 15 18

National Birth Defects Prevention Month Nationwide

National Slavery and Human Trafficking Prevention Month Nationwide

Wednesday, Jan. 3 Friday Jan. 5 NASPA Retreat Laguna Niguel, Calif.

Thursday, Jan. 11

MSHP Committee Day InPerson

FEBRUARY 2024

1-29 2 9 22

Monday, Jan. 15 Martin

22

Thursday, Jan. 18 MPA

23-25

Luther King Jr. Day Nationwide

Committee Day Virtual Only

22

Monday, Jan. 22 MPA Executive Board Meeting Virtual Only

25

Thursday, Jan. 25

30

Tuesday, Jan. 30 MSCP

CSPM Board of Directors Meeting Virtual Only

25 29

Thursday, Feb. 1 – Thursday, Feb. 29

American Heart Month Nationwide

Friday, Feb. 2

National Wear Red Day for the American Heart Association Nationwide

Friday, Feb. 9

MSPT Board of Directors Meeting Virtual Only

Thursday, Feb. 22 MPA EB Meeting, ACE Meeting Detroit, MI

Thursday, Feb. 22

MSHP Board Meeting, ACE Meeting Detroit, MI

Friday, Feb. 23 Sunday, Feb. 25

MARCH 2024

1-31 21-23 22-25 26

Friday, March 1 – Sunday, March 31

National Kidney Month Nationwide

Thursday, March 21 Saturday, March 23 NASPA Annual Conference Orlando, Fla.

Friday, March 22 Monday, March 25

APhA Annual Meeting & Exposition Orlando, Fla.

Tuesday, March 26

American Diabetes Association Alert Day Nationwide

Visit MPA’s social media channels for the most up-to-date information on events, resources and issues affecting pharmacy practice in Michigan.

MPA Annual Convention & Exposition Detroit Renaissance Center

Sunday, Feb. 25

MPA House of Delegates, ACE Meeting Detroit, MI

Facebook.com/MichiganPharmacists

Thursday, Feb. 29

MPF Board of Trustees Meeting Virtual Only

Twitter.com/MIPharmacists

Board of Directors Virtual Only

Please note: Some board and committee meetings may be subject to a change in format to virtual or in-person at the discretion of the members. Please check the online calendar or contact MPA@MichiganPharmacists.org for more information.

Instagram.com/mipharm

Linkedin.com/company/ michigan-pharmacists-association 2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— CE EVENTS —

WEDNESDAY, MARCH 13, 9-11 a.m.

TUESDAY, JAN. 30, 6:30-8:30 p.m.

Medical Cannabis Applications: Mastering the Delivery Systems, Dosages, and Medical Applications for Cannabinoid Medicine Live webinar presented by Dispensary Teams. https://www.lecturepanda.com/a/MasteringCannabinoidMedicine

APhA Pharmacy-Based Immunization Training Mixed format — self-study and live webinar. Self-study must be completed before live session. https://www.michiganpharmacists.org/registration/#/registrationtype sessiongroup/1e80edb9-ae9e-ee11-be37-0022482a9803

WEDNESDAY, JAN. 31, 9 a.m.-1 p.m.

MONDAY, APRIL 1, 4-5 p.m.

MI Pharmacy Law and Ethics Update 2024, Quarter 2

Point-of-Care Test and Treat Training

The self-study component must be completed before the live session date.

Mixed format — self-study and live webinar. Self-study component must be completed before live session. Registration closes Jan. 25. https://www.michiganpharmacists.org/registration/#/registrationtype sessiongroup/7ad029fc-ea99-ee11-be37-0022482a9803

Michigan Pharmacists Association (MPA) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.

https://www.lecturepanda.com/a/PharmacyLawUpdate2024Quarter2

QUESTIONS

If you have any questions about any of these MPA education events, please email MPA@MichiganPharmacists.org.

— NEW PRACTITIONER SPOTLIGHT —

NEW PRACTITIONER MEMBER SPOTLIGHT Member Since: 2021 Why did you join MPA? I joined MPA to network with other pharmacists and help push our profession forward.

Mark Saleh Pharm.D., Walmart Pharmacy

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Why did you become a pharmacist?: I became a pharmacist due to my cousin, Christopher Antypas. He is an independent pharmacy owner in Pittsburgh, Pennsylvania. His compassion and his ability to go above and beyond to help his patients in so many ways are what has inspired me in my practice.

What are you hoping to accomplish in the short term and long term?: In the short term, my goal is to learn as much as I can from my colleagues and grow my knowledge base to help my patients. In

the long term, I would like to change the curriculum in pharmacy schools to better equip newly graduated pharmacists to navigate through the business/insurance side of pharmacy.

Where do you see pharmacy in the future?: I see pharmacy transitioning to a more clinical mindset with more community pharmacists practicing at the top of their license. I foresee pharmacy becoming more integrated with the patient’s providers and making clinical recommendations that are more tailored to the patient and ensuring ideal clinical outcomes.

What do you like to do in your free time?: In my free time, I enjoy spending time with my family and friends, watching Detroit sports and helping in my church.

— FROM THE FOUNDATION —

MOVING FORWARD IN 2024 AND BEYOND

I

have been with the Michigan Pharmacy Foundation (MPF) for the past three years as a board trustee, as a supporter for nearly 30 years and I have had the honor of being the board chair for the past two years. The Foundation is experiencing change and growth. It is gratifying that we as an organization have been able to move forward over the past few years to now be in a place for even more growth through a refreshed strategic plan that was crafted over a year ago with several key accomplishments to date. Much remains, however!

BY CHRISTOPHER J. MAKSYM,

Pharm.D., FNHIA, MPF board chair

“As we continue to aim to be a self-sustaining organization, we look to how we can continue to grow the seeds that have been planted for the future of pharmacists, our Foundation and the pharmacy profession.”

As we continue to aim to be a self-sustaining organization, we look to how we can continue to grow the seeds that have been planted for the future of pharmacists, our Foundation and the pharmacy profession. As we look to the future and continue to dream, we are advancing the pharmacy field. This makes a difference not only within our profession but to those with whom we provide care and walk hand in hand through life’s health and wellness journeys.

Our strategic plan, which guides us through 2025, continues our mission “To Foster the Future of Pharmacy” through our vision of one pharmacy profession, maximizing health and wellness. This strategic plan highlighted three areas: engaging MPF beneficiaries to define the dream and build the profession, expanding the MPF infrastructure through partnership and adopting effective fundraising approaches.

As an effort within our strategic plan, we recently completed a Dream survey of MPA members and MPF supporters, which allowed for further discussion of our programs and future priorities. While I do not have adequate space to cover all the ideas and suggested programs here, I wanted to highlight two that rank high in the results.

• The MPF Leadership Development Program: Health Professional Leadership Academy (HPLA) is a competitive program that builds the future leaders of pharmacy through an intensive, self-reflective experience. Currently, the second class of a redesigned leadership program is comprised of 18 MPA members (six new) who are halfway through their coursework and training which concludes at the MPA Annual Convention & Exposition (ACE) in Detroit in February.

• The MPF Adopt-a-Student program provides an opportunity for student pharmacists from all three Michigan colleges of pharmacy to connect with

experienced, practicing pharmacy professionals to network, develop potential long-term mentors and gain valuable insight for their future careers. Consider adopting a student at ACE, click here for student registration or here to make a donation if you're unable to attend ACE. • Student registration link: https://www. michiganpharmacists.org/student-saturday-at-ace/ • Donation link: https://app.theauxilia.com/pay/ MPF%2520Adopt-a-Student2024 The Foundation also provides grants, scholarships and support to professionals at all levels of their careers.

All of this takes time, effort and finances from our members and supporters. More specifically, these include strengthening the framework for research, board membership and financial stability within MPF. These become areas of continued emphasis for the MPF Board as we look to support our mission of advancing the future of pharmacy.

Through great progress and transformation, especially through our strategic planning efforts, we plan to build on past processes and success to integrate even further within our profession and the Michigan Pharmacy Association, to which we owe continued gratitude for support, encouragement and resources, and to which we embrace for continuing to strengthen the ties and resources between our two organizations.

We invite you to come alongside us in the ways that fit within your availability and resources, whether that is financially through donations, with your time as Adopt-aStudent mentors and even sharing our social media and email communications, or directing others to our new website, MichiganPharmacyFoundation.org. Together, must now grow these seeds we have planted so we can continue to make a difference into the future of pharmacy and all those we serve!

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— MPA EXECUTIVE BOARD —

MPA EXECUTIVE BOARD Elections for the 2024 Michigan Pharmacists Association Executive Board were held last October. The president-elect and board members took office Jan. 1, 2024. Installation ceremonies will be held in person at the MPA Annual Convention & Exposition (ACE) in Detroit Friday, Feb. 23, to Sunday, Feb. 25.

HOPE M. BROXTERMAN

SARAH HILL

RYAN J. GREENLEY

MARK GLASPER

Traverse City

Howell

Chassell

Williamston

ROBIN CURTIS

ANGELA FASZCZEWSKI

CHAIR

MARC GUZZARDO

PRESIDENT-ELECT

PRESIDENT

KATIE AXFORD

TREASURER

SPEAKER OF THE HOUSE OF DELEGATES

VICE SPEAKER OF THE HOUSE OF DELEGATES

LISA BADE

JOHN S. CLARK

MICHELLE KELLY

Rochester

Rockford

DAVID MILLER Alto

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Rockford

Saline

STEVEN WALLNER Negaunee

Ada

Rockford

SARAH LERCHENFELDT Rochester Hills

MARIA YOUNG Canton

SECRETARY/CEO

Lexington

RYAN BICKEL Kalamazoo

ALEKSANDER STAJIC SPEC Liaison-Wayne State

— MEMBERSHIP —

MEMBER SPOTLIGHT

Andrew Nobani Senior clinical pharmacist/consulting pharmacy manager/ clinical analyst, CSPM board member

Describe Your Role/Day in the Life: In my current role, I have the privilege of acting as a regional leader for over eight state Medicaid and health exchange lines of business, making a meaningful impact on health care access and outcomes.

I hold pharmacy licenses in Michigan, Kansas and New Mexico. In addition to my primary role at Centene, I have been acting as the consulting pharmacy manager for the digital pharmacy start-up Capsule and I am the point-of-contact for its first physical location in Michigan, where I oversaw the pharmacy’s setup from construction to licensing.

I also act in a part-time consulting role for Elsevier as a clinical analyst, helping them build artificial intelligence models for clinical use.

Why You’re an MPA Member: My passion for pharmacy extends beyond my daily clinical work.

It's about building a stronger, more connected community, advocating for patients and shaping the future of the profession. That's why I'm an active member of MPA. Through MPA, I've found not just a professional network, but a platform to cultivate my leadership skills. Serving as co-chair of the MSHP Organizational Affairs Committee taught me the intricacies of strategic planning, teamwork and problem-solving. It honed my ability to navigate diverse perspectives, build consensus and drive impactful initiatives. But my growth wasn't limited to committee walls. MPA fostered a thriving network of colleagues and mentors, opening doors to collaboration and resource sharing. This network became my sounding board, my brainstorming hub and ultimately, my springboard to new opportunities.

Recent Accomplishments: In 2022 I received my MBA in health care management and leadership from New England College and in 2023 I received state pharmacy licensure in New Mexico and Kansas. Outside of my professional life, I am deeply involved in my community, church and professional activities, serving as a member of the board of trustees for the Michigan Pharmacy Foundation and a member of the board of directors for the Consultant and Specialty Pharmacists of Michigan (CSPM), as well as being an advisory board member for the George Washington University and University of South Florida MUMA College of Business. I also find fulfillment in mentoring current and prospective pharmacy students through the University of Michigan UCAN program and contributing to public health as a member of the Medical Reserve Corps in the city of Detroit and Macomb County.

How MPA Has Helped You Achieve Any Accomplishments: My membership in MPA

has been a launchpad for my professional growth, transforming me from a pharmacist into a connected leader, skilled collaborator and strategic problem-solver. Serving as co-chair of the Organizational Affairs Committee honed my skills in: trategic planning: Collaborating with •S diverse stakeholders, including through active networking within committees and at association events, to craft the association's vision and implement initiatives that benefit the entire pharmacy community.

• T eamwork and communication: Building strong relationships with committee members and beyond, fostering open dialogue and effectively advocating for impactful solutions through my cultivated network.

• Resource management: Identifying funding opportunities and partnerships through my established network, securing resources that drive the committee's success.

•P roblem-solving: Tackling complex challenges related to organizational structure, membership engagement, and advocacy efforts, often by leveraging the diverse perspectives and expertise within my network.

These experiences not only honed my leadership skills but also expanded my professional network, making me a more resourceful and well-connected member of the pharmacy community. Now, my appointment to the Board of Directors of CSPM presents an exciting opportunity to further leverage my skills and contribute to the success of another vital pharmacy organization.

In this new role, I will be able to: • Advocate for specialty pharmacists: Championing the unique needs and value proposition of specialty pharmacists within the health care landscape, utilizing my network to amplify CSPM's voice and build strategic partnerships.

• Promote collaboration: Fostering even stronger collaboration between CSPM and MPA, leveraging my connections to create bridges and strengthen the entire pharmacy community in Michigan. ontribute to strategic decision-making: •C Providing valuable insights and perspectives informed by my diverse network, shaping CSPM's future direction and initiatives with a broader understanding of the industry landscape.

My journey through MPA has been a dynamic one, fueled by leadership development, teamwork, problem-solving and the power of networking.

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— MEMBERSHIP —

FROM THE DESK OF

T

MEMBERSHIP

hank you for your continued support of the Michigan Pharmacists Association (MPA). MPA would not have had success in 2023 without you, our members. At the end of December, membership growth was slightly more than 2022. This means MPA ended 2023 with nearly 2,300 members. This was accomplished through the hard work and passion of members, MPA staff, MPA executive and section boards, committees and local associations.

2024 is off to a great start with work being accomplished by MPA and Michigan Society of Health-System Pharmacists membership committees. Also, in late 2023, MPA launched the Member-Get-A-Member referral initiative, which is an exciting and rewarding way for members to grow the association and recruit more passionate and dedicated members.

BY BRYAN FREEMAN,

chief strategy officer, Michigan Pharmacists Association

MPA MEMBER-GET-A-MEMBER PROGRAM Joining the MPA Member-Get-A-Member Program is a breeze and the rewards are just a few steps away. Here's a simple breakdown of how it all works: Share Your Passion: Log in to your MPA profile on the MPA website. Click on “Profile” in the upper left-hand corner after you are logged in. Next, click on the “Member Referral” tab and enter your colleague’s name and email address.

An automated email will be sent to your colleagues asking them to join MPA. When your colleague joins MPA, they must use the email address you provided. There are no limits on the number of referrals and associated rewards you can receive.

Welcome New Members: Once your referrals have successfully joined MPA, they'll be welcomed into our vibrant community.

Earn Your Rewards: Here's where the magic happens! You, as the referrer, will be issued a reward coupon within your MPA profile as a token of our appreciation. For each pharmacist you recruit, you'll receive a generous $30 coupon and $20 for each pharmacy technician.

Use Your Rewards: In your user profile, you'll find a "coupons" section under the "My Invoices” tab. Here, you can view any coupons you've received. These reward coupons can be applied towards your membership dues or any MPAsponsored event such, as the Annual Convention & Exposition.

It's that simple! By spreading the word and bringing new members into MPA, you not only contribute to the growth of MPA but also reap the rewards. Join the Member-Get-A-Member Program today and be a catalyst for positive change in pharmacy practice in Michigan.

Thank you for your commitment to MPA, and we look forward to celebrating your success as a member recruiter!

New MPA members (Sept. 1-Dec. 31) Hayah Abbasi Taif Afat Ariel Alber Josleen Albishara Mariam Alghaiti Kathrine Algie Moustafa Alharis McKenzie Allen Sarah Alsomairy Delaney Anglin Chiamaka Aroh Anna Azuz Mark Babich Zeina Bara-Hajjar

Vestine Barere Natalie Barstys Alissa Beachum Erin Beattie Melissa Bergeron Amanda Berishaj Paton Birely Logan Bixman-Surmont Karen Blamoun Ellah Bliler Brooke Bliss Lena Boussi Rebecca Bovee Joanna Bowling Julie Boyden Kathryn Bradley Erin Brinkman

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Stephanie Brown Emily Burleson Jeffrey Calcamuggio Madalina Calin Korin Calkins Sabre Callus Nicole Campbell Anastazia Capparelli Theresa Carrier Carmela Catizzone Khalil Chahine Sarah Channey Guadalupe Chavez Srihari Chowdari Aneesa Chowdhury Grace Ciaramella Denise Clark

Claire Colclough Ziana Collins Kenton Cooksey Alyssa Cosselmon Andrea Cousino Annie Cross Ashley Cummings Megan Cushman Kayla Daly Champa Danappanavar Evangelina Dang Jonathan Danno Kim DeBruin Neha Desai Joanna Donaldson Jordan Donovan Erin Drylie

Travis Edington Chizaram Egele Shayma Elalem Loriann Essak Ada Ezeokonkwo Ali Farhat Taylor Farmer Meghan Farrell Karen Fenton Cynthia Feucht Dennis Fodell Abigail French Ledia Gadallah Brendan Gagnon Nubar Gambourian Madeline Gardner Austin Geer

Leena Ghaeb Taylor Gianfermi Thomas Grover Ned Hall Rae Hammer Amira Hammoud Lama Hamzi Dana Harper Tyler Hart Danijela Hart Morgan Henderson Ashley Hills Zackary Hren Jingyu Hu Lynn Huang Scott Huizenga Nisha Hull

— MEMBERSHIP — New MPA members (Sept. 1-Dec. 31) Macy Ilmberger Sarah Isbrecht Philip Ituah Sophia Jaso Aaron Jeffery Mikala Jewett Martelle Johnson Eric Jones Rula Kakish Bayleigh Kamm Delina Kamposh Wael Kassir Courtney Kauffman Ava Kayner Patrick Kendall Reemah Khallouf Tahreem Khanzada Beyang Kima-Tabong Kristin King Chase Kiriazis Colt Kondel Michael Kosal

Sophie Kubesh Maha Kyasa Hamdi Lababidi Michael Lao Michelle Litrenta Jessica Little Lily Lockhart Louis Lotvola Morgan Maclean Cody Mallo Lillian Martin Bhuvan Mathur Areeba Maysun Jacqueline McDonnell Lea Melistas Craig Merrill Kevin Metushi Diana Mic Rosanna Miceli Julia Miller Vanessa Millisor Lindsey Moore Emily Morrone Jade Mosquera Isabel Muglia

Vyali Naem Eric Nagel Ian Nagy Tiasha Nandi Gregg Nannini Shelby Nelson Lucille Nguyen Julianna Nichols Melanie Nickerson Leanne Olney Danielle O'Mara Holly Ornelas Rylee O'Rourke Brent Osentoski Sam Oudsema Almedina Pargan Ji Hun Park Aska Patel Samantha Patrician Sheila Payne Micah Pepper Nicholas Phillips Rachel Pinkney Alexia Pizzuto Sarah Pravinth

Abigayle Price David Prospal Patricia Railling Sarah Ramadan Adnan Restum Devin Rice Nicole Richards Stephen-Anthony Rimando Brooke Romero Deanna Saleh Danny Salem Barbara Salmela Moses Sarkisian Kayla Sarles Tassnime Sebaei Jordan Sedlacek Alexa Sekulovski Marwa Shahin Gloria Shakory Waleed Shamoun Maryam Shatit Dana Shepard Julie Shepler Erica Sheridan Jenna Slater

Maureen Smythe Maria Sobhie Scott Somerfield Alexandra Sornson Allison Spitery Mia Stewart Howard Stocker Emma Stoner Vayda Suleiman Jenna Szafranski Marrissa Tatti Michele Thatcher Ron Thatcher Destiny Thornton Rita Tobya Kathryn Tyler Tyler Uebele Nathan VanderVeen Lucy Vang Kali VanLangen Thomas Vassas Manuel Velazquez Viveca Velez Negron Angelina-Jessica Vita Teresa Vu

Maria Vukaj Maria Walczyk Aidan Walsh Ashley Watson Natasha Webb Samantha Weisbrod Brian Wheaton Hailey Wheeler Micaiah Whitaker Ashlyn Whitesell Paige Whittaker Thomas Willett Melanie Williams Christopher Wolfinger Kwanta Wu Mariam Yasin Cheryl Ylkanen Mellisa Yousif Simon Zerom Zhen Zhao Andrea Zielinski

PTCB Launches New Certificate for Pharmacy Technicians As part of its mission to ensure pharmacy technicians meet the evolving challenges in medication safety, the Pharmacy Technician Certification Board (PTCB) has launched a new Supply Chain and Inventory Management Certificate. This advanced credential assesses pharmacy technicians’ knowledge of laws and regulations, administrative processes, inventory management, documentation requirements and key players in the supply chain.

Pharmacy technicians play an increasingly vital part in patient care teams, and fluency in supply chain and inventory management can help keep the focus on safety at every step, from the manufacturing lab to the medicine cabinet. By earning this certificate, technicians can demonstrate their understanding of supply chain and inventory management regulations, processes, and responsibilities and better adapt to changing guidelines.

View all pharmacy technician credentials at ptcb.org/credentials 2024 Jan./Feb./Mar. | Vol. 62, Issue 1

11

— PROFESSIONAL AFFAIRS —

ACIP Unveils 2024

RECOMMENDED IMMUNIZATION SCHEDULES I n November 2023, the Centers for Disease Control and Prevention (CDC) released the much-anticipated 2024 Advisory Committee on Immunization Practices (ACIP) recommendations on immunization schedules.

This summary aims to highlight the pivotal changes concerning significant changes identified.

The 2024 immunization schedule has undergone several significant changes: • The headers have been modified from "Vaccine" to "Vaccines and Other Immunizing Agents" to include monoclonal antibodies.

• New information has been incorporated for the following: oR SV-mAb (nirsevimab): addresses children from birth up to 8 months and high-risk groups from 8 to 19 months. This includes details on the timing of immunization and guidance for jurisdictions with varying respiratory syncytial virus (RSV) seasonality.

BY NOREEN MIKA,

Pharm.D. candidate 2024, University of Michigan and

FARAH JALLOUL,

Pharm.D., MBA, director of professional development, Michigan Pharmacists Association

12 MichiganPharmacists.org

oR SVPreF vaccine (Abrysvo) for pregnant individuals, featuring information on immunization timing and guidance for jurisdictions with RSV seasonality differing from most of the continental United States. oM POX vaccine (Jynneos) for individuals aged 18 years and at risk.

• Several vaccines have been removed from the schedule due to discontinuation or no longer being recommended for use in the U.S. These include bivalent mRNA COVID-19 vaccines, 13-valent pneumococcal conjugate vaccine (PCV13), diphtheria and tetanus toxoid vaccine (DT) and Menactra.

• COVID-19 vaccination recommendations for children and adolescents have been updated in the routine vaccination and "Special Situations" sections.

• Meningococcal (Men) information has been expanded to include the use of the newly licensed MenACWYTT/MenB-FHbp (Penbraya) vaccine. A resource aiding health care providers with shared clinical decision-making recommendations for MenB vaccination has also been added.

• Pneumococcal recommendations now include guidance for the 15-valent pneumococcal conjugate vaccine (PCV15), PCV20, and 23-valent pneumococcal polysaccharide vaccine (PPSV23) for routine vaccination, catch-up vaccination and "Special Situations."

• The poliovirus "catch-up" vaccination has been revised to include updated recommendations for adolescents aged 18 years. The "Special Situations" section now describes administering one lifetime inactivated polio vaccine (IPV) booster to adolescents aged 18 years who have completed the primary series and are at an increased risk for exposure to poliovirus.

• Finally, the influenza vaccine states that individuals with a history of egg allergy of any severity can receive any influenza vaccine suitable for their age and health status without additional safety considerations.

— PROFESSIONAL AFFAIRS — In addition, according to the updated guidelines, ACIP suggests that adults 65 years and older should preferably receive one of the following higher dose or adjuvanted influenza vaccines: quadrivalent high-dose inactivated influenza vaccine (HD-IIV4), quadrivalent recombinant influenza vaccine (RIV4), or quadrivalent adjuvanted inactivated influenza vaccine (aIIV4). If none are available at the time of vaccination, any other age-appropriate influenza vaccine is deemed acceptable for administration.

The decision to prioritize these specific vaccines is based on data indicating a potentially more significant benefit in this age group when compared to standard-dose unadjuvanted influenza vaccines. Notably, the recommended vaccines include HD-IIV3, aIIV3 or RIV4, with the most data available for HD-IIV3. It is important to note that direct comparisons between these recommended vaccines are limited.

ACIP also advises all individuals 6 months or older with an egg allergy should receive the influenza vaccine. This contradicts previous recommendations as there had been concern for residual egg protein

in vaccine development. The guideline stresses that an egg-based influenza vaccine appropriate for the recipient's age and health status can be administered without hesitation.

ACIP further discussed that in the context of egg allergy, there is no need for additional safety measures beyond those recommended for any vaccine recipient, irrespective of the severity of previous reactions to eggs. ACIP emphasizes that severe and life-threatening reactions to vaccines can occur with any vaccine and in any vaccine recipient.

Therefore, the committee highlighted the importance of administering all vaccines in settings equipped with the necessary personnel and equipment to recognize and treat acute hypersensitivity reactions rapidly.

Pharmacists are encouraged to adhere to these updated recommendations when administering influenza vaccines to adults 65 years and older and persons with egg allergies. Your continued dedication as pharmacists in promoting public health remains invaluable, as well as your steadfast efforts to safeguard the well-being of our communities!

"The decision to prioritize these specific vaccines is based on data indicating a potentially more significant benefit in this age group when compared to standard-dose unadjuvanted influenza vaccines. Notably, the recommended vaccines include HD-IIV3, aIIV3, or RIV4, with the most data available for HD-IIV3. It is important to note that direct comparisons between these recommended vaccines are limited."

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— CSPM FOCUS/ADVOCACY —

2023

PBM REFORM RECAP

BY MATTHEW G. MCTAGGART, RPh, Pharm.D., CSPM board chair

S

ince the mid-20th century, pharmacy benefit managers (PBMs) have played a major role in the United States health care system as intermediaries between pharmacies, patients, insurance companies, drug manufacturers and drug wholesalers. Beginning in the 1970s, rapid vertical and horizontal integration among PBMs, pharmacies, pharmaceutical industry and drug wholesalers led to the emergence of behemoth PBMs. As of 2023, just three PBMs accounted for more than 80% of all prescription claims processing by volume: CVS/Caremark, Express Scripts and OptumRx. With the massive consolidation in the PBM market space, various PBM reform movements have emerged to mitigate monopolistic, unfair and dodgy business practices on the part of the largest PBMs at the state and federal levels.

In Michigan, much of the attention on PBM reform in 2023 has focused on the implementation of a trio of PBM reforms passed in 2022, with the effective date for many of the provisions starting Jan. 1, 2024.

Public Acts 11, 12 and 13 of 2022 included a plethora of PBM reforms. Public Act 11 of 2022 (PA 11) prohibits PBMs from engaging in “spread pricing,” where the PBM reimburses the dispensing pharmacy at a lower rate than what the insurance plan has allocated and then pockets the difference. PA 11 also prohibits

14 MichiganPharmacists.org

PBMs from enforcing so-called “gag clauses” on pharmacists to prevent them from telling patients that they could pay a lower cash price instead of using the PBM’s negotiated copay or coinsurance. In addition, PA 11 requires PBMs to obtain a PBM license from the Michigan Department of Insurance and Financial Services (DIFS), as well as file annual transparency reports with DIFS detailing the “backend cost and profits” of medications that the PBM processes. DIFS spent a considerable amount of time in 2023 attempting to work out the logistics involved in the new PBM licensure and enforcement process.

PA 12 further prohibited PBMs from discriminating against non-network pharmacies and/or 340B Program entities and made PBMs third-party administrators (TPAs) subject to TPA certification and conduct requirements. PA 13 codified the previous acts into the Michigan Public Health Code and prohibited pharmacies or pharmacists from agreeing to a contract with “gag clauses” around drug pricing.

So how has implementation been going? As of December 2023, DIFS has added information to its website notifying PBMs that they must be licensed starting on Jan. 1, 2024, and that TPA certification is also required. DIFS is also requiring a “PBM pharmacy network adequacy report” in the license application to ensure that PBMs are contracting with

sufficient pharmacies to meet the distance standards and access requirements in each county. Unfortunately, DIFS does not yet have a complaint mechanism in place to file a grievance or report against a PBM in Michigan. In addition, the requirements for the transparency report required by April 1, 2025, and each April 1 thereafter, have not yet been published. The reform legislation passed in Michigan in 2022 has some of the toughest provisions for PBM reform in recent years, but without a robust complaint and resolution process in place from DIFS and other regulators, it seems likely that PBMs will continue to operate with relative impunity.

At the federal level, there were significant legislative and regulatory efforts in 2023 designed to help rein in some of the most egregious PBM offenses. There are currently seven federal policy proposals in the U.S. Senate and House of Representatives. These proposals generally focus on: increasing PBM transparency; prohibiting spread pricing; ensuring rebates negotiated by PBMs are passed along to payers and (hopefully) patients; delinking PBM compensation from medication list prices; limiting patient steering and mandatory mail-order to PBM-owned pharmacies; and, capping patient cost sharing. Table 1 lists the current bill numbers, names, sponsor(s), and statuses as of December 2023.

— CSPM FOCUS/ADVOCACY — Table 1: 2023 Federal PBM Reform Policy Proposals Proposal Designation (Senate Bill or House Resolution Number)

Name

Sponsor(s)

Status

Modernizing and Ensuring PBM Accountability (MEPA) Act

Sens. Ron Wyden (D-Ore.) and Mike Crapo (R-Idaho)

Advanced out of Senate Finance Committee

S. 127

PBM Transparency Act of 2023

Sens. Chuck Grassley (R-Iowa), Maria Cantwell (D-Wash.),Cindy Hyde-Smith (R-Mo.),Mike Braun (R-Ind.), Jerry Moran (R-Kan.), Thomas Tillis (R-N.C.), Jon Tester (D-Mont.) and Shelley Moore Capito (R-W.Va.)

Advanced (as amended) by the Committee on Commerce, Science and Transportation

S. 2405

Strengthening Pharmacy Access for Seniors Act

Sens. John Thune (R-S.D.), Sherrod Brown (D-Ohio), John Barrasso (R-Wyo.), and Debbie Stabenow (D-Mich.)

Referred to Senate Finance Committee

S. 1038 / H.R. 1613

Drug Price Transparency in Medicaid Act of 2023

Sens. Peter Welch (D-Vt.) and Roger Marshall (R-Kan.)

Referred to Senate Finance Committee

H.R. 2880

Protecting Patients Against PBM Abuses Act

Reps. Buddy Carter (R-Ga.), Lisa Blunt Rochester (D-Del.), Nicole Malliotakis (R-N.Y.) and Jake Auchincloss (D-Mass.)

Referred to Energy and Commerce Subcommittee on Health

H.R. 3561

Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023

Reps. Cathy McMorris Rodgers (R-Wash.) and Rep. Frank Pallone, Jr. (D-N.J.)

Advanced out of Committee on Energy and Commerce

H.R. 5385

Medicare PBM Accountability Act

Reps. Diana Harshbarger (R-Tenn.) and Greg Landsman (D-Ohio)

Introduced

S. 2973

“In December 2023, CMS sent a strongly-worded letter to health plans and PBMs warning them to expect “robust oversight” to help protect small and independent pharmacies from predatory PBM practices, particularly regarding vaccine access and payment.”

In addition, the Federal Trade Commission (FTC) and the Centers for Medicare and Medicaid Services (CMS) have each taken actions over the last year in scrutinizing PBM abuses. In July 2023, FTC Chair Lina Khan issued a statement warning the public against relying on previous FTC guidance regarding PBMs. More specifically, the statement noted that “extensive consolidation” by PBMs has placed health care stakeholders at a “severe information disadvantage.” The FTC went on to expand its existing inquiry from six of the largest PBMs to include three group purchasing organizations (GPOs) linked to existing PBMs. While no action has been taken by the FTC against PBMs at this time, the tone and timber of the current statement suggests that the FTC may look to exercise long-dormant “trust-busting” authority should the inquiry findings support such action. In December 2023, CMS sent a strongly-worded letter to health plans and PBMs warning them to expect “robust oversight” to help protect small and independent pharmacies from predatory PBM practices, particularly

regarding vaccine access and payment. While it is unclear what actions CMS would take for PBMs and plans that do not heed the warning, the letter does serve as notice that CMS has at last taken issue with the most glaring PBM and plan malfeasances.

PBMs have also come under fire from rival start-ups in the marketplace, most notably from Mark Cuban Cost-Plus Drugs. Under this model, Cost-Plus Drugs offers a highlytransparent pricing breakdown directly to the consumer at the point of purchase, including the drug acquisition cost, any markup and associated service fees. While the full impact of this new player in the PBM space has yet to be understood, at least one large PBM has taken note: CVS Health now plans to launch CVS CostVantage and CVS Caremark TrueCost beginning in 2025.

The TrueCost program will offer drug pricing based on the net cost of drugs with defined fee structures and promises to offer clients more visibility into prescription drug pricing and administrative fees. CostVantage, on

the other hand, appears to be an attempt to emulate the discount card program successes of businesses like GoodRx. Under the CostVantage program, consumers who pay cash for prescriptions would get pricing based on cost of the drug, a set markup and a fee that reflects pharmacy service value, all of which sounds very similar to the Mark Cuban Cost-Plus Drug model. Whether all of these market forces combine to actually increase transparency in the pharmacy marketplace and lower costs for patients remains to be seen.

References: 1. M attingly TJ, Hyman DA, Bai G. Pharmacy Benefit Managers: History, Business Practices, Economics, and Policy. JAMA Health Forum. 2023;4(11):e233804. doi:10.1001/jamahealthforum.2023.3804 2. h ttps://www.ftc.gov/system/files/ftc_gov/pdf/ 3. h ttps://www.cms.gov/files/document/pharmacybenefit-manager-insurer-letter.pdf 4. h ttps://www.aha.org/aha-center-health-innovationmarket-scan/2023-12-12-cost-plus-drug-pricingmodels-gain-momentum-will-they-last

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— CSPM BOARD —

SOLVING THE DRUG SHORTAGE CRISIS IN THE UNITED STATES S

BY MATTHEW G. MCTAGGART, Pharm.D.,

RPh, CSPM board chair

hortages of many commonly used medications, including many lifesaving drugs, have become commonplace over the last several decades. In 2023, the number of medications currently experiencing a shortage reached over 300 different drugs at one point, numbers not seen since a major manufacturing crisis in the early 2010s. Recent breakdowns in fragile supply chains that depend on significant overseas production collided with rising demand for many products due to increasing utilization by the U.S. population.

In addition, market forces have made sustainable production in the U.S. largely untenable for many unprofitable but commonly used generic medications, including lifesaving antibiotics like amoxicillin; antineoplastic drugs like cisplatin and carboplatin; and many formulations of stimulant drugs used to treat ADHD. Even newer and more profitable drugs, such as the GLP-1 receptor agonists, have seen shortages – albeit largely due to inability to meet demand from off-label use.

The situation reached a critical point in early 2023 as many commonly used oncology drugs suddenly became unavailable, especially the platinum-based agents cisplatin and carboplatin. Patients, physicians, pharmacists, nurses and other health care providers were faced with the terrible choices of having to ration lifesaving drugs. The heartbreaking stories soon made national news and caught the attention of state and federal leaders. Regulators at the FDA acted with uncharacteristic haste to allow importation of Chinesemanufactured cisplatin products for emergency use in the U.S., which helped but did not truly fix the underlying issues. During testimony before Congress, FDA Commissioner Dr. Robert Califf admitted that it was largely powerless to help fix the drug shortage crisis, as the real solutions would require increasing production capacity and paying sustainable reimbursement for quality drug products.

In the interim, several other policy proposals have emerged which could offer additional solutions for solving the drug shortage crisis. Setting a minimum price – or “floor price” – for generic drugs, especially for sterile injectables, has been suggested by some

16 MichiganPharmacists.org

generic industry executives. Government production of some critical medications, particularly those deemed vital to national security, has also been suggested by some members of Congress as well as the American Medical Association. Adding more transparency to the supply chain through enhanced reporting, particularly of the active pharmaceutical ingredients, has also been a priority for the FDA Drug Shortages team.

Tactical stockpiling has also been suggested to help act as a buffer, but even proponents like the American Cancer Society admit that this solution will not fix the underlying issue of “chronic unsustainable market conditions.”

Making more medicines in the U.S., or “reshoring” drug production, has also been proposed. Critics point out that many domestic generic drugmakers have already gone bankrupt and even domestic facilities are subject to natural disasters, like the tornado that tore through a Pfizer warehouse in 2023. The use of 503b compounding pharmacies to help produce small batches of commercially unavailable products on shortage has also been proposed, but the American Society of Health-System Pharmacists requested that the FDA provide more information on the quality of the compounding facilities before endorsing this solution.

While most of these solutions focus on “internal” U.S. remedies, it is important to remember that the U.S. is irrevocably intertwined with drug manufacturers around the globe and any solution must also factor in not just sustainable U.S. supply, but global medication supply.

For example, importation of some medications from Canada was floated as a possible solution, but Canadian officials quickly rebuffed U.S. overtures, pointing to existing shortages of the same products in Canada and other industrialized nations. It will likely require a combination of all the proposed solutions to help secure a robust drug supply chain. In the meantime, patients and providers are left with little alternative but to ration and horde scarce resources, hoping that it is enough for one more day.

References: 1. Jewett C. Possible ways to ease drug shortages. The New York Times. December 19, 2023. Accessed December 19, 2023. https:// www.nytimes.com/2023/12/19/health/cancer-drugs-solutions.html.

— FROM THE FOUNDATION —

2024 MPF BOARD OF TRUSTEES

The Michigan Pharmacy Foundation (MPF) is proud to introduce its new officers and members of the 2024 MPF Board of Trustees. Members are elected by the board annually on a rotating basis to three-year terms. Newly-elected trustees for 2024 are Andrew Nobani, Mohannad "Mike" alNabolsi and Amy Smendik. Christopher Maksym was chosen to return as chair, while John Brubaker and James Vander Linde take over as vice chair and treasurer, respectively. Returning trustees are Denise Markstrom, Ghada Abdallah, Margaret "Peggy" Malovrh, Rox Gatia, Scott Huizenga and Terry Gottschall. MPA CEO Mark Glasper serves as secretary, while MPA President Sarah Hill also sits on the board.

CHRISTOPHER MAKSYM

JOHN BRUBAKER

JAMES VANDER LINDE

Dexter

Sterling Heights

East Lansing

Williamston

MOHANNAD AL-NABOLSI

SARAH HILL

DENISE MARKSTROM

MPF CHAIR

ANDREW NOBANI Saint Clair Shores

MPF VICE CHAIR

Livonia

MPF TREASURER

MPA PRESIDENT

MARK GLASPER

MPF SECRETARY/MPA CEO

Sterling Heights

Howell

GHADA ABDALLAH Grosse Pointe

MARGARET MALOVRH Okemos

ROX GATIA Bloomfield Hills

RICK DRABEK

MPF EXECUTIVE DIRECTOR St. Johns

SCOTT HUIZENGA Ann Arbor

TERRY GOTTSCHALL Wixom

AMY SMENDIK Middleville

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— STUDENT FOCUS —

WHY MPA ACE 2024 IS A

A

ttending the Michigan Pharmacists Association Annual Convention & Exposition (ACE) is an empowering journey, with various networking opportunities, social events and a chance to learn from experts in the field! This year's ACE will take place Feb. 23-25, 2024, at the Detroit Marriott at the Renaissance Center in the vibrant city of Detroit. As a pharmacy student at the University of Michigan, I had the privilege of experiencing the 2023 ACE, and let me tell you, it's not just a conference – it's an unparalleled opportunity for students to dive into the heart of the pharmacy profession.

BY NOREEN MIKA,

Pharm.D. candidate 2024, University of Michigan

Imagine being surrounded by seasoned professionals, engaging in insightful discussions and expanding your network in ways you never thought possible. At ACE, students from Michigan’s three colleges of pharmacy – Ferris State University, the University of Michigan and Wayne State University – have the chance to be mentored by distinguished pharmacists; contribute to discussions in the House of Delegates; listen in on continuing education sessions; compete in the National Alliance of State Pharmacy Associations (NAPSA) SelfCare Competition; participate in the Adopt-A-Student program and much more.

On Friday of the conference, you can expect to listen to and engage in various continuing education topics led by pharmacists and other leaders within the practice.

This is a great day to hear about the current topics with pharmacists' attention around Michigan.

Something new this year is "Student Saturday." This is truly the most eventful day for students.

18 MichiganPharmacists.org

As students, we all think about money and how we will repay our dreadful student loans. Students are invited to participate in a financial planning session to kick off ACE and become more knowledgeable about this aspect of college. If you feel you are already well-versed in this topic, you can mingle with other students in the student social room. Students may also sign up for a resume review in which they will be paired with a professional at a later date; more information will be available on-site at the registration desk!

The clinical pearls session led by PGY1 and PGY2 residents is next up on the agenda. This is an incredible opportunity to ask questions to those well-versed in residency programs, especially if you are considering applying to residencies.

After that, you can attend a keynote session presented by speaker Michael Hogue, executive vice president and CEO of the American Pharmacists Association. The topic of his presentation will cover the challenges we are facing in pharmacy. I hear he is a speaker who enjoys

— STUDENT FOCUS —

MUST-ATTEND FOR PHARMACY STUDENTS! engaging his audience, so consider what challenges you think student pharmacists face as you prepare to enter the career and consider raising them as a question during this session!

Following the keynote session, a free lunch is provided to students, courtesy of the Michigan Society of Health-System Pharmacists (MSHP). To participate, you must sign up to attend the free luncheon. This opportunity allows you to sit down with students and health-system pharmacists and network over your career interests! If you aren't interested in health systems, MPA also provides free lunch in the Exhibit Hall, where you can find representatives from drug companies and experts in pharmacy.

One of the most memorable experiences at ACE takes place shortly after: the Self-Care Competition. This competition provides a stage for students from all three Michigan colleges of pharmacy to come together and battle for a trophy and bragging rights on who is most well-versed in over-the-counter products! For the past two years, Ferris State University's College of Pharmacy has taken that title home. I think it is time either the University of Michigan or Wayne State University has that trophy! If you are interested in participating in the OTC

competition, please talk to your chapter's president or student liaison.

Believe it or not, the conference is still not over! It’s now is time to party at the Michigan Pharmacy Foundation (MPF) annual student social event.

During the evening, MPA offers all students in the "Adopt-A-Student" program the opportunity to attend the Cocktail Reception and Awards Banquet. During this event, you are seated with your mentor from the AdoptA-Student program and other students and their mentors. Enjoy dinner and the awards ceremony for pharmacists who were chosen to receive awards for their involvement in the pharmacy profession. If you are interested in the Adopt-A-Student program, visit the MichiganPharmacyFoundation.org/ adoptstudent or talk to your chapter's liaison to help you register for the free opportunity.

If you thought the fun was over, you forgot that ACE continues on Sunday. Students invited to the House of Delegates participate in sessions to vote on and discuss proposed resolutions that provide MPA with direction on advocacy and strategic efforts to strengthen the Association and profession. Student pharmacists are encouraged to submit resolutions for discussion during the House

session. For more information, email HOD@ MichiganPharmacists.org. But before the House session, you can enjoy breakfast and a few other sessions on pharmacy topics!

As someone who has attended ACE and witnessed the impact firsthand, I encourage all pharmacy students to seize this incredible opportunity. It's not just a conference; it's a chance to shape your future, amplify your voice and become an active part of the pharmacy community.

The earlier you sign up, the more you can save! As a student pharmacist, you can sign up for $85 to attend the entire conference if you register by Feb. 19. On-site registration is $95 for student members. Please visit the MichiganPharmacists.org/educationevents/annual-conference-exhibition/ for more details on this experience or how to sign up. Additionally, you are welcome to contact MPA Student Pharmacist Executive Council staff liaison Farah Jalloul at FJalloul@ MichiganPharmacists.org. Don't miss out on the chance to unlock your potential at MPAACE 2024!

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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2 024 ANNUAL

CONVENTION & EXPOSITION Friday, Feb. 23 — Sunday, Feb. 25

The rumors are true: it’s the last year of our 15-year stint hosting the Michigan Pharmacists Association’s (MPA) Annual Convention & Exposition (ACE) at the Detroit Marriott at the Renaissance Center. While we’ve certainly enjoyed our tenure and partners in Detroit, we’ll be moving ACE around the state the next few years – and to a new month! Beginning in April 2025, ACE will head north to Traverse City and from 2026-28 it will shift to Lansing in the early spring!

You’ll absolutely want to join us in 2024 from Friday, Feb. 23, to Sunday, Feb. 25, to experience an ACE like no other.

We’ve heard from our members, board, partners and staff on their experiences from ACE 2023, and an overwhelming many of you stated it was the best ACE you had ever attended. Even our long-time attendees said it was the most engaging convention in more than a decade! We’re dialing it up even more this year at our in person-only 2024 ACE – read on for all the need-to-know details. Note that for those who cannot attend ACE in-person this year, MPA will release sessions that were recorded at a premium to non-members and discounted to members on a session-by-session basis.

BY LISA N. POWERS,

CAE, CTA, director of education & events, Michigan Pharmacists Association

RMACISTS A

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2024

We’re looking forward to the growth that happens not only professionally, but also personally as we look to strengthen the network of pharmacy professionals and allies. In addition to professional and personal growth, the keynotes and sessions offered this year will grow your knowledge in key areas including infertility and sexual health; drug updates and immunization; law and drug updates; and so much more. If you were to attend every keynote and a session at each breakout offering, you could acquire more than 15 hours of live CE credit at this year’s Annual Conference. Our detailed agenda is available for viewing on the Annual Convention & Exposition home page of MPA’s website.

It is important to note that MPA is keeping the safety of our members, staff and partners top of mind. MPA will be following guidelines from the Centers for Disease Control and Prevention (CDC), state of Michigan and Detroit Health Department for any current COVID-19 or health precautions during the conference.

"You’ll absolutely want to join us in 2024 from Friday, Feb. 23, to Sunday, Feb. 25, to experience an ACE like no other."

— ON THE COVER —

KEYNOTE HIGHLIGHTS FRIDAY OPENING KEYNOTE

SATURDAY KEYNOTE SESSION

After a full morning of educational programming that begins at 8 a.m.

Friday, Feb. 23, MPA is honored that its opening keynote address will be given by Antonio Ciaccia, Antonio Ciaccia the co-founder and president of 3 Axis Advisors and the co-founder and CEO of 46brooklyn Research. Known throughout the nation as the “PBM Slayer,” his engaging and interactive session titled “Out of the Shadows: The National Push for PBM Reform Has Arrived” will address topics such as how Michigan “stacks up” nationally when it comes to PBM reform, the importance of regular reporting, the data available to all parties and how we can move the needle in the right direction for pharmacy and patient care benefit. Get all your queries and questions answered by one of the top leaders in the nation working diligently to ensure equity in the PBM world. Be sure to come prepared with your questions and to learn some of the hard truths and common myths surrounding this subject.

Saturday, Feb. 25 is another full day of programming.

Breakfast will be served at 7 a.m., followed by more education sessions at 8:30 a.m. The keynote address, “Hope for the Future in Michael Hogue Current Challenging Practice Circumstances,” will be given by none other than Michael Hogue, the executive vice president and CEO of the American Pharmacists Association (APhA). The workplace environment issues surrounding pharmacy has taken on a life of its own over the past year. Learn more about the current national landscape, the concern from colleges of pharmacy, the imperative influence of regular reporting, the board of pharmacy’s role and how these parameters are utilized to make decisions. Hogue is planning an interactive, participatory session, so please come ready with your questions as challenging practice circumstances can affect us all – and patient care.

Don’t miss this opening keynote beginning at 1:30 p.m., after the welcome address from MPA CEO Mark Glasper at 1 p.m.

One of ACE’s most popular events, the National Alliance of State Pharmacy Associations (NASPA)-NMA Self-Care Challenge returns again at 2 p.m. The Self-Care Challenge provides students an opportunity to showcase their extensive

over-the-counter (OTC) knowledge against their rival pharmacy students in a lighthearted competition while granting continuing education credits for attendees. This year’s competition will feature three students from each college of pharmacy in Michigan: Ferris State University, Wayne State University and the University of Michigan. These threestudent teams will compete in a three-round, “Jeopardy!”-style competition for a chance to be crowned the victors! Each round will have a lead from the team who oversees buzzing in and answering the questions for that round, while still being able to communicate with teammates.

For the first two rounds, the first team to buzz in after a question is read will get a chance to answer the question. If they get it right, they get points. If they get it wrong, the question is open for the remaining two teams to buzz in and try to answer correctly. The third and final round allows teams to bet all or a portion of their total points on the final question — either gaining or losing the amount of points they “gamble.” The team with the most points at the end of the game wins!

Careful attention has been given to create pharmacy continuing education programs that not only help pharmacists and pharmacy technicians fulfill licensure and certification requirements, but to also help you grow in your health care setting as a community, consultant, specialty or health-system pharmacist or pharmacy technician.

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— ON THE COVER — Fred W. Arnold Public Relations Award (MPF)

Product Theater Lunches on Friday

RMACISTS A

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MPA has partnered with pharmaceutical sponsors to offer product knowledge programming during lunch Friday. From 11:30 a.m. to 12:25 p.m., attendees will be able to choose a product theater session to join while you eat lunch, which will be provided. Product theater sessions offer an opportunity for our industry partners to provide educational insights about new pharmaceutical products and services, as well as the latest in data and research findings.

Distinguished New Pharmacist Practitioner Award

2024

Student Saturday!

New this year is an entire day of programming for those just beginning their career in pharmacy. MPA and its subsidiary, the Michigan Pharmacy Foundation, exist to “foster the future of pharmacy!” Introducing pharmacy students to leaders in the industry while also fostering a love of networking and showing the ease of conventions for acquiring CE is imperative. We ask that you consider “adopting a student” for this year’s ACE so they can join you at Saturday evening’s Awards Banquet. The full agenda for students can be found at MichiganPharmacists.org/ student-saturday-at-ace/.

Annual Banquet & Awards Ceremony MPA honors many distinguished individuals who serve and advance the profession of pharmacy and the health of our patients at our Annual Banquet & Awards Ceremony.

Come celebrate 140 years of MPA history, at this fancy and fun feast! The ceremony will take place Saturday evening during the awards banquet dinner. MPA will recognize several worthy awardees, including our 25-, 40- and 50-year members with the Years of Membership Awards; our volunteer leaders through induction into our Pharmacy Hall of Honor; as well as our elected boards, leaders and fellows for their service. MPA also honors scholarship recipients, the MPA Pharmacist of the Year and other honorable awardees for their noteworthy achievements.

The following awards will be recognized, among others:

Years of Membership Award

The Years of Membership Awards are given to honor and thank pharmacy professionals for their many years of membership and dedicated service to MPA.

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This award is presented to an MPA member or team of MPA members who have shown outstanding achievement and dedication to the pharmacy profession through community education and awareness.

Pharmacy Hall of Honor

The Pharmacy Hall of Honor was established

by MPA in 1986 to recognize members who have provided volunteer leadership in service to the Association by participating on committees and in designated Association programs.

Each year, qualifying members who have accumulated 500 points for their volunteer activities are inducted into the Hall of Honor.

In addition to the individual’s name being displayed in the Pharmacy Hall of Honor at the MPA office, the recipient receives an exclusive lapel pin to signify their accomplishment.

Fellow of MPA

The ‘Fellow of MPA’ designation recognizes the honoree’s achievements and dedication to the practice of pharmacy and the community.

This distinction signifies the recipients’ actions well beyond regular pharmacy practice. The fellowship is divided into three areas: professional actions in practice, public service and Association participation — all of which help define a well-rounded pharmacist.

Recipients receive an exclusive lapel pin, a certificate and recognition in the Michigan Pharmacist.

Student Scholarship Program

The Michigan Pharmacy Foundation (MPF) recognizes exceptional student pharmacists during ACE. The Larry Wagenknecht Leadership Scholarship awards $3,000 to a student who exhibits exceptional leadership capabilities. Each year, a $2,500 scholarship is awarded to one student pharmacist at each of Michigan's three colleges of pharmacy. Since establishing the program in 2002, MPF has awarded more than $110,000 in scholarships to deserving future practitioners.

The Distinguished New Pharmacist Practitioner Award is presented annually to an MPA member pharmacist who has been licensed to practice for less than 10 years and participates in local, state and national pharmacy associations, professional programs and/or community service.

Excellence in Innovation Award

The Excellence in Innovation Award is presented annually to an individual or team who has demonstrated an innovative pharmacy practice program, resulting in improved patient care or safety, advancement of the profession, enhanced pharmacy systems or other professional development.

Executive Board Medal Award

The Executive Board Medal Award is given annually to an individual who has demonstrated an extraordinary personal commitment to MPA. The award was developed to recognize individuals who have been instrumental to the Executive Board and the Association in advancing pharmacy’s agenda.

Bowl of Hygeia Award

The Bowl of Hygeia derives its name from Hygeia, who was the Greek goddess of health, cleanliness and hygiene. Her classical symbol was a bowl containing a medicinal potion, with the serpent of wisdom (or guardianship) partaking of it. The Bowl of Hygeia Award is given to a pharmacist who has made outstanding professional contributions and has participated in community or governmental activities that reflect well on the pharmacy profession.

MPA Pharmacist of the Year Award

The MPA Pharmacist of the Year Award is given to a pharmacist who demonstrates professional excellence and exemplary service to the profession in advancing public health at either the state or local level and displays all the traits and characteristics of someone with a true commitment to advancing the pharmacy profession and public health.

— ON THE COVER — House of Delegates

The MPA House of Delegates is the policyforming body of the Association. The MPA House of Delegates is comprised of pharmacy professionals from across the state and includes delegates from the Executive Board, the Michigan Society of Pharmacy Technicians, local associations, regional societies and the Michigan colleges of pharmacy. It is the

responsibility of the House of Delegates to interpret the objectives of the Association as stated in its bylaws and to serve as the policy-forming body of the Association. The House of Delegates will act on all policy reports and adopt resolutions of policy directed to the Executive Board. The House of Delegates will also act on proposals for amendment of the bylaws. The House of Delegates may adopt

rules of procedures for the governing and administration of the House of Delegates.

Registration

Go to MichiganPharmacists.org/educationevents/annual-conference-exhibition for more convention information and to register if you have yet to do so.

We can’t wait to see you again soon!

We wouldn’t be able to host you without the support of our sponsors!

At the time of publication, the companies below had committed to sponsoring the 2024 Annual Convention & Exposition. We thank them for their continued partnership and support.

PLATINUM

GOLD

SILVER

BRONZE

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— ON THE COVER —

PROGRAM SCHEDULE THURSDAY, FEB. 22

SATURDAY, FEB. 24

3:30-6:30 p.m. — Exhibitor Move in and Registration

8:30-10 a.m. — Concurrent Breakout Sessions

FRIDAY, FEB. 23 8-9:30 a.m. — Four Concurrent Breakout Sessions • M SCP | New Drug Update 2024: Inpatient and Infusion Clinic Focus | Speakers: Regan VanderVeen, Preston Taylor and Katie Wenstrom • M SHP | Biologic Therapies: Improving Patient Outcomes Through Collaborative Care Models in Ambulatory and Specialty Pharmacy Practice | Speakers: Amber Lanae Martirosov and Melissa Pleva • C SPM | USP Update | Speaker: Matthew McTaggart • I mmunization Update 2024 | Speaker: Joe Fava 9:45-11:15 a.m. — Four Concurrent Breakout Sessions • V alue-Based Care: Stepping Outside the Traditional Scope | Speaker: Hae Mi Choe • D eveloping a Roadmap for Enhancing Community Pharmacy Practice: Navigating the Speed Bumps and Potholes | Speakers: Brittany Stewart, Michelle Kelly and Karen Farris • M anagement of Patients on Opioids Across Care Settings: Where Do We Go From Here? | Speaker: Insaf Mohammad • R ecognizing and Managing Oral Anticoagulant Drug Interactions | Speakers: Maureen Smythe and Candice Garwood 1-3 p.m. — ACE Welcome and OPENING KEYNOTE • O ut of the Shadows: The National Push for PBM Reform has Arrived | Speaker: Antonio Ciaccia, co-founder and president, 3 Axis Advisors; co-founder and CEO, 46brooklyn Research 3:15-4:45 p.m. — Four Concurrent Breakout Sessions • W EC Update 2023: Rising Challenges and a Call to Action | Speaker: Rony Foumia

• T ake a Fresh Breath: Updates in Respiratory Care | Speakers: Amber Lanae Martirosov and Alison Lobkovich • T he Risk Landscape of Medication Errors | Speakers: Brooke Roe and Charlie Mollien • R ethinking Race and Hypertensive Treatment | Speaker: Shelby Kelsh • S tudent Session | Financial Planning for Students, Residents and Emerging Leaders • R esume Review for Students (ongoing throughout the day; pre-registration required) 10:15-11:45 a.m. — KEYNOTE • H ope for the Future in Current Challenging Practice Circumstances | Speaker: Michael Hogue, executive vice president and CEO, American Pharmacists Association 2-3:30 p.m. — NASPA Self Care Competition 3:45-5:45 p.m. — Breakout two-hour session • I mplicit Bias Training – Disability Awareness Training for Health Professionals: Equitable and Inclusive Health Care Practices| Speakers: Steve Erickson and Elizabeth Janks 4-5:30 p.m. — Three Concurrent Breakout Sessions • E mbracing Clinical Autonomy: Strategies to Enhance Consistency and Efficiency | Speakers: Lisa Bade and David Bright • E ngaging Community Pharmacists in Outpatient Antimicrobial Stewardship | Speakers: Michael Klepser and Austin Brown • M SHP/Student Session | Clinical Pearls for Pharmacy, 2024 | Moderator: Amber Lanae Martirosov

SUNDAY, FEB. 25 8-9:30 a.m. — Three Concurrent Breakout Sessions

• M SPT | Rx-Rated Trivia | Speaker: Erith Welch, MSPT president

• L aw and Jurisprudence | Speaker: Kim Sveska

• P harmacotherapy for Infertility: A Pharmacist’s Primer | Speaker: Sheila Wilhelm

• T he Impact of Prescribing GLP-1s for Weight Loss on Commercial and Medicare Part D Prescription Drug | Speaker: Brooke Penny

• I t’s OK to Ask – Talking to Patients about Sexual Heath | Speakers: Katie Axford and Bianca Clarke, Michigan Department of Health and Human Services

• H elp, My Patient Has a Codeine Allergy! Tackling Opioid Allergies Safely and Effectively | Speaker: Rebecca Rudaski Nelson and Steve Erickson 9:45-11:15 a.m. — Breakout Session • T he Impact of Community Pharmacist Intervention on 30-Day Readmission Rates for Patients at High Risk for Readmission (MTM) & Resident Poster Presentation | Speakers Tonino Michienzi and Anthony Sleep 9:45 a.m.-12:45 p.m. — House of Delegates

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— LEGAL INSIGHTS —

MICHIGAN'S DRUG PRODUCT LIABILITY IMMUNITY STATUTE REPEAL

BY KIM SVESKA, R.Ph., Pharm.D., J.D., Foley, Baron, Metzger and Juip, PLLC

On Dec. 7, 2023, Michigan Gov. Gretchen Whitmer signed into law a bill repealing Michigan's Drug Product Immunity statute (MCL 600.2946(5)). In 1995, Michigan became the only state in the country to codify into law an immunity statute that prevented Michigan residents from suing pharmaceutical manufacturers in the state unless the manufacturer had intentionally withheld information or made misrepresentations to the United States Food and Drug Administration (FDA) during the drug's approval process. The repeal becomes effective Feb. 13, 2024. It is expected that there will be a number of cases filed shortly after the law becomes effective in order to "beat" the three-year product liability statute of limitations.

outside of Michigan it is entitled to transfer the case to federal jurisdiction. Many times, the case against the prescriber is weak, but it is still named to prevent the transfer to federal jurisdiction that tends to be more defense-friendly.

The repeal did not toll the statute of limitations or provide any type of grace period for claims older than three years. As it pertains to drug prescribers, they are commonly brought into these cases as a co-defendant to prevent the defense from removing a county-based lawsuit to the federal jurisdiction under diversity statutes. The way that works is if the plaintiff only sued the pharmaceutical manufacturer that has its main place of business in another state, the defendant pharmaceutical manufacturer would say under the “diversity theory” that since it resides

Given that it has been almost 30 years since Michigan residents could sue pharmaceutical manufacturers, it is likely that there are few practitioners, both on the plaintiff and defense side, that actually have experience in drug product liability cases.

As it pertains to the pharmacies who dispensed the drug in question, they are only occasionally brought into the lawsuit under the same theory to prevent diversity jurisdiction. The typical claim under that scenario is that the pharmacy failed to properly screen the medication for this particular patient and/or tell the patient of the possible side effects that are at issue. Again, it is relatively rare for a pharmacy to get brought into one of these cases, however it does occur.

Kim Sveska has handled many drug and medical device cases over the years, including many of the largest mass tort cases to date. Feel free to contact Sveska at KSveska@fbmjlaw.com if you have any questions.

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— CE HOMESTUDY —

THE INCURABLE ACRONYM:

ALS

BUT NOT UNTREATABLE Michael D. Tiberg, Pharm.D., has been an active MPA member who, with his colleagues Nick Torney and Derek Vander Horst, submitted a session proposal for MPA’s 2024 Annual Convention & Exposition entitled, "The Incurable Acronym: ALS – But Not Untreatable." When MPA’s education team met with Michael, they soon learned why it was imperative that this CE occur soon, as well as being accessible in the future to as many within the pharmacy profession as possible. Why? Michael has ALS. He noted he’s not sure how long he may have to be able to educate his colleagues on how pharmacy can impact and assist those, who like himself, have a personal plight with this devastating disease.

Therefore, MPA got to work on how it could best disseminate Michael’s passion project to the pharmacy community. The article below is straight from Michael himself and will help you understand why participation in this PCE event is imperative. In addition, we’ll be recording this session for future home study opportunities personally, in colleges of pharmacy and in health care settings. We encourage you to join us – space is limited, so register today!

A

s pharmacists, we have all encountered individuals that have been diagnosed with a terminal illness. Most often this occurs as a member of their health care team, but when we are confronted with our own diagnosis it’s something that we often don’t expect to occur.

I had practiced pharmacy for many years as an infectious diseases (ID) pharmacy specialist. My primary focus during my professional career has often been on hospitalized ID patients, such as those with respiratory tract infections, skin and soft tissue infections, or urinary tract infections.

BY MICHAEL D. TIBERG,

Pharm.D.

So, when I first began having neurologic symptoms of weakness in my right arm when exposed to cold temperatures, I really didn’t pay much attention at the time. I thought potentially I had Raynaud’s-like symptoms. Being a runner for decades, it was not uncommon after running in the cold to experience tingling in my right hand, but over the last few years these symptoms had changed to progressive weakness.

The definitive diagnosis of amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease) took more than two years.

Like most patients with ALS, the diagnosis is often delayed. I consulted my primary care provider and an orthopedic hand specialist. After a surgical intervention failed to produce improvement, I was ultimately given the diagnosis at a neuromuscular disorder clinic at a major medical center. My whole perspective changed

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from being a health care professional to a patient in need of support. I can honestly say the diagnosis of ALS was on my radar, but I thought it was too remote for me. ALS has been defined as rare – between 2 to 5 new cases diagnosed per 100,000 people in the U.S. annually.

Unfortunately, when it happens to you it doesn’t seem rare. Shortly after my definitive diagnosis, I was given an appointment to attend a multidisciplinary clinic in two weeks. The remaining portion of the day and weeks after was an emotional rollercoaster. Informing my children, other family members and friends was very difficult. I could have kept this confidential, but so many knew of my symptoms and I wanted to be open about my health. They were as shocked and grief stricken by the disclosure as we were. As days and weeks passed,

— CE HOMESTUDY —

Michael Tiberg with his colleagues Nick Torney and Derek Vander Horst.

my wife and I came to an understanding that we are now in a new normal. Each day is a new and special day — we take one day at a time. Most of us try to do this, but still think “once I get through this week, I can’t wait for the weekend to arrive.” I try to connect with friends more than I did in the past, not knowing if we’ll be able to meet like this in the future. Many of them are also reaching out to me to help where they can. As this disease progresses, I know I will be much more dependent on my family and friends for my daily activities.

During my pharmacy career, like many others in pharmacy, I have been minimally educated on ALS, knowing that there currently is no cure to this severe neurologic disease and that life expectancy for most with ALS is 2 to 5 years from the time of diagnosis. Due to the few medications available, most of us are not well-informed regarding ALS. Many of us don’t know much more than that. What I wasn’t aware of was the vast amount of organizations that are available to assist individuals and their families living with ALS. This assistance is not only for symptom management and managing the foreseen complications, but also the psychological factor. The emotional support is an essential part of treatment. Even though I feel that my family and I have come to grips with ALS, some days are good but some are more difficult. Many, even in the pharmacy profession, don’t realize that addressing the individual with ALS is extremely important.

I’m not under the illusion that there will be a miraculous cure developed any time soon. I do know that there are several randomized clinical trials that demonstrate great promise for the future. Will I be part of that future? I don’t have a crystal ball, but I hope so. The most important role that I can take now is to support and provide for my family since I know they are, and ultimately will be, caring for me in the time I have remaining. I also believe that I need to assist the pharmacy profession – both pharmacists and pharmacy technicians, and other health care providers — with the understanding of this rare and rapidly progressive disease.

My pharmacy colleagues have been extremely supportive. I’m very fortunate and proud to be in the pharmacy profession. I’m still learning firsthand of ALS. I am not looking for sympathy, but understanding by others, as well as being able to openly discuss the disease. The multidisciplinary team that I report to quarterly continues to amaze me in how they focus on optimizing the individual’s life expectancy and assist with their quality of life.

Along with two of my colleagues, Nicholas Torney and Derek Vander Horst, we have created a continuing educational program on ALS titled: "The Incurable Acronym: ALS – But Not Untreatable." We have developed this program, in conjunction with the Michigan Pharmacists Association (MPA), to be delivered as a live webinar on April 23, 2024, from 2-3:30 p.m. at MPA’s headquarters in Lansing. We hope the impact of this

presentation will help everyone in the pharmacy profession (technicians, pharmacy students, residents and practicing pharmacists), as well other health care providers to be advocates for ALS patients and to become more knowledgeable in ALS therapy, both drug and nondrug. It’s so important that we attend this presentation to gain knowledge of ALS and assist patients and family members with ALS.

IN-PERSON

VIRTUAL

EVENT DETAILS: • Session: The Incurable Acronym: ALS – But Not Untreatable • Date: April 23, 2024 • Time: 2-3:30 p.m. (Doors will open at 1:30 p.m.)

• Location: MPA Headquarters | 408 Kalamazoo Plaza | Lansing 48933 • Presenters: Nick Torney, Derek Vander Horst • Format: Live and in-person at MPA Headquarters (virtual option available) • PCE: 1.5 hours of live CE • Cost: $7.99 for MPA Members | $35 for non-members 2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— LADC CALENDAR —

LOCAL MEETINGS AND EVENTS Capital Area Pharmacists Association (CAPA)

CONTACT YOUR LADC

Jan. 29 – CAPA CE: Updates in Pain Management (in-person), 6:30 p.m.

Kent County Pharmacists Association: kcpapharmacists@gmail.com

March 18 – Culver’s Fundraiser for CAPA Scholarships March 19 – CAPA Executive Board Meeting, 5 p.m.

March 19 – CAPA CE: Nuclear Pharmacy (live virtual) 7-8 p.m.

March 23 – Poison Prevention Week Event at Impression 5 Science Museum, 11 a.m.-3 p.m.

March 30 – Advent House Community Outreach Contact: capapharm@gmail.com

Macomb County Pharmacists Association: MCPA586@gmail.com Genesee County Pharmacists Association: geneseepharmacists@gmail.com Wayne County Pharmacists Association: waynepharmacists@gmail.com Oakland County Pharmacists Association: roua.dabal16@gmail.com Southwest Michigan Pharmacists Association: william@swmpa.org Great Lakes Bay Pharmacy Association: stephanieleighlapointe@gmail.com Northwestern Michigan Pharmacists Association: nw.mi.pharmacists.assn@gmail.com

PRES ENTS

Learning Objectives: At the end of this activity, participants should be able to: 1. Explain the differences between tetrahydrocannabinol (THC), cannabidiol (CBD), hemp and marijuana.

2. D escribe the pharmacology and physiological response of cannabinoids in the human body.

3. E xplain the Michigan Regulation and Taxation of Marihuana Act and important considerations for pharmacy professionals.

4. D iscuss the 2018 Farm Bill and the 2018 Michigan Public Acts regarding the legalization of industrial hemp.

5. E xplain the variance between federal and state laws related to cannabis.

UNDERSTANDING THE PHARMACIST'S ROLE IN MARIJUANA AND CANNABIS-DERIVED PRODUCTS — CONTINUING EDUCATION — Register Here: https://www.michiganpharmacists.org/event/medical-cannabis-applications-mastering-the-delivery-systemsdosages-and-medical-applications-for-cannabinoid-medicine/

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— COVER YOUR ASSETS —

Happy New Year! Time flies by as it seems we were just beginning 2023, but here we are in another year.

PSI Insurance Agency wants to wish you and yours all the happiness for 2024. We look forward to working with many of you and seeing you at the MPA Annual Convention & Exhibition this year in our final time at the Marriott in Detroit. Stop by our booth and say hello!

With winter storms coming, we wanted to share some ideas for protecting your roof from ice and snow damage.

Know Your Roof

• Don’t wait until media reports of collapses occur before monitoring your own building.

• The roof’s design may be compromised by building use and condition.

• If the roof already has a significant amount of snow or ice, and a new storm is expected in a few days, safely reduce the snow load before the next storm.

• Be alert to lower buildings or roof top equipment that can trap drifting snow.

BY RON DEVERS,

CIC, CPIA, director of operations, PSI Insurance Agency

Monitor the Situation

• To reduce the risk of roof collapse, know your roof’s design capacity.

• Snow loading is more likely to occur on flat or low slope roofs.

• If your building has a wood or metal truss roof, you should be more aware of snow loads.

• If any signs of deflection due to weight of snow are noted, evacuate the building and seek professional help to determine structural stability • Snow removal is best done from the ground, with a snow rake or an aerial lift.

• If done improperly snow removal can severely damage a roof surface or pop out fasteners.

• Push brooms and roof rakes should be used for snow removal instead of snow blowers or shovels.

Here’s to a safe, happy, and healthy 2024! From our PSI Insurance Agency family to yours.

2024 Jan./Feb./Mar. | Vol. 62, Issue 1

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— PAAS NATIONAL —

USP 800 SETS NEW “NATIONAL PROFESSIONAL STANDARD”

T

he United States Pharmacopeia (USP) revealed that more than 8 million U.S. health care workers are exposed to hazardous drugs each year and that more than 12 billion doses of hazardous drugs are handled by U.S. providers each year, with pharmacists and pharmacy technicians at the top of the list.

BY TRENTON THIEDE,

Pharm.D., MBA, president, PAAS National®, expert third-party audit assistance and FWA/HIPAA compliance

Community pharmacies have been dispensing hazardous drugs long before the potential for harm (due to low dose, long-term exposure) was known. Exposure to a hazardous drug is often inadvertent and unknown to the employee. There is some surprise when presented with the list of hazardous drugs which includes pharmaceuticals that you may handle on a daily basis including; fluconazole, fluoxetine, carbamazepine, warfarin and oral contraceptives. There are more than 400 hazardous drugs and their unique dosage forms.

Occupational exposure to hazardous drugs, or their residue, can be an everyday experience and the true effect of this exposure is unknown for many, and may result in both acute and chronic health issues due to trace exposure to hazardous drugs. Acute toxicity may present as nausea, rashes, hair loss, kidney damage, hearing loss and cardiac toxicity. Long-term effects may include cancer, infertility, and other reproductive health issues. Certain populations, including those that are immunosuppressed and women and men of childbearing age, may therefore be more at risk.

This occupational exposure extends to everyone working in the pharmacy, from the pharmacists and pharmacy technicians who handle HDs, to those who work at the pharmacy counter or in the receiving and delivery areas. The exposure risk extends to anyone who may come into contact with HD particles or residue.

Exposure can occur: • through the skin or oral mucosa when counting and pouring • by inhalation of dust particles when splitting a tablet or when working with an uncoated tablet that simply creates a lot of dust • by ingestion if eating or with hand to mouth contact without cleaning or hand washing • by injection, as is the case with an accidental needlestick

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Different activities in the pharmacy come with different levels of potential risk: • dispensing a unit of use or a blister package of a hazardous drug may have a very low risk of exposure • counting and pouring an uncoated hazardous drug tablet or capsule increases the risk • splitting a hazardous drug tablet where dust can be created creates potential for increased exposure • cleaning a spill of a liquid hazardous drug introduces another level of risk The key is developing good practices to contain or greatly reduce risk. Per OSHA, the safe handling of hazardous drugs in accordance with USP 800 is now considered a “national professional standard” as a pharmacy process “to protect the safety and health of employees.” A USP 800 compliance program is a necessary step to protect the health and safety of your employees, patients in your pharmacy, and the environment. It can also help reduce employer liability from frivolous lawsuits through employee training, competency documentation and employee acknowledgments.

PAAS National® is committed to serving community pharmacies and helping keep hard-earned money where it belongs. Contact us today at (608) 873-1342 or info@paasnational.com to see why membership might be right for you.

Copyright © 2023 PAAS National, LLC. Unauthorized use or distribution is prohibited. All use subject to terms at https://paasnational.com/terms-of-use/.

Welcome to the MPA Store One design, many products

MichiganPharmacists.org/online-store T-Shirts • Aprons • Tote Bags • Baseball Caps • Hoodies Sweatshirts • Polo Shirts • Water Bottles • Pharmacy Resources

2022 Oct./Nov./Dec. | Vol. 60, Issue 4

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