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PHARMACIST November/December 2019 • Volume 100 • Issue 6

PENNSYLVANIA PHARMACISTS ASSOCIATION

2019 Conference Recap

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO. 533

THE SEVEN SPRINGS MOUNTAIN RESORT CHAMPION, PA

THE OFFICIAL PUBLICATION OF THE


CONTENTS ON THE COVER: PPA BOARD OF DIRECTORS PPA OFFICERS President: Richard Demers, MS, RPh, FASHP President Elect: Chuck Kray, RPh Vice President: Thomas Franko, PharmD, BCACP Immediate Past President: Lauren Simko, PharmD REGIONAL DIRECTORS Central Region: Deron Shultz, RPh Northeast Region: Vick Shah, PharmD, BCPS Northwest Region: Brandon Antinopoulos, PharmD Southeast Region: Karleen Melody, PharmD Southwest Region: Brian Sidone, PharmD PRACTICE DIRECTORS Academia: Nicole Pezzino, PharmD, BCACP, CDE Chain Pharmacists: Renee Richardson, PharmD Community Independent: Shawn Nairn, RPh Community Independent: Christopher Antypas, PharmD Health System Pharmacists: Darryle Tillman Jr., RPh MCO/Industry/Government/Other: John Barrett, MBA, RPh Associates: Pat Lavella, RPh STUDENT DIRECTORS Student Director East: Dylan Fox Student Director West: Elizabeth Leonard PPA OFFICE STAFF CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Conference and CE Manager: Linsley Gentile lgentile@papharmacists.com | Ext. 2 Government Relations Manager: Angela Zaydon azaydon@papharmacists.com | Ext. 6 Communications Manager: Victoria Madonna vmadonna@papharmacists.com | Ext. 5 Membership Coordinator: Katie Hoster khoster@papharmacist.com | Ext. 1 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Director of Network Operations: Stephanie McGrath, PharmD smcgrath@papharmacists.com Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com | ppa@papharmacists.com Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA.

EDITORIAL BOARD Hershey S. Bell, M.D.,M.S.,FAAFP Kim Coley, FCCP, PharmD, RPh, Chair Michael Gionfriddo, PharmD, PhD Yardlee Kauffman, PharmD, MPH, BCACP Jinsun Paek, PharmD, BCPS Associate Editor: Victoria Madonna Editor/Manager: Pat Epple PUBLISHED BY GRAPHTECH Alexis Kierce, Publications Manager (717) 238-5751 x119 alexis@thinkgraphtech.com For Advertising Information: Jen Smith, Account Manager (717) 238-5751 x124 jen@thinkgraphtech.com DESIGNED BY GRAPHTECH PHARMACIST STATE BOARD OF PHARMACY MEMBERS Institutional: Vacant Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Board of Pharmacy Meeting Dates: December 10, 2019 January 28, 2020 March 17, 2020 May 5, 2020

ANNUAL CONFERENCE RECAP Over 350 people attended some part of the four day conference. We thank our members and sponsors for helping us celebrate patient care. Pharmacy in Pennsylvania has been strengthened by our pharmacists who make it their life’s work to care for the health and wellbeing of the community across the commonwealth.

DEPARTMENTS 5

President’s Message

7

Calendar of Events

8

Member News

10 Affiliated Member News 12 Welcome! New Members 30 Campus Checkup

FEATURES 14 Student Member Profile 16 Member Profile 24 Legislative Profiles 26 Pharmacy Spotlight 27 Top Tier 2019–20 Residents 28 Pharmacy and the Law: A Pharmacist’s Duty to an Unknown Third Party 29 Financial Forum: Making a Charitable Gift From Your IRA

OUR VISION Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers. OUR MISSION The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

32 Holiday Shopping With AmazonSmile

ASSOCIATION NEWS 18 2019 Annual Conference Recap 33 PPCN Update 34 Meet PPA’s New Membership Coordinator

RESEARCH 35 Navigating the IRB Approval Process www.papharmacists.com 3


President’s Message As the Summer months have faded behind us, I think it was fitting that one of the final celebrations was the 2019 PPA Annual Meeting. I would like to recognize the Program Committee for “a job well done!” The meeting was held in a beautiful location and had first rate programming throughout. As I visited many sessions and meetings all had great attendance and lively discussions. This conference had a number of “firsts”; both the first ever mini-golf competition and the first ever lip-sync competition, both of which raised money for the Foundation. For those who were not able to attend, I highly recommend coming to our Mid-Year Meeting in Harrisburg in January. Another subject associated with the coming of the fall season is our back to work mind set. It is with great pleasure that I can announce that the “Flip the Pharmacy” program is off and running. The program is actively enrolling 40 pharmacies in a rigorous program to adapt workflow toward enhanced clinical management and engagement with patients. In addition to the selected 40, other pharmacies may also follow-along! This will be a tremendous asset for all those who directly participate. In addition, PPA is co-supporting, with NCPA, an “Enhanced Services Boot Camp” in Conshohocken PA, on November 16. This will be another day of great learnings and networking for any of our membership who wish to attend and ramp up their patient care services. I believe PPA is in a great position to continue to voice itself and have an important impact in ongoing changes and challenges within healthcare. I challenge all who are members of PPA to take an active role in our organization. Let’s get out and talk about the profession to our peers and engage them to join this important organization. If you are asked about what one gets from a PPA membership, I think it is easy to see the value of PPCN and our primary care network of pharmacists — PC2 and the great work that has stemmed from both groups. We must continue to work together in these innovative forums to advance our practice. Ben Franklin once said that “Without continual growth and progress, such words as improvement, achievement and success have no meaning.” This is our time to work together to achieve. It will not happen on its own though and we need all of us to engage.

Richard Demers, RPh, MS, FASHP PPA President 2019–2020

“Ben Franklin once said that “Without continual growth and progress, such words as improvement, achievement and success have no meaning.” This is our time to work together to achieve. It will not happen on its own though and we need all of us to engage.” — Richard Demers

Lastly, as holiday season is upon us I hope that we can all spend time with our loved ones and look upon all of the blessings that we have.

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Calendar of Events December

March

April

5

10–11

21–24

PPA Board of Directors Meeting — Harrisburg, PA

NACDS Rx Impact — Washington, DC

Academy of Managed Care – Houston, TX

8–12 American Society of Health System Pharmacists Mid-Year Clinical Meeting — Las Vegas, NV

20–23 APhA Annual Meeting — National Harbor, MD (Washington, DC area)

19–20

22–23 NCPA Congressional Fly In, Washignton, DC

25–28

January

National Alliance of State Pharmacy Associations — National Harbor, MD (Washington, DC area)

23–26

21

2020 PPA Mid-Year Conference — Harrisburg, PA

May

Pennsylvania Reception at APhA — National Harbor, MD

4–6

NACDS Annual Meeting, Scottsdale, AZ

NCPDP Annual Conference, Scottsdale, AZ

24 PPCN Board of Directors Meeting

24 PPAEF Board of Directors Meeting

26 PPA Board of Directors Meeting

For additional events including webinars, CE opportunities, and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!

Advertisers Index Pharmacists Mutual 2

Wilkes University 17

IPBG 4

Flannery Georgalis LLC 25

Value Drug Company 6

EPIC 33

Keystone 9

Temple University 37

PRS 13

McKesson 37

Jefferson 15

RDC 40

17–18 NASPA – PMI Leadership Conference, San Antonio, TX

FOLLOW US ON SOCIAL MEDIA @PAPHARMACISTS

R.J. Hedges 16

www.papharmacists.com 7


Member News Legislative Advocates PPCN Board Members and Luminaries met for a 1.5 day strategic planning session at the PPA office. The initiative developed some exciting and aggressive strategies for keeping our PPCN pharmacies relevant in the marketplace. Watch for more announcements!

A Heartfelt Thanks PPA wishes to express its appreciation to Dan Hussar for providing some much needed back issues of the Pennsylvania Pharmacist for our historical archives.

A Future Pharmacist Has Been Born! Congratulations to Brandon Antinopoulos, PPA Northwest Regional Director, on the recent birth of his second child. Brandon and his wife, Kristy, welcomed Olivia Jo born July 2019, at 8lbs 2oz and 21.25in. Congratulations to Brandon and his family.

Congratulations to Roshni Patel! Congratulations to Roshni Patel, Associate Professor of Pharmacy Practice, Jefferson College of Pharmacy on her recent marriage. Roshni and her husband, Brett, tied the knot in Drexel Hill, PA in June 2019. Congratulations to Roshni!

Editorial Board Visit A special thanks is extended to the following members who participated in various editorial board meetings around Medicaid Reform: Mel Brodsky Scott Miller Greg Drew Deron Shultz Tom DePietro Darrin Silbaugh Chuck Kray Mat Slakope Pat Lavella Bill Thompson The meetings were part of our media campaign around Your PA Community Pharmacies.

8 Pennsylvania Pharmacist — Nov/Dec 2019

SHARE YOUR NEWS WITH US Send all snippets of achievements and honor to PPA’s Communications Manager —

Victoria Madonna

vmadonna@papharmacists.com


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Affiliated Member News Allegheny County Pharmacists Association (ACPA) Update ACPA kicked off the school year with a flurry of events! The school year started off with an introduction to ACPA and committee recruitment at the Back to School Picnic led by our 2019-2020 president Amy Woods. The picnic was the most well attended in recent years and was capped off by our annual University of Pittsburgh vs Duquesne University kickball game. Members of both ACPA and the Duquesne University PPA chapter stepped up to serve the community by hosting a booth at the Pittsburgh Recovery Walk, an organization working to celebrate the many roads to addiction recovery and remove the stigma association with substance use disorder. Led by seven pharmacists and eight student pharmacists, our booth focused on myths and facts of recovery and discussed alternative options to opioid pain medication for pain management.

programs with a program at Alla Famiglia focused on Treatment of Type 2 Diabetes in Patients with Established Cardiovascular Disease. We appreciate the support of our dinner sponsors and look forward to more educational opportunities throughout the year.

Programming Committee Chairs Lindsey Meston and Katie Sulkowski wasted no time in starting our educational dinner

Last, but certainly not least, ACPA would like to extend the greatest of thanks to all PPA members who attended the annual meeting

at Seven Springs and especially those who “popped by” our exhibition booth. We are so proud of our many continuing education presenters and the information shared during their discussions. ACPA would like to congratulate the many fantastic award recipients and their accomplishments throughout the year. Looking forward to a great midyear in Harrisburg!

Lancaster County Pharmacists Association (LCPA) Update In October, LCPA held their meeting with Avanir Pharmaceuticals at John J Jeffries, who provided an update on the package labeling of their product Nuedexta. Thank you to all of the people who participated with the fundraiser at Issac’s Restaurant on Manheim Pike in Lancaster which benefited the scholarship fund. LCPA could not continue to help deserving students achieve their pharmacy school goals without your support. The members and entire LCPA board would also like to extend their thanks and gratitude to Issac’s for providing the fundraising opportunity. Please check www.lancasterpharmacists.com for the meeting schedule and information on upcoming events.

10 Pennsylvania Pharmacist — Nov/Dec 2019


BucksMont Pharmacists Association (BMPA) Update BucksMont Pharmacists Association Attends Temple University Pharmacy School 2019 White Coat Ceremony On Wednesday, September 11, BucksMont Board Director Jan Kitzen and BucksMont VicePresident Frank Konzelman staffed an information table at a reception following the annual White Coat Ceremony at the Student Faculty Center on Temple’s Health Science Center campus. Our table was attractively displayed with our stand-alone banner, new descriptive brochures about the benefits of joining

BMPA and additional information about student membership in PPA. Our table was stocked with a generous supply of water bottles and flashlights to offer the PY1 students. Many of the students visited our table and we provided them with information regarding student membership in our association. We discussed our scholarship program and also explained our new procedure of providing transportation to our

meeting venues from local public transportation stations to make it more convenient for students residing in Philadelphia to attend our meetings. This was a very exciting day for the students and we are delighted that we were invited to be a part of this important event. We are confident that many of the students will eventually become student members of our association.

BucksMont Pharmacists Association Experience at the Fall PPA Conference BMPA was well represented at this year’s conference with eight of our members and spouses present along with a few special guests of our organization. Our booth was attractive and visited by many conference attendees who appreciated our valuable water bottle and flashlight giveaways. We offered information about membership in our association to students and pharmacists who visited our booth. Our members were also actively involved in many aspects of the conference.

Jan Kitzen, Ashley Robold, and Frank Konzelman moderated CE programs while Rob Frankil swore in the new officers and directors of PPA at the Saturday morning session. BMPA member Rick Demers was sworn in as the new President of PPA. Frank and Ashley also participated in the PPA LEAD session on ‘habits for highly effective pharmacy leaders.” John Gatto announced the winners of our annual BMPA scholarships were Monica Woloshin from Jefferson and Cynthia Ly from the

Philadelphia College of Pharmacy. Two associates of BMPA member John Barrett, (Lauren Megargell and Amanda Williams, PPA members) presented an interesting CE program titled “Novel Treatments for Orphan Diseases: a Promising Future.” Finally, Temple alumni and BMPA directors Jan Kitzen and John Gatto posed with Temple students Devanshi Patel and Krishna Patel who participated in the Diabetes Challenge Competition and finished as runner-up to Jefferson out of all seven PA pharmacy schools who participated. Congratulations Temple!

www.papharmacists.com 11


Welcome! New Members PPA Welcomes the following New Members who joined the association on July 26, 2019 – October 4, 2019. Please make these new members feel welcome and part of Pennsylvania pharmacy! PHARMACISTS Jamie Akoury, Scranton, DePietro’s Pharmacy Emily Andrascik Susan Anthony, Ligonier, LVRX Pharmacy Amjad Azzawe, Philadelphia Michael Borenstein, Philadelphia, Temple University School of Pharmacy Marcin Cebula, Norristown Heather Condon, Zelienople, Giant Eagle Inc. Tiffany Dawson, Pittsburgh Samantha Demarco, Pittsburgh, UPMC St. Margaret Dominique Fields, Hammonton NJ, Jefferson School of Pharmacy Lea Grondziowski, Pittsburgh Brenda Gruver, Mountain Top, Wilkes University – Nesbitt School of Pharmacy

Pharmacy – Nanty Glo Justin Scholl, Fairview, Bayside Pharmacy Brenda Schwarz, Slippery Rock, Colonial Pharmacy Daniel Shearer, Enola, CVS Megan Sheriff, Reading, Penn State Health St. Joseph Medical Center Leslie Shumlas, Pittsburgh, Highmark BCBS PGY1 Managed Care Pharmacy Residency Program Jason Sinsley, Somerset, Mainline Pharmacy – Somerset

STUDENTS Duquesne University School of Pharmacy

University of Findlay Madison Donnelly, Canton,OH

Elizabeth Bonini, Ridgway Mackenzie Bortmas, Rochester Conor Boston, Pittsburgh Scott Carson, Pittsburgh Katharine Damico, Jefferson Hill Matthew Davis, Mars Clarie Decker, Soddy-Daisy Alisa Fracul, New Castle Daga Gautam, Pittsburgh Zach Gobert, Coalport Madison Hlasnick, Washington Jasmine Johnson, Pittsburgh Allison Kachel, Ephrata Justin Miller, Latrobe Katelyn Owens, Canonsburg Kajal Patel, Pittsburgh Lauren Pheasant, Pittsburgh Lauren Smeltzer, Pittsburgh Jared Williams, Pittsburgh

University of Pittsburgh School of Pharmacy

Kristin Sullivan, Pittsburgh, Spartan Pharmacy Jacqueline Wasynczuk, Philadelphia, Jefferson College of Pharmacy

TECHNICIANS Jen Achey, Bath, Hartzell’s Pharmacy

Julie Jackovic, Pittsburgh

Autumn Balliet, Shickshinny, Harrold’s Pharmacy

Ashley Kalchthaler, McDonald, AllianceRx Walgreens Prime Danielle Kieck, Forty Fort, Wilkes University – Nesbitt School of Pharmacy Patel Kinjalkumer, Reading, Reading Community Pharmacy Pooja Kirpekar, Philadelphia Melissa Koehler, Mountville, Kmart Pharmacy Amy Lamie, Hellertown, Hartzell’s Pharmacy Joel Lehman, Bridgeport, Bridgeport Family Pharmacy Ennio Magnarelli, Rosemont, Rosemont Pharmacy Chelsea Mandell, Media, Paoli Pharmacy Erica McGovern, Warrington, Christiana Care Health Systems Christopher Miller, Gibsonia, Giant Eagle Sarah Ofori, Collegeville, Rutgers Pharmaceutical Industry Fellowship Sehrish Panjwani, Aspinwall, UPMC St. Margaret John Pastorek, Ebensburg, Mainline – Blairsville Pharmacy Jigneshkumar Patel, Sellersville, Sellersville Pharmacy Jamie Rapin, Hummelstown, Cardinal Health Catherine Rebitch, Pittsburgh, University of Pittsburgh School of Pharmacy Marilyn Ruane, Scranton, Lepri-Ruane, Inc. DBA the Medicine Shoppe, Inc. Mike Ruane, Moosic, The Prescription Center Larry Rupert, New Florence, Mainline

12 Pennsylvania Pharmacist — Nov/Dec 2019

Temple University School of Pharmacy Mohammed Ali, Philadelphia Abby Atwater, Philadelphia Rohail Bilal, Philadelphia Fang Chen, Philadelphia Taha Congoz, Philadelphia Justin Gronauer, Philadelphia Unnati Hajari, Philadelphia Rebecca Hersh, Philadelphia Katherine Kim, Philadelphia Seth Kolpack, Willow Grove Savanna Laflamme, Philadelphia Allen Ly, Broomall Tyler Mac, Philadelphia Erika Mackie, Philadelphia Kathy Nguyen, Philadelphia Rachel Nguyen, Philadelphia Krishna Padodara, Philadelphia Tina Paris, Glen Mills Justina Refela, Philadelphia Stanley Tang, Philadelphia Steffan Varghese, Philadelphia

Elizabeth Steadman, Erie, LECOM School of Pharmacy

Jason Harvey, Nanticoke, Harrold’s Pharmacy Kiersti Jones, Camp Hill, Esterbrook Pharmacy

Ingrid Deugoue, Erie Taylor Ewing, Meadville Emily Graber, Litiz Cindy Hawkins, Erie Hadeer Kamel, Erie Kailee Pollock, Sharpsville Emily Rea, Erie Victoria Sirna, Erie Hunter Smith, Punxsutawney Amanda Spirko, Coraopolis Kimberly Thurston, Rimersburg Darienne Yates, Erie

Stephanie Baloh, Shavertown, Harrold’s Pharmacy Richard Crabtree, Monroeville, UPMC Western Psychiatric Hospital Derek Thurman, Lebanon, Rite Aid Pharmacy

Jefferson College of Pharmacy Marta Didukh, Elkins Park Matthew Freidel, Stratford George Tadroes, Philadelphia LECOM School of Pharmacy Saron Belay, Lake City Emily Black, Erie Allyson Bonnoni, Erie Amanda Brancato, Rockwood Alissa DeSanti, Erie

Jasmine Chang, North Potomac, MD Lauren McCabe, Pittsburgh Madison McConnell, Pittsburgh Bryn O’Mara, Pittsburgh Anthony Poliski, Chester Springs Whitney Puyang, Bridgewater, NJ Caleb Schork, White Oak Mr. Smykowski, Fairview Erika Thomas, Cincinnati, OH Philadelphia College of Pharmacy Marta Walewska, Glen Mills Wilkes University Nesbitt School of Pharmacy Jared Byrne, Pequea Kayla Gerenza, Stroudsburg Hannah Gillespie, Orwigsburg Alex Glucksnis, Jessup Auri Glucksnis, Jessup Antonia Gobo, Newton, NJ Jamie Harpel, Mertztown Nicole Jankowski, Mountain Top Hayley Murray, Wilkes Barre Stephen Onulack, Nazareth Maverick Reed, Curwensville Mengying Shi, Lititz


Student Member Profiles

Lauren Hertzog Mertztown, PA 2020 PharmD Candidate Wilkes University Nesbitt School of Pharmacy How did you hear about PPA? The first time I heard about PPA was at a club day our school hosts for students to engage with and learn about the different pharmacy organizations on campus. Favorite drug name to pronounce Carbidopa Levodopa Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now? I would tell my P1 self to work hard and push through the year because it gets better. You will have the time to focus on what interests you later on, but you need to get through the foundations of everything first.

Why did you choose to become involved in PPA? I chose to become involved with PPA because I liked all of the opportunities it provided to get involved on a state and local level. PPA provides students with so many opportunities to engage with other pharmacists and advocate for the profession, and that was something I wanted to be a part of. Have any professors influenced you since you have started down this career path? I am very thankful for the support of my professors at Wilkes. No matter what my interests or passions are, there is always a faculty member to mentor and guide me in the right direction. I am thankful for all of the opportunities and experiences they have provided me with to work towards my goals. Where do you think you’ll be in five years? In five years, I hope to be practicing in the area of public health and serving underserved populations, while using my clinical skills to help people live happy, healthy lives. Favorite food you have eaten on campus? A southwest chicken salad from the POD.

Monica Sue Woloshin Langhorne, PA 2021 PharmD Candidate Jefferson College of Pharmacy How did you hear about PPA? Through APhA (American Pharmacists Association- Academy of Student Pharmacists) at my school. There was a presentation about PPA and all the networking opportunities the organization offered. Favorite drug name to pronounce Tremfya ( guselkumab) Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now? To be less concerned with grades and more concerned with the experiences and extracurriculars that I am in while in pharmacy school. I think my extracurriculars have helped me grow more as a person than any of my classes.

If you, someone you know or a pharmacy would like to be featured in a future issue of the magazine, please contact Victoria Madonna, Communications Manager at vmadonna@papharmacists.com 14 Pennsylvania Pharmacist — Nov/Dec 2019

Why did you choose to become involved in PPA? Dr. Leon spoke very fondly of PPA. He made me motivated to join because he spoke so passionately about the organization. In addition, I wanted to attend legislative day and talk to my state representative about pharmacy. I am very passionate about the profession of pharmacy evolving as time passes. Have any professors influenced you since you have starting down this career path? Yes, a professor at my school, Dr. Nightingale, helped me to get more involved with research for which I am very thankful. Dr. Egras taught me to pursue an area of pharmacy that I am passionate about. Then, Dr. Belottie, through our lab class, has taught me to be very careful when dispensing medication to a patient. Where do you think you’ll be in five years? I want to be a pharmacist that’s a part of a community initiative to teach people about medications through games. In addition, I would like to teach at a Pharmacy school. Lastly, I would like to work in an ambulatory care practice for patients that need medication management for his or her mental health or diabetes. Favorite food you have eaten on campus? Jimmy Johns (Plain Turkey Slim).


Jefferson College of Pharmacy D O C T O R O F P H A R M AC Y M S P O P U L AT I O N H E A LT H P H A R M AC Y Learn more at Jefferson.edu/Pharmacy


Member Profile

Robin Krull, CPhT Certified Tech/Billing Manager Value Specialty Pharmacy, Portage, PA

Pharmacy for Me is: I was inspired to pursue a career in pharmacy because I am very passionate about helping people and trying to make a difference in their lives. I have worked in three different pharmacy fields throughout my 25 years. I started out in Retail Pharmacy, transferred to Long Term

Care Pharmacy and now I am in the Specialty Pharmacy field. I am the Billing/Reimbursement Manager here at our pharmacy. I also stay active as a Certified Technician. There is always the opportunity to advance within the pharmacy field throughout the numerous departments. I am especially passionate to assist all of our patients especially with patient assistance for their high copays. When a patient is prescribed a specialty medication, most of the time they have a very high copay. I try to reach out to all patient assistance foundations to find assistance to help our patients. When a patient is diagnosed with a chronic disease, the last thing they want to worry about is trying to find money to help pay for the cost of medications. I truly can relate to our patients and I have great passion for this part of my job because I am a Breast Cancer Survivor. At the time I was diagnosed years ago, I was

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2019 Annual Conference Recap:

Patient Care is in Our DNA Thank you to everyone who joined us in Seven Springs on September 19th-22nd for the 2019 Annual Conference ‘Patient Care is in Our DNA’. More than 350 people attended some part of the four day conference! For additional photos from conference, please visit PPA’s website and Facebook page! A Special Thanks to our Conference Sponsors!

Achieving Independence Competition

Keystone Level Conference Sponsors: Rite Aid

This year, four schools of pharmacy competed in the 10th Annual Achieving Independence Competition! The teams that participated were from, Jefferson College of Pharmacy, Philadelphia College Philadelphia and the University of Pittsburgh.

Supporter: SmartFill, Walgreens, Novo Nordisk and Independent Pharmacy Cooperative Contributor Level Conference Sponsors: Kinray and PerformRx Saturday Breakfast Sponsor: Coherus Bioscience Sunday Breakfast Sponsor: PharmPAC Coffee Break: NACDS Thank you also to … the companies and individuals who sponsored a golf tee sign to benefit PharmPac and the Educational Foundation and PARD for sponsoring the lanyards!

The University of Pittsburgh came out victorious! Team members included: Holly Graber and Emily Liu; faculty advisor was Dr. Karen Pater and Independent coach was Dan Asti and Chris Antypas. A big thank you to the competition judges: Ed Bechtel, Mike Fapore, Deron Shultz, Ron McDermott, and Garry Mrozek!

Residency Showcase PPA held their Annual Residency Showcase on Saturday with an overwhelming number of residency programs looking for potential residents! This year’s showcase featured over 40 residency programs from Pennsylvania and the surrounding areas! We would like to thank the those programs for attending this year’s showcase.

Rite of Roses We extend our deepest sympathy to the families, friends, and business associates of these members. Their contributions to the profession of pharmacy and the Pennsylvania Pharmacists Association will be forever etched on our memory to not be forgotten. In Loving Memory Of … Natalie Certo, Director of Pharmacy for Children’s Hospital in Pittsburgh Joey Fernandez, PharmD Candidate, Jefferson College of Pharmacy Jack Rinehart, active member with the Capital Area Pharmacists Association John P. Forlenza, owner of Forlenza’s Pharmacy and past president of Luzerne County Pharmacists Association 18 Pennsylvania Pharmacist — Nov/Dec 2019


Golf Outing The PPA Annual Golf Outing benefiting PharmPAC and the Educational Foundation took place on Thursday, September 18th at the Seven Springs. Thank you to all of the golfers who participated, and to all of our Golf Tee Sponsors. The Annual Golf Outing raises money for PharmPAC and The PPA Educational Foundation. This year $721 was raised. We are especially grateful to our Nine Hole Golf Sponsors: Amerisource Bergen Harrisburg Pharmacy Independent Pharmacy Buying Group Keystone Pharmacy Purchasing Alliance (KPPA)

Klingensmith’s Pharmacy McKesson Jerry and Michelle Musheno Pharmacists Mutual Insurance Philadelphia College of Pharmacy Rochester Drug Cooperative (RDC)

Sellersville Pharmacy Shawn Nairn Smart Fill Value Drug Company

Mini Golf The winners of our first-ever PPAEF Masters Mini-Golf Tournament was a student team from Wilkes University called Team Khaki’s consisting of Dylan Fox, Teddy Marines, Dave Moll, and Cody Morcom. Congratulations champs! Second place hailed from the western part of the state and included Representatives from Duquesne faculty, students, and alumni, Janet Astle, Levi Deblase, John DeJames, and Matthew Rozic. The mini golf tournament raised $1279 for the Foundation. A special thank you to all our teams! Thank you to our Mini Golf Sponsors! Bill Ferri Duquesne University Enid McClung Faculty of Nesbitt School of Pharmacy, Wilkes University Ferri Pharmacy Gale Garmong Geisinger Giant Eagle Harrisburg Pharmacy Janet Astle Jerry and Michelle Musheno

Kim and Jon Ference Klingensmith’s Pharmacy Kyle Baker, Edward Jones Investing Missy Krause Pat Epple Sellersville Pharmacy Staff of Nesbitt School of Pharmacy, Wilkes University Stephanie Smith Cooney and Gatti Pharmacy Student Pharmacists of Nesbitt School of Pharmacy, Wilkes University

Putting Contest In conjunction with our nine hole golf outing, a special putting contest was held. For each $10, you could take two putts. Many came close but both Brandon Herk and Pat Lavella landed one in for a putt off. Pat Lavella walked away with the honors of trying a ridiculously challenging putt for the ultimate prize of $5,000. Unfortunately he was not able to make this one.

www.papharmacists.com 19


2019 Annual Conference continued Exhibit Hall Thank you to the companies who exhibited with us this year! Allegheny County Pharmacists Association Amerisource Bergen Bucks Mont Pharmacists Association Cardinal Health Celtic Wind Crops USA Inc Coherus Biosciences Epic Pharmacies, Inc ERApeutics Florajen Probiotics Fresenius Kabi Guaranteed Returns Independent Pharmacy Buying Group Keystone Pharmacy Purchasing Alliance Kinray Drugs Liberty Software Luttner Financial/The Ryan Hicks Group

Lehigh Valley Pharmacists Association Mayne Pharma McKesson Micro Merchant Systems NACDS Novo Nordisk Otsuka Performrx Pfizer PharmaCanna Pharmacists Mutual PioneerRx Prescribe Wellness PRS Pharmacy Services QS/1 RDC Real Value Rx Rite Aid RJ Hedges SARPH

Smart-Fill Smith Drug Company Strand Temptime Corporation TRC Healthcare Value Drug Vinco/Madre Terra Science Walgreens

Lip Sync Battle

Diabetes ImPAC Challenge

The Educational Foundation hosted its first annual Lip Sync Competition. Students and at least one faculty member from Duquesne University, Philadelphia College of Pharmacy, University of Pittsburgh and Wilkes University participated. We would like to thank our judges Nick Leon, Brandon Antinopoulos, Donna Hazel, Megan Weigand, Shawn Nairn and Anthony Bertola. The students from Wilkes University Nesbitt School of Pharmacy or the MMR Brothers came out victorious. The Educational Foundation was able raise over $1000. Thank you to all that participated and donated!

PharmPAC hosted its second annual Diabetes ImPAC Challenge. Students from Duquesne University, Jefferson College of Pharmacy, LECOM, Philadelphia College of Pharmacy, Temple University, University of Pittsburgh and Wilkes University competed. We would like to thank the hosts Jamie McConaha and Nicole Pezzino and score keeper Katie Sulkowski. Shannan Street and Michelle Culbert from Jefferson College of Pharmacy came in first and Devanshi Patel and Krishna Patel from Temple University came in second.

20 Pennsylvania Pharmacist â&#x20AC;&#x201D; Nov/Dec 2019


Leadership and Awards Ceremony Congratulations to all of our Award Winners! To view our award winner bios, please visit papharmacists.com/Awards. Janet Astle, BS Pharm, Ed. D.: Bowl of Hygeia Sponsored by the APhA Foundation, NASPA, and Boehringer Ingelheim

Chris Antypas, PharmD: Pharmacist of the Year Award

Sarah Dombrowski, PharmD: Pharmacists Mutual Companies Distinguished Young Pharmacist Award

Sandra Kane-Gill, PharmD, MS, FCCM, FCCP: Excellence in Innovation Award Sponsored by Upsher Smith Laboratories

Peter Kreckel, RPh: PPA Preceptor of the Year Award

Christan Gist, CPhT: PPA Pharmacy Technician of the Year Award

Honorable Robert Matzie: PPA Legislator of the Year Award

Emily Lohr, PharmD: George H. Searight Community Service Award

AJ Greco, PharmD: J. Allen Duffield Pharmaceutical Industry Award

www.papharmacists.com 21


2019 Annual Conference continued Ron McDermott, RPh: George S. Maggio Memorial Award

LECOM School of Pharmacy: Membership Award

Patricia Kroboth, PhD: PPA Mortar and Pestle Award.

Duquesne University School of Pharmacy: Government Relations Award

J Douglas Bricker, PhD: PPA Mortar and Pestle Award

Wilkes University â&#x20AC;&#x201D; Nesbitt School of Pharmacy: Public Relations and Awareness Award

22 Pennsylvania Pharmacist â&#x20AC;&#x201D; Nov/Dec 2019

Student Organization Awards


PPA Leadership

SPPA Student Advisory Board

From left to right – Front Row: Karleen Melody, Lauren Simko (Immediate Past President), Rick Demers (President), Chuck Kray (President Elect), and Nicole Pezzino.

From left to right – Front Row: Elizabeth Leonard, Erica Jackson, Sydney Keremes, and Hailey Mook Back Row: Lanny Dang, Jacquelyn Madler, Cody Morcom, Dylan Fox, and Nicole Hughes.

Second Row: Pat Epple (CEO), John Barrett, Shawn Nairn, Darryle Tillman, Brandon Antinopoulos, Pat Lavella, Chris Antypas, and Vick Shaw.

PPCN Board of Directors

From left to right – Front Row: Stephanie McGrath, Nick Leon, and Stephanie Smith Cooney Second Row: Melissa McGivney, Chris Antypas, and Pat Epple.

23 Pennsylvania Pharmacist — Nov/Dec 2019

www.papharmacists.com 23


Legislative Profiles Rep. Dan Frankel D-23 What are the key issues you would like to see addressed this session (2019–2020)? As Democratic Chair of the House Health Committee and founding member of the Women’s Health Caucus and LGBT Equality Caucus, I am committed to increasing healthcare access and affordability. My legislative priorities include promoting the PA Fairness Act (a statewide ban on discrimination of LGBTQ+ people), ensuring price transparency in pharmaceuticals, and addressing the trend of health care consolidation and vertical integration. Integrated delivery networks or IDNs, are simultaneously providers and insurers. I have created legislation that requires INDs to fairly contract with insurance companies, so patients don’t get caught in the middle. Tell our members a little about your background and why you are legislator? As a Jewish man with both concentration camp survivors and liberators in my family, my life in public service is motivated by the fact that the atrocities of the Holocaust began subtly-- not accidently. Whether you are an immigrant woman seeking reproductive services or trans man applying for an apartment, words and policies matter. For our state to be a truly great place to live and work, we need laws that explicitly respect and protect all individuals. Recently, my neighborhood in Pittsburgh, Squirrel Hill, was the site of a synagogue shooting, the deadliest act of antiSemitic violence on U.S. soil. This horrific tragedy brought to focus the need for sensible firearm restrictions and hate crime designation and enforcement, both of which I have long called for. Now, my resolve to make these a reality is only stronger. How do you see pharmacy and its role in health care evolving in the future? Pharmacists, particularly in rural or other underserved areas, play a vital role in the management of care. People benefit from having open and honest conversations with a local pharmacist about potential drug side effects, interactions, and costs. Increasingly, community pharmacists are collaborating with primary care physicians and hospital pharmacists to provide coordinated care. While some patients only see their hospital-based 24 Pennsylvania Pharmacist — Nov/Dec 2019

providers twice a year, they may visit a community pharmacy 32 times. This connection allows for continuity of care and better medication therapy management. As the need for complex disease management grows with Pennsylvania’s aging population, pharmacy is going to become more integrated with other supports for health and well-being. Advice for pharmacists about the political process? Democracy is not a spectator sport, and because healthcare is a huge portion of our economy and public policy discussions, pharmacists are far from the sidelines. I recommend pharmacists who want to advocate for their field get to know their elected officials. State House legislative offices represent a relatively small constituency — only around 60,000 people. You can develop a positive relationship with your representative by proactively keeping them updated on the issues that you care about, not only contacting them in response to boilerplate action requests from advocacy organizations. Calls and emails are effective, but personalized and well-written correspondence and meetings are even better. What do you do for relaxation or enjoyment? Some form of exercise, usually swimming, is an essential part of my everyday routine. Being in the pool helps me clear my head and catch up with other members of the local gym — not to mention the benefits for physical health. My wife and I like to go on long walks together, but she is so fast it is difficult to keep up with her sometimes. We also enjoy traveling to visit our daughter in New York, or exploring new neighborhoods locally and in other parts of the world.

Sen. Wayne Langerholc R-35 What are the key issues you would like to see addressed this session (2019-2020)? As Chairman of the Education committee, I have had the opportunity to hear from educators, superintendents, and parents of students in my district and across the commonwealth. Education reform has to be addressed. We have to find a solution that gives every student an opportunity to have a quality educational experience that adequately prepares them for the future.


Tell our members a little about your background and why you are legislator?

Advice for pharmacists about the political process?

I am a former ADA & lead prosecutor of Cambria County Drug Task Force, as well as a former Richland Township Supervisor. Both these positions have made me aware of the issues facing our communities and our commonwealth. I believe as a legislator I can effectively work to make changes that would address those problems and make for a better place to raise our children. How do you see pharmacy and its role in health care evolving in the future? Given that PA has an aging demographic, pharmacy is as important as ever. It’s imperative that we do everything we can to keep prescription costs under control. Healthcare and insurance is an ever evolving and changing field, but I’m hopeful that we can find a solution that keeps our local pharmacy open and available to offer that personal, one on one interaction that our seniors need.

ACTIVE INGREDIENTS: EXPERIENCE, TENACITY and

I would encourage pharmacists to stay involved. Meet with legislators. Keep an open dialogue. I appreciate your knowledge in this subject matter and I look to you who lead with the issues on a daily basis to guide me with regard to legislation that will be impactful in your profession. What do you do for relaxation or enjoyment? I love spending time with my wife and our three daughters. Our daughters are involved in many after school activities, so supporting them at their events is something my wife and I enjoy very much. Running, boxing, and taking Krav Maga are a great way for me to relax and keep in shape.

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Pharmacy Spotlight UPMC St. Margaret For the last 25 years, Patricia (Trish) Klatt has had an integral part in educating physicians, pharmacy residents, and patients through didactic teaching as well as caring for patients both at UPMC St. Margaret and their Family Health Center. Klatt, a Pittsburgh native, graduated from the University of Pittsburgh School of Pharmacy in 1994. After receiving her BS Pharm, she attended University of Rhode Island her PharmD and then completed a Family Medicine Residency at Brown University. In 1995, she found a Pharmacist Faculty position open at UPMC St. Margaret in their Family Medicine Residency Program and the rest is truly history. UPMC St. Margaret has a long history of including pharmacists on their faculty to train Family Medicine Residents how to use medications safely and effectively for patients both in the hospital and in the outpatient offices. The Family Medicine Residency Program at UPMC St. Margaret was established in 1971 – part of the first wave of family medicine programs established across the country. A half time pharmacist faculty position was included in the original design of this residency program, establishing an interprofessional collaboration between pharmacists and physicians that has spread throughout the Pittsburgh region over the years. At the heart of the program is a community hospital run by Family Medicine residents, and outpatient Family Health Centers where families can count on getting patient centered care by an outstanding team of providers. In 2003, Klatt started the pharmacy residency program with in the physician residency with one single resident. Today, that program has expanded and grown to provide training for ten residents at one time. Klatt led the transformation of the inpatient pharmacy into a teaching department with five clinical pharmacy specialists that serve as faculty for the program in addition to contributing to the department . “It’s been a privilege to be able to shape our program to adapt to the changes in health care and pharmacy practice over the years”. Klatt said. The residency program to identify and react current public health concerns affecting the community. The opioid epidemic is at an all-time high across the commonwealth. 26 Pennsylvania Pharmacist — Nov/Dec 2019

After 22-herorin related deaths in the surrounding Pittsburgh area, UPMC St. Margaret Family Health Center initiated a harm-reduction strategy using patient counseling and naloxone kits. The implementation and data collection for this project was spearheaded by a PGY-2 resident working closely with an ambulatory care pharmacist, a family physician, and both clinic and hospital staff. The resident was able to foster financial support and coordinate system electronic health record and pharmacy services resources in order to bring this project to life. In a period of just over one year, 51 patient outreach letters were mailed to patients deemed high risk due to opioid use or history of illicit opioid use, and 67 naloxone kits were dispensed. Four successful overdose reversals were reported during the data collection period. The program also provides small group education on Asthma, Teddy Bear Clinics (sessions for Kindergartner’s about what to expect from a routine doctor’s visit) and HPV Vaccinations. UPMC St. Margaret also provides chronic disease state management as well as transitions of care for the underserved and medically frail population. Klatt was able to design a Free Medication Program for a small formulary of primarily chronic medications. For the last 17 years, the program has helped patients with financial burden receive medications used to treat hypertension, diabetes, depression, hyperlipidemia, and infections. As the profession of pharmacy is rapidly changing, the future is still bright. Professional organizations such as PPA allow colleagues to share practice models, research and clinical knowledge. To grow with the changes, Klatt initiated the concept for the Primary Care Pharmacist Consortium (PC2) within PPA. “PC2 has provided opportunities to make an impact on payers and subsequently patients are so much greater when we unify as a group rather than work independently from each other”. Klatt said. To join Trish Klatt and others in the PC2 group, please contact ppa@papharmacists.com for information.


Top Tier 2019–20 Residents Courtney Ellingsworth, PharmD

Disha Soni, BS, PharmD

Practice site: ACME Sav-on Pharmacy

Practice Site: ACME Sav-on Pharmacy

University Affiliation: University of the Sciences/PCP

Residency Program: Temple University School of Pharmacy

PharmD education: Temple University School of Pharmacy

Pharmacy Degree: University of the Sciences/PCP

Year of PharmD graduation: 2019

Year of PharmD graduation: 2019

“I chose to pursue a community residency because this opportunity uniquely combines my interests in direct patient care, academia, and advancing the practice of pharmacy in the outpatient setting!”

Carly Gabriel, PharmD Practice Site: Giant Eagle Pharmacy University Affiliation: University of Pittsburgh School of Pharmacy Pharmacy Degree: University of Pittsburgh School of Pharmacy Year of PharmD graduation: 2019 “I decided to pursue a community pharmacy residency because I wanted to build upon the strong foundational experiences I had through-out school, and understand how to better serve the community through multiple disciplines within pharmacy.”

Kelsey Hake, PharmD

“I chose to do a community residency because I wanted to solidify my pharmaceutical knowledge through practice and intense training. The acme residency will provide me with an abundant amount of opportunities to be challenged, push myself and learn.”

Evan Turco, PharmD Practice Site: Asti’s South Hills Pharmacy Residency Program: University of Pittsburgh School of Pharmacy Pharmacy Degree: West Virginia University Year of PharmD graduation: 2019 “I chose to pursue a community pharmacy residency to gain practical clinical experience related to how we as community pharmacists can effectively help bridge the gap between inpatient and outpatient care, improving health and wellness outcomes for our patients and advancing our role as healthcare providers in the community.”

Practice Site: Rite Aid University Affiliation: University of Pittsburgh School of Pharmacy Pharmacy Degree: University of Pittsburgh School of Pharmacy Year of PharmD graduation: 2019 “I chose a Community Residency because I saw firsthand, through research and rotations, the impact that advanced clinical services have on patients in the community. It inspired me to want to learn more about the implementation of new clinical services and, further-more, have the opportunity myself to help expand upon them for other pharmacists.” www.papharmacists.com 27


Pharmacy and the Law: A Pharmacist’s Duty to an Unknown Third Party By Don. R. McGuire Jr., R.Ph., J.D. This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community. A recent court decision in Michigan re-examined an issue first discussed in this column about ten years ago. In the Sanchez case from Nevada in 2009, the patient, driving while under the influence of prescription medications, hit two men, killing one. The survivor and the decedent’s family sued a number of parties, including eight pharmacies, for the injuries and wrongful death. The Nevada court cited Common Law principles that a person has no duty to control another’s dangerous conduct, or to warn others of that dangerous conduct absent a special relationship and foreseeable harm. The court decided that there was no special relationship because the plaintiffs in that case were unidentifiable prior to the accident. The Michigan decision dealt with a very similar situation. In this case, a patient’s car crossed the centerline and collided with another car, killing two women and injuring another. The patient had received a number of prescriptions for controlled substances, including fentanyl patches, over the previous two years. On the day of the accident, the patient received a prescription for fentanyl patches. Upon leaving the pharmacy, he put a patch in his mouth and chewed it presumably in an attempt to bypass the time-release mechanism. The decedents’ families and the survivor filed suit against both the prescriber and the pharmacy alleging that a special relationship existed between the patient and the pharmacy and that it was foreseeable that the patient would drive while intoxicated. The pharmacy filed a motion for Summary Judgment stating that no such relationship existed and that it was not foreseeable that the patient would misuse the patch. The trial court disagreed with the pharmacy’s position and denied their motion. The pharmacy appealed the ruling to the Michigan Court of Appeals. The Court of Appeals reviewed a line of pharmacy cases in Michigan dating back to 1980. The existing rule in Michigan is that a pharmacist does not have a duty to warn a patient of possible adverse events when dispensing a drug pursuant to a facially valid prescription. Based on these cases, the Court concluded, “. . . it would be illogical to impose such a duty on the pharmacist with respect to a third party.” The Court also concluded that the pharmacy had no duty to monitor the patient’s use of fentanyl. In a somewhat unusual circumstance, one judge filed a concurring opinion in which he agreed with the conclusion, but urged the Michigan Supreme Court to take up the case 28 Pennsylvania Pharmacist — Nov/Dec 2019

because he believed that Michigan case law was based on an incorrect interpretation of the law. He reviewed legislation and regulations from which he concluded that a pharmacist does have a duty to warn of possible adverse events and to monitor the patient’s use of medications. The first of these was the Federal regulation under the Controlled Substances Act that created a pharmacist’s corresponding responsibility to consider the validity of an order for a controlled substance. The conclusion was that the Michigan case law stating that a pharmacist has no legal duty to monitor the prescribing of controlled substances was at odds with Federal law. The judge also cited Michigan laws and regulations supporting the conclusion that pharmacists have a broader duty than the current case law outlines. The judge urged the Michigan Supreme Court to take up the case because the Court of Appeals did not have the authority to overturn Michigan case law. However, in April 2019, the Supreme Court declined to hear the appeal and the Court of Appeals ruling stands. While some states’ case law still follows the concept of the Learned Intermediary (i.e., the pharmacist has no duty to warn the patient because of the involvement of the prescriber who is the Learned Intermediary). The concurring opinion in this case gives us a glimpse of where the law is likely to go. As pharmacists continue to expand the array of services that they can provide to patients and technological advances place more information into their hands, it seems unlikely that pharmacists will be able to continue to rely on the defense of filling a facially valid prescription. While this may not extend to a duty to unknown third parties, pharmacists should be prepared for future courts to impose a duty to warn patients of possible adverse events and to monitor their medication usage. © Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.


Financial Forum:

Making a Charitable Gift From Your IRA Follow the rules, and you might get a big, federal tax break This series, Financial Forum, is presented by PRISM Wealth Advisors, LLC and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Is your annual IRA withdrawal a bother? If you are an affluent retiree, that might be the case. The income is always nice, but the taxes that come with it? Not so much. If only you could satisfy your yearly IRA withdrawal requirement minus the attached taxes. Guess what: there might be a way.

If you gift traditional IRA assets to charity, you could see some big tax savings. The Internal Revenue Service calls this a Qualified Charitable Distribution (QCD), and you may want to explore its potential. Some criteria must be met: you need to be at least 70½ years old in the year of the donation, the donation must take the form of a direct transfer of assets from the IRA custodian to the charity, and the charity must be “qualified” in the eyes of the I.R.S. Any 501(c)(3) non-profit organization meets the I.R.S. qualification, as do houses of worship.1 The amount you gift can be applied toward your Required Minimum Distribution (RMD) for the year, and you may exclude it from your taxable income. If you are retired and well-to-do, a charitable IRA gift could be a highly tax-efficient move.1,2

Just how much could you save? That depends on two factors: how much you gift, and your federal income tax bracket. As an example, say you are in the 35% federal income tax bracket, and you donate $40,000 from your traditional IRA to a 501(c)(3) non-profit organization. That $40,000 will be gone from your taxable income, and the donation will cut your federal tax bill for the year by $14,000 (as 35% of $40,000 is $14,000). Yes, the savings could be significant.2 You can donate as much as $100,000 to a qualified charity this way in a single year. That limit is per IRA owner; if you are married, and you and your spouse both have traditional IRAs, you can each donate up to $100,000.1,2

What about the fine print? There is plenty of that, and it is all worth reading. You may be curious if you can make a QCD from a SIMPLE or SEPIRA; the answer is no. You can make a QCD from a Roth IRA, but there is little point in it: Roth IRA withdrawals are commonly tax-free.1 Regarding the asset transfer, the critical detail is that you cannot touch the money. The distribution must be payable directly to the non-profit organization or charity, not to you. (Income tax does not need to be withheld from the distribution since the amount

withdrawn will not count as taxable income.) In addition, your tax preparer must identify the distribution as a QCD on your federal tax return. This is crucial and must not be overlooked, because the custodian of your IRA will probably report your QCD as a normal IRA distribution.2 If you itemize your deductions, you should know that a charitable IRA gift does not count as a deductible charitable contribution. (That would amount to a double tax break.) Of course, fewer taxpayers have incentive to itemize now, since the standard deduction is so large, thanks to the Tax Cuts & Jobs Act.1,2

If you want to make a charitable IRA gift, start the process before the year ends. If you try to make the gift in late December, your IRA custodian might not be able to move fast enough for you, and the asset transfer may occur later than you would like (i.e., after December 31). Talk with a tax or financial professional before the year ends, so that you can plan a charitable IRA donation with some time to spare. Citations. 1 - thebalance.com/qualified-charitable-distributions-3192883 [1/15/18] 2 - marketwatch.com/story/how-retirees-can-save-on-charitabledonations-under-the-new-tax-bill-2018-03-02 [3/2/18] Pat Reding and Bo Schnurr may be reached at 800-288-6669 or pbh@ berthelrep.com. Registered Representative of and securities and investment advisory services offered through Berthel Fisher & Company Financial Services, Inc. Member FINRA/SIPC. PRISM Wealth Advisors LLC is independent of Berthel Fisher & Company Financial Services Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment

www.papharmacists.com 29


Campus Checkup

Duquesne University School of Pharmacy Contributed by: Dakota Miller, Communication Ambassador During the month of September, Duquesne PPA chapter has participated in several events in Pittsburgh. We had a booth at the annual Pittsburgh Recovery Walk with a poster board activity about common medication facts and myths that attendees were able to participate in. Many of our members also attended the annual PPA conference held at The Seven Springs Mountain Resort. We held our first meeting as well with Dr. Johnathan Kloss, a recent Duquesne graduate and a current fellow at Bristol-Myers Squibb and Rutgers, as our guest speaker. Our final event that we held was a GRASP and advocacy letter writing night for students so they could work on their GRASP modules or write a letter to their legislator regarding current bills. Some of our members are going on an advocacy trip to Washington, D.C. in the upcoming weeks to speak to representatives. We’ve had a great turnout so far and are excited for the events we have planned for the rest of this semester!

Pittsburgh Recovery Walk - 9/14/2019

30 Pennsylvania Pharmacist — Nov/Dec 2019

Jefferson College of Pharmacy Contributed by: Ashling Cook, Communication Ambassador This semester has been off to a great start for Jefferson’s chapter of SPPA! Jefferson has some really exciting events planned for this upcoming semester! We are in the process of planning fall legislative events including a pizza and letter writing event to state senators advocating for PBM transparency and the pharmacist’s role in public health. We also plan to have more members complete the GRASP program this year and plan to organize an event where students register for and complete the GRASP program to prepare for legislative day. We are participating in PPCN’s day of service in early November and will hold a blood pressure event at a local pharmacy in the Philadelphia area.

LECOM School of Pharmacy Contributed by: Samantha Adams, Communication Ambassador The PPA chapter at LECOM started off the semester with a welcome picnic to introduce LECOM’s clubs such as PPA and spark interest in PPA for the P1 class. P2 students shared details on what PPA has to offer to the incoming students and explained events PPA has been apart of in the past. In September PPA/APhA held a membership drive where current PPA members could help new interested students sign up for PPA. LECOM’s PPA chapter also participated in the Diabetes Competition at the PPA’s Annual Conference in Seven Springs. During the Leadership and Award Dinner, LECOM’s chapter also won the Student Membership Award for 2019. We look forward to starting on the GRASP modules so that we can get as many students as possible to attend Legislative Day this year!


Philadelphia College of Pharmacy Contributed by: Julia James, Communication Ambassador September at PCP was a busy month for our PPA members! We held our first General Body Meeting of the semester where students were given the opportunity to learn about our upcoming events and compete in our Diabetes Competition while enjoying great local pizza. Jenna Jansuzka and Ali Cerino were our champions and they had the honor of representing PCP at the Annual Conference in the Diabetes ImPAC Challenge. In preparation for the Annual Conference, our PPA Executive Board Trick-or-Treated around PCP faculty offices collecting donations to benefit PPA’s Educational Foundation.

Temple University School of Pharmacy Contributed by: Brett Nguyen, Communication Ambassador Temple PPA began our fall semester with a school wide welcome back BBQ where our e-board met with many students from the new class and encouraged involvement. The BBQ was followed by a general body meeting that saw a healthy turnout from the new class that expressed interest in e-board positions and events we have planned throughout the semester. One of which is a golf outing fundraiser in support of World Heart Day where all proceeds will be donated to the American Heart Association. There will be another fundraiser taking place this fall with our second annual Patagonia sweatshirt sale. We also had two 4th year students, Krishna Patel and Devanshi Patel, participate in the Diabetes Competition at PPA’s Annual Conference in Champion, PA where they placed 2nd. Their photo can be found on page 20. We’re looking forward great semester filled with fun activities planned such as our future meet up with students from Jefferson and PCP for a night out in the city!

PPA members held multiple Lip Sync Battle practices and studied hard for the Diabetes ImPAC Challenge! PCP had over 20 students and faculty attend the Annual Conference this year and enjoyed networking with their fellow pharmacy students from across the state. In the coming months, PPA plans to hold events focused on preparing students for the Mid-Year Conference including Pain Management study sessions and an OTC Competition where students can compete to represent PCP next year. We also plan on hosting a letter writing campaign in conjunction with other pharmacy organizations and promote advocacy for pharmacy at local festivals.

University of Pittsburgh School of Pharmacy Contributed by: Emily Dell, Communication Ambassador The University of Pittsburgh Chapter of PPA has been participating in many exciting events in the past few months. Several of our students attended the Annual Conference at Seven Springs Mountain Resort in Champion, PA. We are happy to announce that two University of Pittsburgh students, Emily Liu and Holly Graber, won the Achieving Independence Competition while at the conference. A photo of the project and winners can be viewed on page 18. Earlier this semester, members of Pitt PPA attended the Annual Picnic with the Allegheny County Pharmacists Association (ACPA) and learned about how we can be more involved in advocating for the profession of pharmacy at the county level. Throughout the semester, we will be promoting awareness of this year’s “Dean’s Theme,” which is an initiative taken from APhA-ASP that we base our events on. This year’s theme is Generation Rx, and it focuses on medication safety and preventing medication abuse. We are very excited about the events that we have coming up later in the semester with PPA! continued on next page www.papharmacists.com 31


Campus Checkup continued

Wilkes University Nesbitt School of Pharmacy Contributed by: Stephanie Ostir, Communication Ambassador The Wilkes University Student PPA Chapter started the semester off with many fun activities and events to welcome members back to campus and to gain new memberships into the chapter. These events included club mixers and a “Breakfast Clubs” brunch, co-hosted with Wilkes’ APhA-ASP Chapter, to educate students about membership. In the weeks following, our members participated in many Katy’s Kids events at the Wilkes Homecoming football game, the Wilkes-Barre YMCA, and the Halloween Health Fair, which were very fun and rewarding experiences! One of our favorite parts of the semester was attending the Annual Conference. Many of our students and faculty members attended, and everyone enjoyed the fun weekend full of networking, competing, and learning. Some of our members competed in the Lip Sync Battle, Diabetes ImPACt Competition, and Educational Foundation Golf Tournament. The conference was definitely a weekend to remember, and the chapter took many ideas home to improve our club, our profession, and the health of our patients we will care for. We look forward to the events planned for the remainder of the semester, including the Penguins Hockey social, t-shirt fundraisers, blood pressure screenings, Katy’s Kids, legislator postcards, and Legislative Week preparations.

Time to start holiday shopping with AmazonSmile! Did you know that Amazon donates 0.5% of the price of your eligible AmazonSmile purchases to the PPA Educational Foundation? This contribution supports the grant program, student poster presentations, the LEAD program, pain competition, and much more! All you need to do is: STEP ONE: Go to Smile.Amazon.com. STEP TWO: Choose PPA Educational Foundation as your charity. STEP THREE: Whenever you are shopping, start at Smile.Amazon.com! Take advantage of this easy way to do your holiday shopping and help your Foundation!

32 Pennsylvania Pharmacist — Nov/Dec 2019

You can help PPA’s Educational Foundation just by buying the stuff you need every day, using Smile.Amazon.com.


PPCN Update Flip the Pharmacy Launched! With the University of Pittsburgh and PPA, PPCN is one of 20 networks who was awarded grant funding from the Community Pharmacy Foundation for the two-year Flip the Pharmacy initiative. Our Practice Transformation Team is partnering with more than six payers, five schools of pharmacy, three eCare plan technology vendors, one wholesaler and the PA Department of Health to execute this innovation. Through this progressive initiative, our Practice Transformation Team will support over 40 pharmacies in the “flip” from a product-focused business model to one that can sustain clinical services. Each month an operational “Change Package”, which is based on principles of Implementation Science, is released to pharmacies with goals and objectives for the month. Over 24 Practice Transformation Coaches from across the state are mentoring pharmacies in the implementation of the monthly change package. The program launched October 1 with a focus on medication synchronization to support workflow efficiency and the appointment based model of care. You can learn more about the national Flip the Pharmacy initiative at www.flipthepharmacy. com and follow @flipthepharmacy for exciting program developments!

PPCN Networking Event At the PPA Annual Meeting in Seven Springs, PPCN hosted a “Mix and Mingle” networking reception for Flip the Pharmacy participating coaches and pharmacies. Our energetic group paused strategy discussion and gathered for a quick picture during the reception.

Kicking Off Practice Transformation With Medication Synchronization Three of PPCN’s innovative and talented pharmacists collaborated to share their challenges and best practices on medication synchronization at the PPA Annual Meeting in Seven Springs. Medication synchronization may be considered the “powerhouse” of community pharmacy practice transformation as it significantly improves pharmacy workflow efficiency, reduces “chaos”, and frees up time for pharmacy staff to focus on clinical services.

Thank you to Adrienne Cervone, PharmD, President, Beaver Health Mart Pharmacy, Jeff Covelli, RPh, MTM Coordinator, The Hometown Pharmacies and Robert Maher, Jr., BS, PharmD, CGP, Director of Clinical Services, Patton Pharmacy for sharing your time and expertise with your fellow pharmacists!

Welcome to New PPCN Members PPCN would like to welcome Mainline PharmacyBushy Run, Crestwood Pharmacy, Beaver Falls Health Mart Pharmacy, Weis Markets #182, Custom Care Pharmacy (Sunbury and Milton), White Oaks Pharmacy, Spartan Pharmacy, Lewisburg Pharmacy and Boothwyn Apothecary! We appreciate your partnership!

Flip the Pharmacy coaches and participating pharmacies “Mix and Mingle” while discussion community pharmacy practice transformation

If you would like to learn more about PPCN, visit http://papharmacistsnetwork.com/ or email PPCN Executive Director of Network Operations Stephanie McGrath, PharmD at smcgrath@papharmacists.com. Follow us on Twitter @PPCN_CPESN and Instagram papharmacistsnetwork

www.papharmacists.com 33


Meet PPA’s New Membership Coordinator! PPA has a new Membership Coordinator, Katie Hoster! Katie, a 2019 graduate of Penn State with a Bachelor of Science in Health Policy and Administration and a minor in Human Development and Family Studies, started working at PPA at the beginning of September. Prior to her work at PPA, Katie worked at Chandler Hall Continuing Care Retirement Community as an Administrative Intern in the nursing home. As a unique part of her internship, Katie lived in the assisted living section of the community where she gained a new and valuable perspective on senior living in Pennsylvania. In her free time, Katie enjoys attending Penn State Football games, travelling, seeing Broadway shows, and spending time with her family and friends. Please welcome Katie to PPA!

We Deliver Solutions for a Healthier Bottom Line EPIC Pharmacies, Inc. provides more than 1,500 independent member pharmacies across the U.S. with the group buying power and managed care solutions essential to delivering quality patient care. Membership offers: • Group volume purchasing power • Aggressive wholesaler pricing programs • Profits distributed to members at year-end • EPIC Pharmacy Network, Inc. (EPN) membership fee included at no cost – access to third-party contracts • Clinical services tools, including expert assistance from our in-house pharmacist and access to custom PrescribeWellness offerings and EQuIPP •

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Professional Development for the Practicing Pharmacist:

Navigating the IRB Approval Process

Stephen Martin BSc. Project Manager, Investigator Initiated Research Operations, Geisinger. Adam Gross PharmD, CCRP. Investigational Drug Pharmacist, Center for Pharmacy Innovation and Outcomes, Geisinger. No matter your role within the practice of pharmacy, you likely have encountered a clinical question without a clear answer and wondered what type of evidence is available to support an answer. You search the literature and discover a need exists for a deeper understanding of the topic. After some thought, you formulate a research question and are excited to begin your research! However, seeking approval from an Institutional Review Board (IRB) may be necessary before you proceed. This article provides a basic introduction to the purpose of an IRB and how to navigate through its processes as a practicing pharmacist.

What is an IRB?

Why do we have IRBs?

Institutional Review Boards are review committees that play an important role in that protection of human subjects in research (animal research is covered by a separate entity not discussed here). Part of conducting research includes ensuring that the rights and welfare of the human subjects being studied are protected. Per federal regulations, IRBs are composed of at least five individuals with distinct backgrounds, including one scientist, one nonscientist, and one individual not affiliated with the institution. Research, even if it does not involve direct patient contact (e.g. using a retrospective database), may still require IRB approval, or an acknowledgement letter from the IRB. U.S. federal regulations require IRB review and approval for human subjects research that is associated with federal departments or agencies. However, many organizations may apply the same oversight to all research that is conducted within their institution. In addition to having the authority to approve (or reject) a research project, federal regulations specify the powers of an IRB (Table 1)

Historically, research has not always been conducted in an ethical manner. These unethical practices laid the modern foundation of research ethics. Perhaps among the most well-known are those atrocities conducted by the Nazis during World War II. As a response to these atrocities, The Nuremburg Code was created, outlining rules for “Permissible Medical Experiments” which include: 1) consent for research must be voluntary, 2) benefits associated with the research should outweigh the risks, 3) participants may withdraw consent at any time, and 4) the research must have scientific merit. This code influenced other ethical codes such as the Declaration of Helsinki, an early statement on physicians’ ethical commitments, and The Belmont Report, a response to unethical research practices in the U.S. such as withholding of beneficial syphilis treatment from African Americans during the infamous U.S. Public Health Service Tuskegee Syphilis Study. The Belmont Report identifies three fundamental principles for research which act as the basis for current IRB regulations: 1) respect for persons (i.e. that a person’s autonomy or right to self-determination should be respected), 2) beneficence (i.e. researchers are obligated to minimize harm to research subjects while maximizing benefits), and 3) justice (i.e. all persons or population have an equal chance to benefit from research and no population is unduly burdened with the risks of research).

Table 1: Powers of an IRB Federal regulations stipulate the institutional review boards have the authority to: Require approval to make changes to research staff, materials, and methods Carry out recurring reviews research (i.e. “continuing reviews”) Observe the consent process and the conduct of your research Suspend or terminate approval for research at any time Violation of IRB regulations can range from suspension of a research project and inability to publish results, to loss of licenses, immediate shutdown of all research at your institution, and termination of employment.

Do I need to submit my idea for IRB approval before I start? It is possible that the topic you plan to investigate does not qualify as a research project, but rather as a quality improvement (QI) project. While research focuses on the generation of generalizable knowledge, the data collection and analysis involved in a QI project aims at improving processes and/or outcomes within your organization. It typically does not require IRB approval. Consulting your IRB is recommended as many IRBs provide guidance that will help you determine if your project is QI or research. Continued on next page www.papharmacists.com 35


Navigating the IRB Approval Process continued Types of IRB approval If your project meets the definition of research, it will be classified by the IRB into one of three review categories: exempt, expedited, or full review. These classifications are based on the level of risk to potential participants and indicates the level of review by the IRB (Table 2). During

a full board review, your research will be presented by a least one reviewer who will discuss the risks and merits of your study with the board. Subsequently, they will vote on whether to approve or reject your proposed study.

Table 2: IRB Review Categories Review Category

Level of risk

Requirements

Examples

Exempt

Minimal*

No initial or continuing review required

• Analysis of de-identified secondary data • Interviews • Surveys • Selected behavioral interventions

Expedited

Minimal*

• Initial review by one or more IRB members required • Continuing review sometimes required, may be expedited

Full

Greater than minimal

• Initial review and approval by vote of full IRB

• Studies of approved drugs or devices • Studies involving only a blood draw • Studies involving prospective non-invasive sample collection (e.g. urine sample) Studies of new drugs or devices

• Continuing review by the full board usually required annually, but may be expedited * No more risk than that which a person would encounter during normal activity

What things does the IRB consider during their approval process? If your project meets the definition of research, it will be classified by the IRB into one of three review categories: exempt, expedited, or full review. These classifications are based on the level of risk to potential participants and indicates the level of review by the IRB (Table 2). During

a full board review, your research will be presented by a least one reviewer who will discuss the risks and merits of your study with the board. Subsequently, they will vote on whether to approve or reject your proposed study.

Table 3: Responsibilities of the IRB Ensure that any risks posed to participants are minimized and, if present, are reasonable. Selection of participants is fair and impartial. Informed consent will be sought and documented, or appropriately waived. Adequate steps are taken (i) to monitor data for participant safety, (ii) to protect the privacy of subjects, and (iii) to maintain confidentiality. Additional safeguards are included, where applicable, to protect vulnerable participants (e.g. prisoners, pregnant women, children, and developmentally delayed individuals). 36 Pennsylvania Pharmacist — Nov/Dec 2019


The IRB ensures that participants will be informed about the risks and benefits of the research through a written or verbal informed consent form. The informed consent document contains several essential elements and the specific type of study may require you to include additional

information (Table 4). The process of informed consent involves documenting a participant’s voluntary agreement to participate, gives them information about the study, and provides a platform to answer any questions to ensure their understanding of the research.

Table 4: Essential elements of informed consent That the subject will be participating in research Purpose of the research and expected length of participation Participation is voluntary, and opting to not participate at all or discontinuing participation will not result in any penalty to the subject whatsoever Procedures involved in the research, distinguishing those which are experimental and disclosing any appropriate alternative procedures or courses of treatment, if applicable Any potential risks/discomfort and any potential benefits the subject may experience as a result of participating in the research If applicable, confidentiality of records identifying the subject will be stored and, in the case of FDA-regulated research, that the FDA may inspect those records Contact information for the subject to use for any questions about the research, the subjects’ rights, and injuries resulting from research For greater-than-minimal-risk research, information on any compensation or medical treatments available to the subject if they experience an injury as a result of participation For research involving collection of identifiable private information or identifiable biospecimens: • That the subject’s information or biospecimen collected as part of the research will not be used or distributed for future research, regardless of removal of any identifiers, or • That the subject’s identifiers might be removed from private information/biospecimen, after which point the subject’s information/biospecimen could be used for future research without additional informed consent from the subject

What happens after IRB approval?

Ensuring Ethical Conduct of Research

Your study activity can begin after the IRB performs their initial review and approves your research. There are other key moments throughout your research that will require you to submit additional documentation. Changes to the study (e.g. change in personnel, protocol, procedures, risk/benefit ratio, etc.) need to be communicated to the IRB in the form of a modification or amendment. This amendment is reviewed by the IRB as either a full board review or expedited review depending on the extent and nature of the changes. On a regular basis (usually annual), your study may require a continuing review by the IRB. This type of review updates the IRB on the progress of the study and ensures compliance with ethical research principles. It may require full board or expedited review. In some cases, the requirement for continuing review may be waived for minimal risk studies and studies for which data collection has been completed.

Striving to guide the field of research toward safer and morally sound practices through formalized rules and regulations, IRBs are a necessary result of difficult lessons learned through a history of discriminatory and ethically inadequate study conduct. Institutional review boards play a number of roles in their objective to protect individuals who are participating in research. Understanding how to navigate the processes involved is a relevant skillset for any researcher who wants to implement ethical study design principles. This article provides a brief overview of an IRB and scenarios that you may commonly encounter. Consult your institution’s IRB for in-depth detail about their research guidance. References Amdur R and Bankert EA (eds). Institutional Review Board Member Handbook. 3rd ed. Sudbury, MA: Jones and Bartlett Publishers; 2011.

www.papharmacists.com 37


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