Pennsylvania Pharmacist May/June 2017

Pennsylvania May/June 2017 z Volume 98 z Issue 3

The official publication of the Pennsylvania Pharmacists Association

Pennsylvania Pharmacists Networked in San Francisco at the APhA Annual meeting!

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CONTENTS On the Cover APHA’s Annual Meeting and Exposition

Our Vision

On March 23–27 in San Francisco, California, attendees were given the chance to network and reconnect with APhA conference attendees!

Our Mission

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as healthcare providers.

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.

DEPARTMENTS 5 Calendar of Events 7 President’s Message 8 Welcome! New Members 10 Campus Checkup

features 12 Member Profile 13 Student Member Profiles 14 Pharmacy Spotlight 16 PPA Educational Foundation Grant Final Report ssociation news a 17 Member News 18 Important Message — PPA Elections for 2017–2018 19 PharmPAC Support Needed 21 Affiliated County News 22 Congratulations to the 2017 PPA Graduating Students 38 Call for 2018 PPA Educational Foundation Grant Applications

INDUSTRY news 25 Rx and the Law — Indemnification 26 Retirees Should Have Spending Plans 26 PRS Pharmacy Services Partners with the National Community Pharmacists Association (NCPA) 28 How to Survive a DEA Inspection Series 29 New Online Fall Prevention Training for Pharmacists 30 APHA’s Annual Meeting and Exposition 31 Dr. Daniel A. Hussar, Ph.D. Recognized by the Philadelphia College of Pharmacy/University of Sciences 32 Legislator Profile 33 Editorial Review Board 34 PPCN Contract Update 36 PPA’s Legislative Priorities

PPA Board of Directors PPA Officers President: Eric Pusey, RPh President Elect: Nicholas Leon, PharmD, BCPS, BCACP Vice President: Lauren Simko, PharmD Immediate Past President: Donna Hazel, RPh Regional Directors Central Region: Robert Killoran, RPh Northeast Region: Thomas Franko, PharmD, BCACP Northwest Region: Nickolas Kernich, PharmD Southeast Region: Mark Lawson, PharmD, MBA Southwest Region: Cory Krebs, RPh Practice Directors Academia: Roshni Patel, PharmD Community-Independent/LTC: Stephanie Smith Cooney, PharmD Community Independent/LTC: Chuck Kray, RPh Chain Pharmacists: Stephen Pfeiffer PharmD, MBA Health System Pharmacists: Richard Demers, RPh, MS, FASHP Managed Care/Government/Industry and Other: Julene Vidic, RPh Associates: Greg Drew, RPh

Student Directors East: Rachel Von Vital West: Marissa Badzik PPA Office Staff CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Program Manager: Sara Powers spowers@papharmacists.com | Ext. 2 Government Relations Manager: Jeff Stuby jstuby@papharmacists.com | Ext. 6 Communications Coordinator: Danielle Adams dadams@papharmacists.com | Ext. 1 Membership Coordinator: Ashley Robbins arobbins@papharmacists.com | Ext. 5 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Manager: Mindy Kozminski, PharmD, BCACP mkozminski@papharmacists.com PPCN Trainer: Brandon Antinopoulos, PharmD ppcntrainer@papharmacists.com

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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 Olufunmilola Abraham, PhD, MS, BPharm Hershey S. Bell, MD, MS, FAAFP Kim Coley , FCCP, PharmD, RPh Bernard Graham, PhD Michael Gionfriddo, PharmD, Ph.D Associate Editor: Danielle Adams Editor/Manager: Pat Epple

Designed and Published

by Graphtech Sarah DiCello, Publications Manager (717) 238-5751 x118 sarah@thinkgraphtech.com For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 x119 alexis@thinkgraphtech.com Pharmacist State Board of Pharmacy Members Institutional: Gayle Cotchen, BSPharm., PharmD., MBA Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Independent Community: Mark J. Zilner, RPh Board of Pharmacy Meeting Dates: May 31, 2017 July 11, 2017 August 22, 2017 October 3, 2017

Pennsylvania MAGAZINE

papharmacists.com | ppa@papharmacists.com |

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CALENDAR OF EVENTS | ADVERTISERS INDEX

MAY 7–9

8–10

JUNE

SEPTEMBER

NASPA Leadership Conference Rockville, MD

3–7 ASHP Summer Meeting Minneapolis, MN

15–17 ACCP Annual Meeting San Diego, CA

NCPDP Annual Conference Scottsdale, AZ

JUly

11–12 Pharmacy Law Review Philadelphia College of Pharmacy 20–23 National Association of Boards of Pharmacy Annual Meeting Orlando, FL

21–24 PPA Annual Conference 2017 Kalahari Resorts – Pocono Manor, PA

10–11 PPA Leadership Retreat and Board Meeting State College, PA 15–19 AACP Annual Meeting Nashville, TN

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 PRS Pharmacy Services – 2 IPBG – 4 LECOM – 6 Bowl of Hygeia Award Recipients – 9 S&L Solutions LLC – 12 Hayslip & Zost – 15 Thomas Jefferson University Jefferson College of Pharmacy – 16 RJ Hedges & Associates – 20 Value Drug Company – 24 The Keystone Pharmacy Purchasing Alliance – 27 HD Smith – 33 Pharmacist Mutual – 35 McKesson – 37 Smart-Fill – 39 RDC – Back Cover 

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PRESIDENT’S MESSAGE

PPA is a movement!

A movement is sometimes described as a grass roots effort or as a groundswell of activity toward a specific goal. PPA is a Movement! PPA will begin celebrating its 140th anniversary in 2018 with an official kickoff at this year’s Annual Conference being held at Kalahari Resort in the Pocono’s this September. PPA began as a small group of like-minded individuals dedicated to their profession of pharmacy and the advancement of pharmacy practice in Pennsylvania.

PPA will be sharing our history, our mission, our professional advocacy and legislative interventions over the past 140 years.

Stay tuned, as it will be quite a trip down memory lane. The movement continues today with an even greater sense of urgency and commitment. PPA is all about

the profession and all of our legislative success and advancements in pharmacy to date can be directly attributed to the grass roots efforts of our organization. Almost every aspect and branch of pharmacy practice is represented in our committees, our officers, our Boards of Directors and our student members.

I would like to personally thank the Executive Officers, our Boards of Directors, our committee members, CEO, Pat Epple and her exceptional staff for everything that you all do for the betterment of our Pharmacy Profession. Please do remember to “HELP KEEP PHARMACY GREAT AGAIN.” 

As has been said before our healthcare system in the state and nationally is changing and looking nationally it’s obvious how quite challenging it can be to make positive change happen. Advancing our healthcare system and specifically our pharmacy practice in Pennsylvania will be successful as long as the “movement” continues. We will succeed because of the dedication and perseverance of our members.

Eric M. Pusey, R.Ph, CDE PPA President 2016–2017

Students Interested in Pharmacy Ownership Attend NCPA this fall on us!

Sponsored by PPA’s Special Interest Group (SIG) for Independent Pharmacy Receive an expense paid trip to attend the NCPA (National Community Pharmacists Association) Annual Convention

October 14–18, 2017 Orlando, FL The Pennsylvania Pharmacists Association SIG will present up to four students with grants covering the related expenses for attending the NCPA Convention: (provided certain requirements are met!)

4 1 roundtrip plane ticket 4 Up to 4 nights hotel accommodations (room and tax) 4 Student registration at student member rate 4 Up to $200 in meals and incidentals such as tolls and parking at the hotel, (receipts and an itemization must be submitted). These must be in accordance with the expense reimbursement policy. *Expenses are reimbursed subject to the completion of several criteria and attendance at the meeting.

Qualifications: • 5th or 6th year* pharmacy student enrolled at a Pennsylvania School of Pharmacy • Pennsylvania resident • PPA Student Member • Must not have previously received this grant • Interest in Community Pharmacy particularly Independent Pharmacy

*or equivalent of last two professional years More information and the application may be found at: http://www.papharmacists.com/SIGNCPA www.papharmacists.com • 7

WELCOME! NEW MEMBERS

PPA Welcomes the following New Members who joined the association on February 2, 2017 – March 24, 2017. Please make these new members feel welcome and part of Pennsylvania pharmacy!

Pharmacists Caterina Briglia, Emmaus, Sears Holding Corporation Adrienne Cervone, Industry, Beaver Health Mart Pharmacy Lauren DelVecchio, Bethlehem, Walgreens Sarah Donnelly, Philadelphia Jennifer Fay, Corry, Rite Aid Mary Ellen Giordano, Mechanicsburg Scott Kuhn, Perkasie, Giant Suzanne O’Donnell, Quaketown, Professional Pharmacy Ralph Pater, New Kensington, PCA Mission Pharmacy Danielle Perfetti, Clifton Heights, Hospital of the University of Pennsylvania Valley Forge Pharmacy Sharon Rosal, Collegeville Samuel Sebastianelli, Dunmore, Health Systems and Solutions Molly Shirey, Pittsburgh, UPMC Falk Pharmacy Pharmacy Technicians Kim Buzzendore, Columbia, Walmart Matt Glotzbach, Burgettstown, Walgreens Specialty Pharmacy Barbara Parsons, Enola, Cumberland Apothecary

Kellie Sadler, Bethel Park, Med-Fast Pharmacy Marie Sleigh, Gatti Pharmacy Felix Yemetey, Philadelphia, Sankofa Pharmacy Associates Sharon Norris, Dallas, Self Health Students Duquesne University – Mylan School of Pharmacy Matthew Cippel, Ford City Emily Fardo, Pittsburgh Rachael Gerstein, Wayne Timothy Heath, Osceola Mills Katherine Hilton, Mechanicsburg Elizabeth Leonard, Sewickley Anna-Corrine Lobas, Pittsburgh Brenna Moriarity, Pittsburgh Lisa Mutooni, Pittsburgh Briana Schreckengost, Creighton D’Youville College Zethan Koch, Martinsburg Jefferson School of Pharmacy Nicholas Paulson, Wilmington

LECOM School of Pharmacy Lauren Bobby, Erie Tzveta Bradley, Erie Kelli France, Randolph Tommy Nguyen, Erie Julia Sporer, Franklin University of Pittsburgh Michael Cikovic, Pittsburgh Kirsten Coyle, Johnstown Eryn Gordon, Pittsburgh Matthew Haupt, Pittsburgh Eric Jenkins, Mountain Top Kimberly Lui, Fort Washington Anish Patel, Mission Viejo Michael Pinto, Bensalem Max Prokopovich, Imperial Seth Stahl, Pittsburgh Michael Udovich, Pittsburgh Lauren Woolley, Pittsburgh Benjamin Yoder, Nescopeck Philadelphia College of Pharmacy Wen Kong, Philadelphia Morgan Lorrilliere, Voorhees 

2016 Recipients of the “Bowl of Hygeia” Award

Buddy Bunch Alabama

John Cotter Alaska

Carl Labbe Arizona

Jon Wolfe Arkansas

Fred Mayer California

Randy Knutsen Colorado

Ernie Mrazik Connecticut

Pat Carroll-Grant Delaware

Armando Bardisa Florida

Hugh Chancy Georgia

Marcella Chock Hawaii

Joyce Fogleman Illinois

H. Christian Johnson Indiana

Ken Anderson Iowa

David Schoech Kansas

Ron Poole Kentucky

Marty McKay Louisiana

Roberta Brush Maine

Ellen Yankellow Maryland

Diane Martin Massachusetts

Geri B. Smith Michigan

Linnea Forsell Minnesota

Robert Salmon Mississippi

David Eden Missouri

Tobey Schule Montana

Adam Porath Nevada

John V. Mini, Jr. New Hampshire

Stephen Brickman New Jersey

Jack Volpato New Mexico

Mike Duteau New York

Joseph Moose North Carolina

James Carlson North Dakota

Marialice Bennett Ohio

Greg Huenergardt Oklahoma

Ann Murray Oregon

Gayle Cotchen Pennsylvania

Francisco Javier Jiménez Puerto Rico

Heather Larch Rhode Island

Dan Bushardt South Carolina

Curt Rising South Dakota

Ronnie Felts Tennessee

Nathan Pope Texas

Gerald Petersen Utah

Alex Wiatt Virginia

Nanci Murphy Washington

The “Bowl of Hygeia”

Patricia Noumedem Washington DC

Robert Stanton West Virginia

James Olson Wisconsin

Jaime Hornecker Wyoming

The Bowl of Hygeia award program was originally developed by the A. H. Robins Company to recognize pharmacists across the nation for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks for their high example. The American Pharmacists Association Foundation, the National Alliance of State Pharmacy Associations and the state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia by emailing current contact information to awards@naspa.us. The Bowl of Hygeia is on display in the APhA Awards Gallery located in Washington, DC. Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program.

CAMPUS CHECKUP

Duquesne University Contributed by: Danielle Taciuch, Communication Ambassador Duquesne continued to stay busy in the spring semester with numerous activities and fundraising events across the many pharmacy organizations. PPA has been busy electing a new executive board for next year, as well as participating in Legislative Day and performing Tanita Body Composition Screenings there. PPA has also been busy working with the local YMCA to hold more presentations on healthy lifestyle choices.

APhA-ASP had their Annual Auction in March, in which they were able to raise money for their organization and auction some great prizes for students and professors. Some of these prizes included Pittsburgh Pirates Tickets, Escape Room Pittsburgh tickets, and free coffee delivery for professors.

APhA and PPA also came together back in March to hold a “State of the Union Viewing Party” fundraiser in support of APhA’s “Back the PAC” initiative.

Other pharmacy organizations have been busy with fundraising events, welcoming new members, and continuing to advocate for our profession!

Jefferson Contributed by: Gianna Girone, Communication Ambassador Since our last update, our organizations have been busy planning and executing events for our students! Our PPA chapter attended Legislative Day on April 19th, where we had a strong outpouring of Jefferson students present to talk to legislators. We’re proud that our student voice matters to our legislators, and that they are willing to meet with us to discuss our thoughts on the future of pharmacy.

Our PPA chapter also planned an emergency preparedness seminar where students learned skills to use as future pharmacists in disaster situations.

Our APhA-ASP chapter planned a panel discussion in collaboration with Be a Part of the Conversation on the substance misuse epidemic and how its increased presence 10 • Pennsylvania Pharmacist • May/June 2017

Jefferson Operation Heart committee members at Walgreens conducting blood pressure checks and counseling sessions is shifting the nation’s conversations about prescription drug. Also within APhA-ASP, members of our Operation Heart committee set up a booth at our local Walgreens to conduct blood pressure checks and counseling sessions with shoppers. We had a great turn out, and many customers were appreciative of the heart healthy advice we could give.

As always, we are so proud of all the events our students have participated in this semester, and we can’t wait to host more in the upcoming future!

LECOM Contributed by: Ashley Freeman, Communication Ambassador LECOM successfully completed their Script Your Future Campaign.

This campaign included various student held health fairs at multiple locations around Erie.

One health fair focused on underserved and multi-cultural populations, which included many patients whose primary language was not English. Pharmacy students who spoke Spanish, Arabic, French, and several African languages were available as translators to

communicate with patients. We used their language abilities to communicate with patients as to why they may not be adherent to their medications.

Students provided blood pressure screenings at local churches and handed out pamphlets to the public to stress the importance of monitoring chronic medical conditions.

LECOM pharmacy students, in collaboration with dental students, presented educational information to patients and talked to parents and children about dental hygiene. This stimulated the importance of proper dental hygiene, while showing children how it is important to prevent the spreading of germs.

In addition, LECOM pharmacy students, in collaboration with the local health department, are continuing their efforts in the national “Check. Change. Control.”

Campaign. This campaign is intended to combat heart disease in poor populations of African Americans in the Erie area.

LECOM pharmacy year 1 students will be completing their first year of school at the end of April. Following this, they will be preparing to go on IPPE rotations over the summer. Pharmacy year 2 students will be continuing their didactic work through August. Following this they will then go off on their APPE rotations.

Ohio Northern University Contributed by: Katherine Platt, Communication Ambassador Secretary Ohio Northern University welcomed Larry J. Merlo, President and Chief Executive Officer of CVS Health for the annual Sebok Pharmacy Lecture on February 16th. At the conclusion of the presentation, Mr. Merlo presented the ONU College of Pharmacy with a corporate grant of $50,000 to support the ONU HealthWise mobile clinic, which features comprehensive smoking cessation programming, in addition to primary care services for the rural Hardin County region.

In March, 400 future students visited campus for Orange and Black Day. Current pharmacy students showcased their involved in pharmacy organizations and outreach programs for potential students and their families.

Our chapter of PPA held officer elections for the 2017-2018 school year on March 15th and we are looking forward to our second year as a chapter of PPA. In other exciting news, the ONU AMCP Pharmacy and Therapeutics team represented ONU at the national competition on March 28th.

Finally, ONU took time to recognize individual academic and extracurricular achievements at Honors Day on April 4th and celebrated the success of our pharmacy organizations at the second annual Phi Lambda Sigma awards banquet.

University of Pittsburgh Contributed by: Nicolette Diehl, Communication Ambassador As our spring semester comes to an end, our pharmacy students are preparing to transition into the next academic year. This article will serve as a small recap of this year and highlight some of Pitt’s biggest moments during the 2016-2017 term.

Our school year opened with our annual Back to School Picnic to welcome in the incoming P1 class and invite them to participate in our student organizations In October, five student organizations including APhA, LKS, PPA, SCCP, and SnPha hosted the first annual Rock the Block event in Squirrel Hill. The event served to educate the community about diabetes, which was this year’s Dean’s Theme. Together we talked to over 2,000 community members about different aspects of diabetes.

In January, our Pharmacy Weeks concluded with the annual White Coat Ceremony for the P1 class. P1 students invited their friends and family to the ceremony and can officially wear their white coats.

In March, many of our students including those in the CLIP Area of Concentration and APhA E-board made the trip out to APhA Annual in San Francisco, California.

These students attended many student programming sessions and presented posters on their research projects.

Currently, our current P4 students are approaching graduation and starting their jobs, residencies, and fellowships. We have had another successful year at Pitt and we are excited to see what next year brings us!

Wilkes University Contributed by: Kayla Bardzel, Communication Ambassador After a thrilling beginning to the Spring semester, Wilkes PPA continued on their Katy’s Kids marathon with more events through March and April. These events were promoted on our Facebook page to show our audience everywhere we have been taking the program.

Our main focus through these months was preparing for Legislative Day on April 19th. Felicia, our Government Relations Ambassador, has been getting our chapter ready and prepared by holding Legislative Day information sessions and teaching everyone about PPA’s priority legislative issues, so we were prepared when we talked to our legislators. We currently have seven members on their way to completion of the GRASP program.

In April, we were excited to collaborate with our APhA-ASP chapter at Wilkes to bring Eric Pusey in as a guest speaker. Our chapter loves to bring PPA’s influential and well-known leaders to discuss with us the evolving nature of our profession.

As we are closing out the end of the semester, this leads to the election of a new executive board for our chapter. Our 20162017 board loved serving the Wilkes PPA chapter and we can’t wait to see what the new board will do. Best of luck to them for next year! 

University of Pittsburgh students receiving their white coats

www.papharmacists.com • 11

FEATURE ARTICLE

MEMBER PROFILE

Capt Benjamin R. Beidel, USAF

Chief, Satellite Pharmacy Element JBSA-Lackland

Capt Benjamin R. Beidel, USAF Chief, Satellite Pharmacy Element JBSA-Lackland

What made you choose the profession of pharmacy?

When you are not working, where can you be found?

I was really interested in the biochemistry of the body and “miracle” of modern medicine, when I was in high school. Then I made it to Biochemistry in college, and that changed fast. I found that I absolutely fell in love with clinical interaction and engaging directly with patients in a non-retail environment. In the process of my work in the Air Force, I’ve found a great joy in the development and implementation of new technology, and working more as an “engineer”, improving processes and focusing on making my team’s lives easier and improving patient safety. I truly appreciate the flexibility that pharmacy has to offer!

Traveling and hiking. I get the opportunity to travel for work and for play. I’ve been able to see some interesting parts of the country. My favorite trip from this year was a trip to Sequoia and Kings Canyon National Park. Spent the 4th of July weekend, camping and hiking with good friends. 2017-2018 will be an adventure in its own right, as I move to South Korea and explore Asia for a year!

Where would you like to see the profession go in 10 years?

Obviously, I’d like to see pharmacists recognized as providers, but more importantly, I’d like to see pharmacists in a position where they are providing extreme value to the health care system. Continued integration into the healthcare team, helping the team make informed evidence based decisions, and an admission that sometimes, a medication isn’t the right answer. (Blasphemy, I know) Let’s get out there and help people live longer, happier, healthier lives!

Who has been the biggest influence in your life?

What a difficult question! Pharmaceutically speaking, The Ference’s changed my life. Kim helped ignite my passion for pharmacy again, when I was thinking about quitting. Jon provided more education on “real life” than the rotation we were on. He helped me to learn a lot about how I wanted to practice pharmacy, and I’ve gained a great mentor from my time with him. I owe them both a great deal.

Personally, my parents. Both of my parents are selfemployed go-getters. My Dad works hard every day to run his dairy farm and Mom has built her own business from the ground up. They’ve taught me the importance of hard work and determination, and without them, I wouldn’t be where I am. 

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FEATURE ARTICLE

STUDENT MEMBER PROFILES Dana Achenbach Why did you choose to study pharmacy?

I have always had a passion for helping people and when two of my family members were put on medications for their heart conditions, I just had to know how they worked. Becoming a pharmacist was the perfect choice for me.

Dana Achenbach, Wilkes University University PharmD Candidate, 2018

If you were not studying pharmacy, what would you be doing?

If I were not studying pharmacy, I would be studying to become a high school chemistry teacher.

Where do you see yourself in five years?

In five years, I see myself working in a pediatric hospital as a clinical pharmacist.

What is the best advice you’ve ever received?

There are only two things you can control: your effort and your attitude.

Why did you choose to become involved in PPA?

Benson Aningalan, Jefferson College of Pharmacy PharmD Candidate, 2017

I chose PPA because I wanted to get involved on a state level and see first-hand what impact we can have on our local communities through our advocacy efforts.

“I found that going to the gym or watching a movie to refresh my mind helped me regain my energy and motivation to succeed throughout pharmacy school.”

Benson Aningalan If you were not studying pharmacy, what would you be doing?

I would be studying agriculture and expanding my family’s business. For many generations, agriculture has been a major staple for my family in the Philippines. My family has depended on these crops as a source of food and income for many years. I would have probably brought the education that I learned in the United States back home to help expand our business. I am very proud of my family’s accomplishments and hope to assist in maintenance of our business once I graduate pharmacy school.

What advice would you give to first year pharmacy students?

To treat yourself every once in a while and do something that you enjoy. Juggling pharmacy school, work and being active in pharmacy organizations can be stressful at times. However, I would go to the gym or watch a movie to help clear and refresh my mind. I found that these methods helped me regain my energy and motivation to succeed throughout pharmacy school.

When you aren’t working, where can you be found?

I would probably be spending time with friends and family. As time goes on everyone becomes busy with life and their career that having free time becomes rare. I have found to cherish the times that I spend with my friends and family because you may never know when you will see them again.

If you could have dinner with any person, living or dead, who would it be?

Definitely retired basketball player: Shaquille O’Neal.

The man had a very accomplished NBA career and is very entertaining to watch on TV either playing or commenting on the game. Additionally, he is a very successful businessman with many investments. Did you know that he owns over 150 Five Guys franchises?

Having dinner with someone who is over 7-feet and 300 pounds, the food will surely be delicious and never end! 

— Benson Aningalan

www.papharmacists.com • 13

FEATURE ARTICLE

PHARMACY SPOTLIGHT

Custom Prescriptions of Lancaster Puts a Whole New Spin on Pharmacy By: Shaina Kulp, PharmD, Williams Apothecary This article was contributed while Shaina was on rotation with PPA. Owned and operated by Diane Boomsma, PharmD, Custom Prescriptions of Lancaster gives individualized care a whole new meaning. They specialize in compounding pharmacy, customizing prescriptions to meet the needs of their patients.

Diane graduated from Duquesne University School of Pharmacy and later received her PharmD from the Bernard J. Dunn School of Pharmacy at Shenandoah University.

Before starting her career in compounding pharmacy, she worked in hospital pharmacy, community chain pharmacy and independent pharmacy, often working in more than one pharmacy setting at a time. Once she realized her passion for compounding, she concentrated her efforts on that area of pharmacy and received

special training in that field.

After working in compounding pharmacy for 20 years, Diane opened Custom Prescriptions of Lancaster in 2007. She has since grown the pharmacy to serve a variety of patients in her area. She employs 15 pharmacy technicians and has recently hired a new pharmacist, Lauren Bisonic, to provide care for even more patients. Diane has also been honored as a full Fellow in the International Academy of Compounding Pharmacists (IACP).

Custom Prescriptions of Lancaster however, is not your typical compounding pharmacy and offers a large variety of unique services. The facility is equipped to compound both non-sterile (USP 795) and sterile (USP 797) preparations to treat a multitude of disease states.

“Organizations like PPA give pharmacists a voice on the state and national levels. It is important for pharmacists to stay current and to always be on their game; there is no room for error. New practitioners need to make themselves as marketable as possible, and be different. ” — Diane Boomsma A large amount of the sterile compounds that they prepare are opthalmics, injectables, and irrigations, which can be challenging for patients to find outside of a hospital setting.

Due to these challenges for patients, Custom Prescriptions of Lancaster specializes in areas like adrenal dysfunction/ thyroid imbalance, hormone replacement therapy, pain management, dentistry, podiatry, pediatrics, and wound care just to name a few.

Also, a unique patient population that the pharmacy serves are veterinary patients and actually about half of the non-sterile prescriptions that are compounded there are for a diverse population of animals.

The majority of their veterinary patients are pets like dogs, cats,

14 • Pennsylvania Pharmacist • May/June 2017

and horses, but they have also compounded prescriptions for some more unique veterinary patients like turtles, snakes, ferrets, and even monkeys.

Another important service that Custom Prescriptions of Lancaster offers to patients is one-on-one counseling. These patient counseling sessions are appointment only and by referral from the patient’s physician. Diane has a close working relationship with many of the local physicians and collaborates with them to provide the best care for her patients. She also has similar strong working relationships with local veterinarians to serve a sometimes overlooked population. Custom Prescriptions of Lancaster bases their care around the model of caring deeply for patients, delivering quality care without compromise, serving alongside other healthcare professionals, collaborating as a family, and empowering each other.

Although running your own compounding pharmacy is hard, Diane believes that one of the biggest benefits is that there is a lot more flexibility for her and her employees and that she can basically make her own schedule. She also enjoys that she has “total freedom” to determine how to best service her patients. However, running a compounding pharmacy is not without its challenges and Diane identifies that one of her biggest obstacles besides all of the regulations that accompany compounding, is that she is totally in control of every aspect of running the pharmacy.

In addition to running her own pharmacy, she is involved in organizations like the Pennsylvania Pharmacists Association where she identifies the importance of pharmacy advocacy. She believes organizations like PPA give pharmacy and pharmacists “a voice” on the state and national levels.

Diane has undoubtedly accomplished a lot in her

pharmacy career and had some great advice to give to other pharmacists. First and foremost, she said it is important to “stay current and stay active” because there is new information to learn every day. Pharmacists also need to “always be on their game, there is no room for error.” And last but not least, Diane advises all pharmacists, especially new practitioners to “make yourself as marketable as possible and be different.”

As many have seen, the profession of pharmacy is always growing and changing and one particular area of pharmacy that has seen substantial growth is individualized care. Fortunately, Custom Prescriptions of Lancaster has been at the forefront of this growing field. Diane and her staff use technology, years of education and experience, and a love of compounding pharmacy to deliver the highest quality individualized care to their patients. 

www.papharmacists.com • 15

FEATURE ARTICLE

PPA EDUCATIONAL FOUNDATION GRANT FINAL REPORT

Appropriate Antimicrobial Selection in Dental Practice Natalie Kokta, PharmD Candidate 2017, Anthony J. Guarascio, PharmD, BCPS, Autumn Stewart, PharmD, BCACP, CTTS This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2016. This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation Section — Programs — Grant Program — 2016. | http://www.papharmacists.com/FBOD_Grants16.

Introduction Antibiotics are one of the most commonly prescribed medications; with over half of the time not being prescribed optimally, leading to inappropriate prescribing practices and use.1 Irrespective of health care professionals’ specific discipline, interprofessional collaboration has been designated by The Institute of Medicine as one of the five core competencies that every health care professional should meet.5 Pharmacists have the unique opportunity to influence the use of antibiotics through collaboration with a variety of healthcare professionals, including dentists. Dental practitioners prescribe medications for many oral conditions, primarily orofacial infections.

Antibiotics are the most commonly prescribed medications in dental practice due to the frequency of odontogenic infections.2,3 Most odontogenic infections do not warrant antibiotic use and only require debridement along with an analgesic.2 Antibiotic use for odontogenic infections is only warranted when there is evidence of systemic infection. Likewise, prophylactic antibiotic use for dental procedures is not recommended unless the patient’s history warrants use (i.e. patients with structural heart disorders are at an increased risk for endocarditis post procedure). Various studies have demonstrated that antimicrobial prescribing habits in dental practice often include inappropriate selection, frequency,

and duration,3,4 and that patient expectations can influence the unnecessary use of antibiotics.3,5 Improving antibiotic prescribing practices and increasing antimicrobial stewardship is one of the core actions to fighting antimicrobial resistance per the Centers for Disease Control and Prevention.1

Objectives The objective of phase 1 of this project is to assess the baseline antimicrobial knowledge and attitudes of dental providers. Using these findings, the objective of phase 2 is to assess the impact of a pharmacist-led intervention on dental providers’ knowledge and attitudes towards appropriate antibiotic prescribing and use. 

ELEMENTS of Success Re

Af

Cn

Lo

Reputation

Affiliation

Connections

Location

Jefferson College of Pharmacy is recognized as an emerging force in the future of Pharmacy education. We prepare students to be leaders, as demonstrated by victories in ASHP, APhA and ACCP student pharmacy competitions. Our grads have an aboveaverage pass rate among all who take national boards. And, it’s happening just steps from the best Center City Philly has to offer. These are contributing elements to our success.

explore.Jefferson.edu/Pharmacy 16 • Pennsylvania Pharmacist • May/June 2017

ASSOCIATION NEWS

MEMBER NEWS Did You Know ...

Pharmacist members now have the option to pay their PPA dues in convenient, low monthly payments! Sign in to PPA’s website when it’s time to renew your membership and check the box for Pharmacist Dues — Monthly Installment Plan. Never worry about renewing your membership again!

Shawn Nairn, opened Acorx, a pharmacy that packages a week’s worth of medicine for patients who have trouble keeping track of their prescription drug regimen, then delivering the pre-filled pill packets to the patient. The packet is divided into pockets of pills that are to be taken in the morning, noon and at night. For more information visit post-gazette.com and search “Carnegie pharmacy tries to write new script for convenience, safety” ACPA President and PPCN Trainer, Brandon Antinopoulos and wife, welcomed baby Owen Charles on March 2nd.

Congratulations to Brandon and family!

Donna Hazel, PPA Past President, received the Distinguished Alumni Award from Duquesne University and Gayle Cotchen received the Alumni Achievement Award!

Karen Pater, Emily Kryger, Emily Fargo and John Chang met with Senator Casey in support of the Pharmacy and Medically Underserved Areas Enhancement Act, S. 109. This act encourages pharmacists to offer health care serves such as health and wellness screenings, immunizations and diabetes management by authorizing Medicare payments for those services where pharmacists are already licensed under state law to provide them.

The following PPA members have supported NCPA for over 50 years: Joseph Bechtel, Ralph Bertolino, William Ferri, Joseph Mosso, and Thomas Stonesifer! 

www.papharmacists.com • 17

ASSOCIATION NEWS

Important Message — PPA Elections for 2017–2018 PPA Online Voting is now open!

Your vote is important and we encourage members to cast your vote for the individuals you wish to represent you and the pharmacy profession.

Your vote is confidential and the system is tied to only allow an eligible person to vote only one time and only for appropriate positions on the ballot!

To cast your vote — here is what you need to do: 1 Go to this website: https://vote.associationvoting.com/ppa/ 2 Login by entering your last name and member ID that were emailed to you — or contact Ashley Robbins at the PPA office if you have misplaced these. Her email is arobbins@papharmacists.com or phone is 717.234.6151 extension 105 3 Review the candidate options for the categories in which you are entitled to vote (see below), check your selected candidates, and cast your ballot!

4 Please note that ballots MUST be cast before midnight on May 12.

Voting is open beginning now and will continue until Midnight on May 12, 2017. At which time, shortly thereafter the Nominating Committee will certify the results.

Your ballot will be matched to your ID and Last name, so you will only be able to vote for the offices for which you are entitled. However, if you believe there is an error in the options you have — do not cast your vote, exit, and please contact us. If you have any problems in doing this or have any questions, please contact the PPA office at (717) 234-6151 and speak with either Ashley Robbins or Pat Epple. Or email one of these individuals at arobbins@papharmacists.com or pepple@ papharmacists.com.

Any member who prefers to receive a paper ballot, may do so by contacting the office, prior to April 30, 2017 and we will send you one which will need to be returned by May 12.

The following elections are scheduled for this year and the Nominating Committee announces the candidates for each: Please note that in some cases these positions have more than one candidate. Please carefully review their brief biographical information available on-line at the voting site, to aid you in selecting the best candidate to represent you, the profession, and PPA! In ALL Cases, you can also submit a write-in vote.

PPA Officers: (All of the following are for one-year terms) (Only active pharmacist categories of membership vote for these positions) President-Elect – Lauren Simko, PharmD First Vice President – Richard Demers, RPh, MS, FASHP, or Chuck Kray, RPh PPA Board of Directors: (All are for two year terms) (Only members of the respective practice setting may vote for the Director by choosing one) Director – Academia – Brandon Antinopoulos, PharmD or Nicole Pezzino, PharmD Director – Community Independent – Chuck Kray, RPh Director – Health Systems – Richard Demers, RPh, MS, FASHP or Darryle Tillman, RPh (Only pharmacist members of the respective region may vote for the Director by choosing one) Director – Northwest Region – Nickolas Kernich, PharmD Director – Southeast Region – David Stone, PharmD

18 • Pennsylvania Pharmacist • May/June 2017

PPA Student Advisory Board (SAB): (Only student members cast their vote for these and only select one in each category: PPA Director East – Anthony Fanucci, Jose Fernandez, Amandeep Kaur, or Matthew McGuire PPA Director West – Christina Schuler or Sally Habusta Foundation Director – Katie Bova, Sophia Cothrel, Matthew McGuire, or Felicia Snyder Chair – Colleen D’Amico, Jose Fernandez, or Sally Habusta Vice Chair – Dianna Arndt, Sarah Bova, Jamie Celento, or Oxana Placinta Corresponding Secretary – Kayla Bardzel or Shannon Ye Recording Secretary – Amanda Schwenk Allegheny County Pharmacists: (Only ACPA members may vote for these positions.) (Choose one) ACPA President Elect – Angelo Greco, PharmD ACPA Vice President – Nicholas Wytiaz, PharmD ACPA Secretary – Corinn Floyd, PharmD

ACPA Treasurer – Renee Richardson, PharmD ACPA Director (Choose 2): Elizabeth Bunk, PharmD, or Katherine Sulkowski, PharmD BucksMont Pharmacists: (Only BMPA members may vote for these positions) President – Steve Pfeiffer, PharmD, MBA Vice President – Rob Frankil, RPh Treasurer – Dave Cunningham, RPh Secretary – Scott Himler, RPh Event Manager – Vacant BMPA Director – (Bucks County) (Choose one): Charlie Palilonis, RPh or Alan Vogenberg, RPh BMPA Director – (Montgomery County) (Choose two): Jan Kitzen, PhD, RPh or John Gatto, RPh Lehigh Valley Pharmacists: (Only LVPA members may vote for these positions.)

LVPA Director (Choose two): Erin Fitzgerald, PharmD or Pauline Vargo, RPh

We need your support of PharmPAC! By simply completing this form and sending in your contribution - you are providing PPA with the resources it needs to advance our legislative efforts. We need your support to help us stay in front of lawmakers on many key issues that are important to you! Need a few reasons why you should contribute? For 2017, PPA is making a strong push to: • Oppose the unfair proposals that would cut pharmacy Medicaid and PACE reimbursement • Expand pharmacist-provided immunizations opportunities for all vaccinations to patients nine years of age and older • Support medication synchronization to coordinate medication refills • Establish guidelines for pharmacy technician registration You can make recurring credit card payment contributions, a single credit card contribution, or a one-time check contribution. Please note we accept MasterCard, Visa, or Discover. o Monthly Contribution — Please charge my credit card every month in the amount of $ o Single Contribution — Please charge my credit card one time in the amount of $ Name as it appears on card: Credit Card Number:

Exp. Date:

/

CC Billing Address: Security Code:

(on back of card)

BY SIGNING BELOW, I PERMIT PPA TO DEDUCT THE IDENTIFIED AMOUNT FROM THE INDICATED CREDIT CARD: (Signature)

(Date)

Credit card contributions may be faxed to PPA at 717-236-1618. Check contributions are to be made payable to PharmPAC and mailed to PA Pharmacists Assn, 508 North Third Street, Harrisburg, PA 17101-1199.

www.papharmacists.com • 19

ASSOCIATION AFFILIATED NEWS COUNTY NEWS

Allegheny County Pharmacists Association Poison Prevention Month March 19th marked the start of National Poison Prevention Week, a tradition in the United States since 1962. “March Poison Prevention Month” was jointly started by the Allegheny County Pharmacists Association and Safe Kids Allegheny County acknowledging the need for the public to be better informed of the need for safety precautions in and around the home, especially for children. Also participating in this program are Children’s Hospital of Pittsburgh of UPMC, Highmark Blue Cross Blue Shield, the Pittsburgh Poison Center, Duquesne University School of Pharmacy, the University of Pittsburgh School of Pharmacy, McKesson HBOC, and Cardinal Health by Prestige Delivery.

Unintentional encounters with improperly stored medicines, vitamins, household cleaners, and chemicals are the cause of the majority of fatal and non-fatal poisonings occurring in children. The Pittsburgh Poison Center’s total service area had 36,552 unintentional poisoning exposures in 2016, with 46% being children 5 years and younger, and 29% of which were ages 1 and 2.

As part of this program, ACPA has created and distributed Poison Prevention kits to pharmacies and Head Starts throughout Allegheny County which contain “Mr. Yuk” home poison check lists and “Mr. Yuk” stickers. These materials are intended to increase public awareness regarding poison prevention. Additionally, carbon monoxide alarms are provided to the City of Pittsburgh Fire Department. Installation of these carbon monoxide alarms will be made at no charge by City of Pittsburgh firemen to low-income City of Pittsburgh and Wilkinsburg residents with at least one child 15 years or younger living in the household. The firemen will provide instruction on the maintenance of the alarm and information on the use and maintenance of gas burning equipment in the home or apartment. Highmark Blue Cross Blue Shield Foundation supports this program through grant funding.

Pharmacist activity in this and other poison prevention programs, as well as the use of safety caps on prescriptions and OTC products, remains our commitment for improving the health of our communities.

BucksMont Pharmacists Association The BucksMont Pharmacist Association held its first meeting of 2017 at Marzano’s restaurant in Jenkintown, PA on Thursday, February 23rd.

The meeting was sponsored by Teva Pharmaceuticals and featured an educational dinner presentation titled “Granix TBO Filgastrin Injection” presented by Brian Waldron, PharmD. The meeting was well attended with over 30 members and guests present, including pharmacy students from Temple University, University of the Sciences/PCP and Jefferson. Granix is indicated for use in patients who have developed chemotherapy induced neutropenia. The product is available in various syringe types designed for either self-administration by patients or administration by healthcare professionals. Various reimbursement plans are available to help defray the cost of this medication.

Following the presentation there was an open business meeting. Several important items were discussed including preparation of a ballot to replace Directors and Officers whose terms are expiring in July, 2017. In regard to our recently reinstated scholarship program, board members agreed to accept PPA’s suggestion to link the BMPA-sponsored scholarships with the PPA named scholarship foundation. Event Manager, Jan Kitzen, mentioned that the next BMPA dinner meeting is tentatively scheduled for May-June and will be sponsored by Eli Lilly. The educational presentation will focus on current therapies for managing diabetes. This meeting will also feature a 0.5 CEU accredited 30 minute CE program designed to provide pharmacists with information regarding how they can assist in managing the current opioid crisis. This program is prepared

by PPA and is being made available to all regional affiliates. Robert Frankil, BMPA board director and PA State Pharmacy board member, has offered to present this program. Sponsors for future meetings include Abbvie and Amarin. 

Stay Connected With PPA Tweet With Us: @PAPharmacists Like Us: www.facebook.com/PAPharmacy www.papharmacists.com • 21

ASSOCIATION NEWS

congratulations to the 2017 ppa graduating students PPA wishes the 2017 PPA graduating students all of the best as they embark on their pharmacy careers!

Remember to remain a committed member of our state pharmacy association, no matter where you reside!

For those staying in Pennsylvania, we invite and encourage you to update your membership as a New Practitioner! This can be done online or by contacting Ashley Robbins, arobbins@papharmacists.com.

Cedarville University Rebecca Kyper

Creighton University Bethany Abrahams Tony Waggoner

Duquesne University Mylan School of Pharmacy Rebecca Broadt Erika Castaneda Hannah Cawoski Mariah Corso Meghan Cunningham Kelsey Daisley Brianna Enderby Jenny Fung Andrew Gaiser Jacob Grmek Kaysee Gruss Jimin Han Nicole Handlow Timothy Heath Samantha Heller Katherine Hilton Brent Hindman Katherine Iseman Lindsey Jachim Branden Kline Natalie Kokta Emily Lauterbach Anna-Corinne Lobas Carly Malivuk Tiffany McClain Kiana Motto Kevin Mrohs Philip Parkinson Brittany Pfoutz Angela Raymond Melanie Renninger Rachael Richter James Stover Alvina Tran Natalie Turin Michelle Turro Heather Whitmer Marie Yarzab Brittany Yu

D’Youville College Zethan Koch

Jefferson College of Pharmacy Benson Eric Aningalan Kristen Boor Jessica Burkhart Jenna Fancher Richard LaCoursiere Elizabeth Shober Anshika Singh Alexis Stinson Jeremiah Warner Deirdre Yarosh

LECOM School of Pharmacy Mary Anwar Dana Bookamer Lindsay Brown Chelsea Ferguson Dalton Fishel Ann Desdemonia Fowajuh Heidi Frynkewicz Abby Gallagher Travis Grey Timothy Heiss Olivia Hines Chelsey Hughes Amanda Hydock Mason Koehle Victoria Matteson Megan McCoy Kayla Mumaw Shivam Patel Emily Petrak Katelyn Weyand Erik Whyne Honore Yonti

Ohio Northern University Allison Fye Shannon Kraus Amanda Scharf

22 • Pennsylvania Pharmacist • May/June 2017

Temple University School of Pharmacy Allison Allen Kara Anderson Sophia Antoine Ilya Braginsky Ashley Depuy Jonathan Douek Michee Etienne Andrew Fadimilehin Ryan Foster Veronica Friedrich Elona Gjini Emily Harkins Mohamed Juboori Hallie Kinecki Lauren Kobren Danielle Laprad Sophie Le Julia Lees Fangchen Lin Betty Lu Jillian Lykon Jennifer Nguyen Tam Nguyen Vu Phan Nguyen Peter Nikolos Scott Opalka Mariela Ortiz Grace Patterson Victor Phan Andre Pillay Alexander Radovanovich Fidel Raposo Willis Richardson Cory Ryhal Carlton Stafford Michelle Stricker Veronika Tereshko Pulsifer Kathy Trinh Michael Ujwary Leanna Usnik Carmen Vasquez Rachel Vonvital Sara Walton Erika White

University of Pittsburgh School of Pharmacy Madison Adams Troy Albrecht April Andreen Dylan Atkinson Melissa Bastacky Scott Bechtel Emily Bobrzynski Jillian Bowker Taylor Buck Hunter Busansky Yun-Hsin Chi Jessica Czapnik Megan Dunlop Andrea Evankovich Karley Fazzone Hayley Fedorek Jennifer Fever Aleta Figurelli Brenda Fuh Rachel Gribbin Zherui Guo Kaleen Hayes Meaghan Herbick Keito Hoshitsuki Eric Jenkins Megan Kwiatkowski Alexandria Lavella Qingqing Liu Kimberly Lor Ashley Lovas Zoe Lubow Jack Mao Kasey Martik Kayla McFeely Ashley Mittereder Kerry Moore Maeghan Moss Niekeu Ndongwa Esther Oder Ingrid Pan Dina Peruso Daniela Policicchio David Rose Christine Ross Danielle Shovel Betsy Smith

Michael Stegmaier Emily Steltenpohl Brittany Stocks Carolyn Ubinger Gabriel Valasek Taylor Watterson Shane Wilson Erica Wilson April Wolski Lauren Woolley Laura Yost Kaitlin Zeis

Philadelphia College of Pharmacy Kashma Abdulraheem Grigor Abelian Noel Abraham Michelle Amena Van Au Jun Hyuk Baek Ashley Barnett Binki Baxi Shivani Bhanderi Alexander Bimson Ryan Burkhardt Katelyn Calderaio Cameron Carlock Robert Cheeseman Ariel Cohen Stephanie Dangelantonio

Deborah Douglas Ethan Englert Lauren Farmer Kevin Fatholahi Milie George Austyn Grim Amit Gupta David He Maria Heaney Soonyip Huang Kyle Hultz Melisa Humble Kimmarie Huynh Kheim Huynh Nikhila Indukuri Samantha Jackson Jobin Johnson Jordan Kolbush Steven Lam Stephanie Liu Kayley Liuzzo Dennis Marjoncu Ivonne Martinez Philip Masaitis Simi Mathew Stacey Mathew Brett Mentzer Daniel Min Hien Nguyen

David Nguyen Brandon Nguyen-Phan Sherri Nye Kyle OBrien Song Oh Amisha Patel Nirali Patel Velu Patel Krish Patel Kenneth Paulish Dorela Priftanyi Jonathan Rhee Margaret Rousis Eric Seda Sunish Shah Hope Shen Ashley Shotwell Andrew Sloskey In Hye Suh Jessica Sylvester Ines Tebas-Pueyo Monica Tran Doniya Varghese Tiffany Varughese Lauren Wigoff Ada Wu

West Virginia University Jessica Fiant Kyle Sukanick

Wilkes University — Nesbitt School Of Pharmacy Jordan Borger Krista Bower Christopher Bright Sarah Brozena Courtney Calamia Virginia Edwards Sarah Fillman Tristram Ford Shannon Gilhooley Todd Grove Rebekah Harris Hillary Harris Emily Jones Michelle Kuzma Kristen Lopatofsky Anastasia Mauger Bradley Moore Anthony Possanza Ashley Robold Thomas Rowe Alex Shreiber Jennifer Smith Elena Stambone Nicholas Stauffer Jonathan Sytko Letitia Warunek Heidi Yanoski Krista Zawistowski 

www.papharmacists.com • 23

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INDUSTRY Rx AND NEWS THE LAW

INDEMNIFICATION

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.

John from Anytown Pharmacy is negotiating to become the supplier of prescriptions and other pharmacy services to the county jail. As a possible vendor to the county, John is presented with a contract covering this relationship. One of the paragraphs is entitled, “Indemnification”. John reads through the paragraph, but he doesn’t really understand it. In his eagerness to win the contract, John signs it and returns it to the county. What is Indemnification and was it wise for John to agree to it before he understood it?

Indemnification is “. . . the obligation [or duty] resting on one person to make good any loss or damage another has incurred or may incur by acting at his request or for his benefit.” It is also known as a Hold Harmless agreement. What it boils down to is if the county gets sued for something Anytown Pharmacy has done wrong; Anytown Pharmacy will defend the county. This can account for significantly higher defense costs, such as attorney fees, to be incurred by Anytown Pharmacy. The pharmacy may also be paying the county’s portion of any judgment in the case.

Indemnity agreements can be one-sided or mutual. A mutual indemnity agreement provides for each party to protect the other. However, a onesided agreement requires only one party has to protect the other. This is a very important distinction and could result in significant costs for the indemnifying party. Anytown Pharmacy should review the agreement to ascertain what it provides. Many vendor agreements as presented do not provide for mutual indemnity.

Another important part of the review is to know what acts qualify for indemnification. Most commonly, indemnification is provided for breach of contract. Other actions that can be covered by indemnification include negligent acts, grossly negligent acts, wanton & reckless acts, intentional acts, and criminal acts. These are listed in an ascending order of seriousness under the law. Part of the pharmacy’s negotiations should be the types of acts that are covered by the indemnification agreement. This is important because many parties entering into such agreements assume that their insurance will take care of this indemnification. However, this is not always true as most insurance policies will likely not provide any coverage for breach of contract, intentional acts or criminal acts. The insurance policy is a contract between the pharmacy and the insurance company and it

is unaffected by any contract between Anytown Pharmacy and the county. Any promises to indemnify made by the pharmacy that are not covered by insurance will have to be paid by the pharmacy.

The acts are not the only key element in the Indemnification agreement. The types of indemnity payments provided can also be listed. Examples of these payments include: any and all losses, claims, expenses, fines, penalties, damages, judgments or liabilities.

Again, there may be payments promised within the Indemnification agreement that are not covered by insurance, such as fines and penalties.

The Indemnification agreement may also provide the procedure that the party requesting indemnification has to follow in order to qualify contractually. This usually involves promptly notifying the other party and providing relevant documents to them. The party asking for indemnification has to cooperate in the defense of the claim with the other party and may have input into the choice of the lawyer who will defend the case. The choice of lawyer can be critical to the success of your case, but this language has the potential to create a disagreement when it comes time to make the choice.

Depending on the language contained in the county’s contract, John may have made an expensive promise because he didn’t fully understand what he was agreeing to in promising to indemnify the county. Obviously, if nothing goes wrong, the issue is moot. But hope is not the best risk management strategy. Careful review of the content of the entire contract, including indemnification requirements, before signing it is a more reliable strategy. © 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. 

www.papharmacists.com • 25

INDUSTRY FINANCIAL NEWS FORUM

RETIREES SHOULD HAVE SPENDING PLANS

Without such strategies, they can risk going through their savings too fast 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.

Every day, articles appear urging people to save for retirement. These articles are so prevalent that it may seem like retirement planning is entirely about getting people to save. Actually, retirement planning concerns much more than that. It has another aspect well worth discussing: the eventual spending of all of that money that has been accumulated.

Too few Americans coordinate their retirement spending. Earlier this year, Ameriprise asked more than 1,300 savers aged 55–75 if they had a drawdown strategy in mind for the future. Nearly two-thirds of the pre-retirees surveyed did not. A third of the retired respondents to the survey also lacked spending plans.1 In retirement, inattention to household spending can have serious consequences. A newly retired couple can travel too much, eat out too frequently, and live it up to such a degree that its savings can be drawn down abruptly. That danger is heightened if a couple’s investments start to perform poorly. A spending plan may help retirees guard against this kind of crisis. Another case occurs when a retiree household becomes overconfident in its decentlyperforming portfolio and its middling level of savings.

A decade or so into retirement without a spending plan, that household finds its investment and bank accounts dwindling mysteriously fast. Sunday brunches give way to $3.99 bacon-and-egg specials, and the golf clubs stay in the garage all year. A plan for drawing down retirement savings in

moderation when retirement starts might help such a couple maintain its quality of life longer.

There is no standardized retirement drawdown strategy. Each retired household (and its retirement planner) must arrive at one specific to its savings, investment mix, income requirements, and age. There are some basic principles, however, that may help in configuring the spending plan. It makes sense for many retirees to tap their taxable brokerage accounts as a first step in a drawdown strategy. This allows assets held within tax-advantaged retirement accounts (such as IRAs) more time to grow and compound. By doing this, a retiree can effectively realize a tax break — money coming out of a traditional IRA is taxed as regular income, whereas long-term capital gains are taxed between zero and 20%.1,2 Of course, Roth IRA withdrawals are never taxed, provided you have followed IRS rules.

That brings up another factor in planning retirement spending — what can be done with regard to asset location and tax efficiency before retirement.2 A retiree with a larger traditional IRA may want to consider a Roth conversion of some or all of those IRA assets before age 70. In the fifties or sixties, an IRA owner may be at or near peak earnings, so handling the tax bite that comes with such a conversion may be comparatively easier than it would be during retirement.

Another tactic is to take earlier, voluntary withdrawals from accounts that would demand Required Minimum Withdrawals

(RMDs) beginning at age 70½. These voluntary withdrawals, which would occur before the start of RMDs, would leave an IRA owner with lower RMDs (and less taxable income) in the future.

Retirement spending should never be treated casually. A spending strategy may play a crucial role in preserving a retired household’s quality of life.

CITATIONS 1 cnbc.com/2016/03/02/spending-in-retirement-isa-balancing-act.html [3/2/16] 2 investopedia.com/ask/answers/102714/how-areira-withdrawals-taxed.asp [10/17/16] 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. 

PRS Pharmacy Services Partners with the National Community Pharmacists Association (NCPA) PRS Pharmacy Services, the pharmacy consulting experts, is proud to announce its partnership with the National Community Pharmacists Association (NCPA).

As NCPA’s trusted partner for many years, PRS Pharmacy Services will be the exclusive seller/buyer action arm recommended

by NCPA to over 22,000 independent community pharmacies via the PRS Seller/ Buyer Offering Plan. The Seller/Buyer Offering Plan will match the interest of potential buyers to owners interested in selling their pharmacy using a customized, 26 • Pennsylvania Pharmacist • May/June 2017

focused marketing plan and PRS’s extensive network of buyers and contacts.

Additionally, NCPA will offer, on a nonexclusive basis, the PRS Seller Prep Plan and the PRS Closing and Transfer Plan services to NCPA-affiliated pharmacy owners. The Seller Prep Plan will ascertain a pharmacy’s current operations, analyzing how to make improvements that will normalize the potential selling price and provide maximum value to the owner. Upon the sale of a pharmacy, PRS provides the expertise and support to plan and execute the transfer of pharmacy ownership by way of the Closing and Transfer Plan.

These three services will assist members in every aspect of the preparation, sale and transfer of a pharmacy business. Each of the plans is available separately or as a package depending on where an owner is in the selling process.

Harry Lattanzio, RPh, President of PRS Pharmacy Services, is excited about the partnership, saying, “With this NCPA partnership, we are able to extend the necessary support, tools and expertise to owners who want to successfully sell their pharmacy business to buyers who want to keep the pharmacy independent.”

For more information about NCPA, visit NCPAnet.org. 

THE KEYSTONE The only true transparent buying group in the region. Operiating as a Cooperative, where members share in the profits. over 75 contracts available

WE OFFER CHOICE Over 100 Years experience! Affiliation with Major Suppliers Honest advice about the benefits and problems with pharmacy ownership. Over $16.5 Million disbursed to participating members in 2016. Checks are sent out monthly - No credit slips Compliance is the KEY in Keystone

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INDUSTRY NEWS

HOW TO SURVIVE A DEA INSPECTION SERIES:

Appendix D (Pharmacist’s Guide to Prescription Fraud) of the DEA Pharamcist’s Manual 2010. ©2016 Contributed by: Carlos M. Aquino, Consultant & Founder, PharmaDiversion LLC 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.

Several times a month, I get calls from supervising pharmacists and pharmacy registrants that personnel from the Drug Enforcement Administration (DEA) had questioned opioid prescriptions written for pain. In some cases, this comes from actions being taken against the prescriber

by DEA personnel due to diversion of such prescriptions by the patient or from an overdose by the patient whose Oxycodone or Hydromorphone prescription you filled for them.

Federal and state law enforcement, including DEA, are looking at opioid prescriptions.

They are blaming prescribers and pharmacists for the high demand of Heroin by opioid dependent patients. To make it worst, the Heroin being sold in New York, New Jersey and Pennsylvania is now is being laced with illicit fentanyl making it fatal for some drug abusers. The patient dies because of the fentanyl laced Heroin but the prescriber

and the pharmacist are blamed if it was proven that the patient was seen for pain and received Oxycodone or Hydromorphone as part of a pain management plan. In many cases, their death will place the pharmacist and the pharmacy in the cross-hairs of a DEA investigation.

In a few criminal cases, DEA has proven that the pharmacist had filled the prescription with willful blindness and deliberate ignorance. What it means is that the pharmacist didn’t do their duties to determine that the prescriptions were written for legitimate medical purposes and they didn’t care.

As a supervising pharmacist, a staff pharma­ cist, or a pharmacy registrant, you need to take time to read the DEA Pharmacist’s Manual 2010 and especially Appendix D. You can find it on the website www.deadiversion. usdoj.gov and search under the Publications and Manuals Section within Resources.

DEA writes, “The following criteria may indicate that a prescription was not issued for a legitimate medical purpose”.

They provide several examples to include.

• The prescriber writes significantly more prescriptions (or in larger quantities) compared to other practitioners in the area; • The patient appears to be returning too frequently. A prescription which should last for a month in legitimate use is being refilled on a biweekly, weekly, or even a daily basis; • The prescriber writes prescriptions for antagonistic drugs, such as depressants and stimulants, at the same time. Drug abusers often request prescriptions for “uppers and downers” at the same time; • The patient presents prescriptions written in the names of other people; • A number of people appear simultaneously, or within a short time, all bearing similar prescriptions from the same physician; • People who are not regular patrons or residents of the community, show up with prescriptions from the same physician.

28 • Pennsylvania Pharmacist • May/June 2017

As a supervising pharmacist, a staff pharmacist, or a pharmacy registrant, you need to take time to read the DEA Pharmacist’s Manual 2010 and especially Appendix D. If a pharmacist discovers a pattern of prescrip­tion abuse, they should contact DEA, BNI or their local law enforcement entity.

Both DEA and state authorities, such as BNI, consider retail-level diversion a priority issue, especially with the abuse of fentanyl laced Heroin by opioid dependent patients.

DEA will tell you that dispensing procedures without control and professional caution are an invitation to the drug abuser. Proper controls can be accomplished by following common sense, sound professional practice, and proper dispensing procedures. In addi­ tion, pharmacy staff should have knowledge of these safeguards, as it will help prevent and protect the pharmacy from becoming a source of diversion.

DEA has provided techniques you need to use when filling those Oxycodone and Hydromorphone prescriptions. They include.

• Knowing the prescriber, their signature, the prescriber’s DEA registration number, their field of medicine, their board certification, and review all disciplinary actions taken against the prescriber; • Knowing the patient. Remember no patient travels “100 miles” because of your service; • Check the date on the prescription order to determine if it has been presented in a reasonable length of time since being issued by the prescriber; • When there is a question about any aspect of the prescription order, the pharmacist should contact the prescriber for verification or clarification; • If at any time a pharmacist is in doubt, they should require proper identification. Although this procedure is not foolproof (identification papers can also be stolen/forged), it does increase the drug abuser’s risk; • If a pharmacist believes the prescription is forged or altered, he/she should not dispense it and should contact the Pennsylvania State DOH, the Bureau of Narcotics Investigations (BNI) or call the local police.

Most drug abusers seek out areas where communication and cooperation between health care professionals are minimal because it makes the drug abuser’s work easier. Thus, a pharmacist should encourage other local pharmacists and prescribers to develop a working relationship which will promote teamwork and camaraderie. If the prescriber doesn’t want to cooperate, don’t fill the prescription.

In addition, the pharmacist should become familiar with those controlled substances

that are popular for abuse and resale on the streets in the area and should discuss those findings with other pharmacists and practitioners in the community.

As part of a pharmacy compliance review, I have found that supervising pharmacists allow Oxycodone and Hydromorphone prescriptions to be paid with cash. In many cases, the prescription is for 180 dosage units or high. I’ve seen these prescriptions in dosages of 240, 360 and 480 tablets for a month supply.

With some prescriptions, I research the prescribers field of medicine only to find them practicing Internal Medicine or Family Medicine and their medical education has no training in pain management. Some I know as “Pill Mill” practices. I suggest you go to those websites that will provide the prescribers’ education, field of medicine, board certification and their disciplinary history.

Remember to read the DEA Pharmacist’s Manual 2010 and understand it because it’s your pharmacy or pharmacist registration. I don’t want you to lose it. 

New Online Fall Prevention Training for Pharmacists Falls are a common and serious health threat to adults 65 and older. Every year, more than 1 in 4 older adults falls, but over half of those who fall won’t tell their healthcare provider.

In response to this growing health threat, the Centers for Disease Control and Prevention (CDC) developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative to provide sought after tools and resources to help the healthcare team implement fall prevention strategies.

Recently CDC collaborated with the American Pharmacists Association (APhA) in developing a new online application-based training activity, STEADI: The Pharmacist’s Role in Older Adult Fall Prevention, which launched on March 24, 2017 at the APhA Annual Meeting.

This online training is free for APhA members and non-members alike, accredited by the Accreditation Council for Pharmacy Education (ACPE).

As some of the most accessible members of the healthcare team, and as medication experts, pharmacists play a critical role in older adult fall prevention.

To begin preventing falls, pharmacists can: • Screen to identify patients at risk for a fall; • Assess to identify modifiable risk factors, such as medication use; • Intervene by using effective clinical and community strategies to reduce risk.

Pharmacists are an essential part of their patients’ healthcare team and can improve patient care, prolong independence, and ultimately save lives. 

www.papharmacists.com • 29

INDUSTRY NEWS

APhA’s Annual Meeting and Exposition March 23–27 in San Francisco, California Nearly 200 alumni and students attended the Pennsylvania Reception on Sunday,March 26th at APhA’s Annual Meeting in San Francisco.

Attendees from all seven Pennsylvania schools of pharmacy were given the chance to network and reconnect with APhA conference attendees!

A big thank you to those who served and were present at one or more of the 2017 APhA House of Delegates sessions! Howard Cook, Julie Gerhart-Rothholz, Daniel Hussar, Yardlee Kauffman, Nick Leon, Christina Maher, Mary McManus, Melissa Shiner and Nancy Tang.

Brandon J. Patterson, PharmD, PhD, was awarded the Wiederholt Prize. He knows that “there are a breadth of opportunities for pharmacists to use their training to advance patient care.” For that reason, he said, “While patients remain at the center of I do as a pharmacist in research, I do not feel restricted to a setting or practice environment to make a difference.” Patterson was interested in quantifying pharmacist-provided patient care services. In their awardwinning paper, “Rural Access to Clinical Pharmacy Services,” published in the September/October 2014 issue of JAPhA, Patterson and his collabora­tors quantified pharmacy services in rural areas. Patterson is a U.S. Health Outcomes scientist at GlaxoSmithKline and a member of the PPA/PPCN Research Collaborative.

2017 House of Delegates Ellen Gans, BSN, was selected in recognition of her service and consistent support of the pharmacy profession and APhA. From her husband John Gan’s tenure as Executive CVice President and CEO of APhA through today, Gans has been a powerful voice for the profession of pharmacy.

The APhA Foundation Student Scholarship Program recognizes the following in the APhA Academy of Student Pharmacists: Exceptional Leadership, Active Community Engagement, and Academic Achievement by Student Leaders.

Kaitlin Bova, Ohio Northern University Raabe College of Pharmacy, received the Gloria Francke Scholarship and Ashley Maister, Thomas Jefferson University College of Pharmacy, received the Mary Louise Andersen Scholarship!

Duquesne University and the Center for Pharmacy Care won the APhA Immunization Champion national award for Community Outreach through efforts to improve health outcomes for members of the Duquesne University community and nearby, medically underserved Hill District! 

Temple University

Wilkes University

University of Pittsburgh

The poster, “Pennsylvania Pharmacists: Assessment of Patient Care Services in Medically Underserved Areas” was selected for the APhA-APPM Presentation Merit Award! Authors included: Kim Coley, Hannah Renner, Sarah Dombrowski, AJ Greco, Yardlee Kauffman, Mindy Kozminski, Nima Patel-Shori, Roshni Patel, Brandon Patterson, Eric Wright, and Melissa McGivney.

30 • Pennsylvania Pharmacist • May/June 2017

Congratulations Dr. Hussar!

Daniel A. Hussar, Ph.D., of Newtown Square, PA, is the recipient of the 2017 Remington Honor Medal, the profession’s highest honor awarded by the American Pharmacists Association (APhA). Dr. Hussar was selected in recognition of his numerous contributions to, and impact on, the pharmacy profession and patient care.

The Remington Honor Medal, named for eminent community pharmacist, manufacturer, and educator Joseph P. Remington, was established in 1918 to recognize distinguished service on behalf of American pharmacy during the preceding years, culminating in the past year or during a long period of outstanding activity or fruitful achievement. Dr. Hussar will be officially recognized during the APhA Annual Meeting and Exposition in San Francisco, CA, March 24–27, 2017. APhA’s Awards and Honors Program is the most comprehensive recognition program in the profession of pharmacy.

Dr. Hussar’s peers regard him as the embodiment of all that the Remington Honor Medal stands for as he consistently advocates for the profession while also challenging pharmacists to always keep the patient at the forefront of their work. As one of his nominators noted, “Dr. Hussar is a paragon of professionalism in pharmacy.

He has impacted the professional thinking and attitudes of practitioners in all corners of the nation as well as abroad through his thoughtful and thought provoking editorials and speeches.”

Dr. Hussar has served in a number of capacities within pharmacy and community organizations, including as APhA Honorary President from 2012-13, a member of the APhA Board of Trustees from 1977–79, a member of the APhA House of Delegates since 1971, a member of the World Vision United States Board of Directors from 19992007, a member of the Christian Pharmacists Fellowship International Board of Directors

from 2005–2014, president of the Drug Information Association from 1977–1978, president of the Pennsylvania Pharmacists Association from 1975–1976, and various roles on the Delaware County Christian School’s Board of Trustees, including six years as president.

In addition to spending his entire career at the Philadelphia College of Pharmacy at the University of the Sciences, this is also where Dr. Hussar completed his education. He received his Bachelor of Science degree in pharmacy in 1962 and his Master of Science degree in 1964. In 1967, Dr. Hussar concluded his formal education with his Ph.D. During his career, Dr. Hussar’s areas of teaching responsibility focused around therapeutics topics, new drugs, nonprescription drug therapy, patient safety, drug interactions, patient adherence, smoking cessation, issues in pharmacy practice, and pharmacy ethics. 

Dr. Hussar is a paragon of professionalism in pharmacy. ­— Nominator

The Philadelphia College of Pharmacy

Philadelphia College of Pharmacy/University of Sciences recognized Dan Hussar at a separate reception the evening before. Pictured at right: William M. Ellis, Jr., BS Pharmacy 1985; Daniel A. Hussar, PhD, Pharmacy 1962, MS 1964, PhD 1967 ; Eric F. Hussar, MD, BS Pharmacy 1998 and daughter Cora. www.papharmacists.com • 31

LEGISLATOR PROFILE

Senator Thomas McGarrigle (R) Senate District 26 Co-chair of the Pennsylvania Community Pharmacy Caucus What are the key issues you would like to see addressed this session?

I look forward to working with my colleagues to tackle pension reform, education, and prescription drug transparency and affordability.

Tell our members a little about your background.

I am a former Township Commissioner, a former Chairman of the Delaware County Council, and have been a small business owner for 36 years.

Advice for pharmacists about the political process?

If you see something involving your business get involved, reach out to your elected officials. Let them know what’s helping and what’s hurting you.

What do you do for relaxation or enjoyment?

I enjoy spending time and having dinner with my friends and family, and also enjoy spending weekends at the shore. 

High Prevalence of STIs Among Female Adolescents and Young Adults: Perspectives on the Role of Pharmacist Engagement and Interventions A 2017 Educational Foundation grant recipient needs your help to gain insight on the experiences and willingness of pharmacists to engage with female adolescents and young adults aged 15–24 regarding STI prevention and appropriate medication use.

Pharmacist volunteers are needed to participate in a survey to help answer this research question.

Use this link to provide your insight: http://bit.ly/2oVaPbE

32 • Pennsylvania Pharmacist • May/June 2017

Senator John T. Yudichak (D) Senate District 14 Co-chair of the Pennsylvania Community Pharmacy Caucus What are the key issues you would like to see addressed this session?

I would like to see the General Assembly work in a bipartisan manner to pass a responsible budget that is built upon sustainable fiscal policies that allow us to invest in good jobs, a quality education system, and safe communities.

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

I’m a lifelong resident of Luzerne County, and prior to being elected to the Senate in 2010 I served in the House of Representatives for twelve years. My father, who still serves as a Plymouth Township supervisor at the age of eighty-one, inspired me to seek public office and remains a constant source of inspiration for everything I do. He instilled in me the value of public service and helped understand what a privilege it is to represent the hardworking families of Northeastern Pennsylvania.

How do you see pharmacy and its role in health care evolving in the in the future?

Every day there are new advances in health care that, while exciting, can also be challenging for our health care professionals.

As a co-chair of the Pennsylvania Community Pharmacy Caucus, I know firsthand the important role that a community pharmacy plays in patient care. We need to ensure our pharmacists have the resources they need to perform their jobs to the best of their ability. In my district, the Nesbitt School of Pharmacy at Wilkes University does an incredible job of preparing students for their future careers in the pharmacy field. Additionally, pharmacists play a huge role in the discussion regarding prescription drug costs. We need to make sure that the cost of prescription drugs does not become too exorbitant. With an increasing senior population, we need to make sure that there is access to affordable prescription drugs.

Advice for pharmacists about the political process?

Be engaged in the political process, and stay engaged. There’s a saying—if you’re not at the table, you’re on the menu. Make sure you are at the table---meet with state legislators, voice your concerns, follow the bills, and vote!

What do you do for relaxation or enjoyment?

I enjoy going to the movies with my four daughters, reading, golf and Neil Young music. 

EDITORIAL REVIEW BOARD

Evaluating pharmacist impact on hypertension and diabetes management in the outpatient setting Corresponding Author: Mirza E Perez, PharmD, BCPS Authors: Candis McGraw, PharmD, BCACP; Chidinma Onokogu, PharmD, BCACP; Nima Patel-Shori, PharmD, BCACP; Huaqing Zhao, PhD, MS; Frederick V. Ramsey, PhD Disclosures: This study did not receive grant funding. The authors report no financial or any conflicts of interest related to the subject material of this study. Study results were presented at a poster and abstract at the Eastern States Residency Conference, May 4, 2015, in Hershey, Pennsylvania.

Keywords: diabetes, hypertension, collaborative drug therapy management, pharmacist Background: Pharmacists currently provide collaborative drug therapy management (CDTM) in different clinical settings for the management chronic diseases. The objective of this study was to compare the management of hypertension (HTN) and type 2 diabetes mellitus (T2DM) by pharmacists working through CDTM to usual medical care provided by primary care physicians (PCPs) in the outpatient setting.

Methods: Medical records of patients treated for HTN with or without T2DM between January 1, 2011 and July 31, 2013 were reviewed retrospectively. Patients included in the study were at least 18 years of age with a confirmed diagnosis of uncontrolled HTN with or without T2DM. Patients were assigned to one of two groups: those treated by pharmacists under CDTM (intervention group) and those treated by PCPs (control group). The primary endpoints evaluated were the average change in blood pressure (BP) and change in hemoglobin A1c (HbA1c) from baseline. Secondary endpoints included: percentage of patients at goal BP and HbA1c and percentage of patients with T2DM receiving other medications considered to be standard of care.

Results: A total of 199 patients were evaluated. Patients in the intervention group

achieved a mean change in systolic blood pressure (SBP) of -10.3 mmHg compared to -6.5 mmHg in the control group (p= 0.93).

There was a greater decrease in HbA1c in the intervention group than in the control group (-2.02% vs. -0.35%, p=0.026). Most of the secondary endpoints were similar between groups, except for a greater number of control patients receiving statins and the pneumococcal vaccine.

Conclusion: Pharmacists working under CDTM were able to decrease HbA1c to a considerably greater degree compared to the control arm. The results support the benefits of collaboration between physicians and pharmacists to enhance patient outcomes in the outpatient setting.

The full article can be found at: http://www. papharmacists.com/Articles 

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PPCN CONTRACT UPDATE!

PPCN is currently planning for a summer 2017 payer contract! We will be sharing more details in the coming weeks and months. The contract is with a Medicaid MCO and pharmacists will have the opportunity to be reimbursed for CMRs with multiple follow-up encounters and specific targeted interventions focused on impacting HEDIS measures. This opportunity is for PPCN members only—if you are interested in joining PPCN please reach out to Pat Epple at pepple@papharmacists.com Preparing for the Contract — Complete the required training!

We will be holding several Live trainings in preparation: Friday, May 12th 9am–12p Red Lion Hotel Harrisburg Hershey Friday, May 19th 9am–12pm Pittsburgh Marriott North Friday, June 23rd 9am–12pm or 1pm–4pm Beaver County Convention Center* *Held during the Value Drug Merchandising Expo- for Value Drug Members Only

Go to PPA’s website under “Pharmacists Care Network” to find out more!

Resources/Updates

Find Out More

• Toolkits — PPA recently launched the latest Toolkit focused on immunizations available on their website. The Mentor Collaborative is currently working on a Smoking Cessation toolkit to be launched soon.

Visit our newly launched website! www. papharmacistsnetwork.com.

• Smoking Cessation Provider through Medicaid Update ­— Last month we announced a “How To” guide that would be included in the Smoking Cessation Toolkit. One step around required training was left out and we are working with the tobacco division to update that for you. Please be patient as we are working hard to get you the most complete information possible. Once it is live on the toolkit we will let you know!

34 • Pennsylvania Pharmacist • May/June 2017

Sign up for Patient Care Training Program: http://www.papharmacists.com/page/CMMC Contact Mindy Kozminski or Pat Epple with questions or feedback at: mkozminski@papharmacists.com or pepple@papharmacists.com 

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Our Mission To help our customers attain peace of mind through specialized insurance products, risk management solutions, and superior personal service.

INDUSTRY NEWS

PPA’s Legislative Priorities

In any given legislative session, PPA monitors close to 100 bills that affect pharmacy. The items listed below are priority issues for which we are devoting considerable resources and were the major focus of Pharmacy Legislative Day held on Wednesday, April 19, 2017.

Number One Priority – Opposing Proposed Cuts to Pharmacy Reimbursement The following two issues — the proposed cuts to Medicaid reimbursement and the proposed cuts to PACE reimbursement — are closely tied together. This is because Governor Wolf has requested uniformity in pharmaceutical pricing and proposed merging four state agencies to create a new Pennsylvania Department of Health and Human Services.

Opposing the Proposed Cuts to Pharmacy Medicaid Reimbursement In 2016, the Center for Medicaid and Medicare Services (CMS) published its Final Outpatient Drug Rule requiring states to adjust their Medicaid reimbursement methodology. This includes migrating the ingredient cost reimbursement benchmark to an Actual Acquisition Cost (AAC) payment methodology more reflective of the cost pharmacies pay for medications and paying pharmacies an increased professional dispensing fee that reflects the true cost to dispense as evidenced by a Pharmacy Cost of Dispensing Study. CMS stipulates that states submit a State Plan Amendment (SPA) detailing their proposal for compliance by April 1, 2017 and finalize their proposal by June 30, 2017. States are then required to pay pharmacies at the new rate retroactive to April 1, 2017.

The Pennsylvania Department of Human Services (DHS) contracted with Mercer to conduct its Pharmacy Cost of Dispensing Study and mandated pharmacies throughout Pennsylvania to participate in this study, which was completed on September 2, 2016.

Since then, DHS has announced the proposal it plans to submit to CMS. This proposal includes two major provisions, one that DHS claims is based on its Pharmacy Cost of Dispensing Study. The first provision is adopting an AAC payment methodology for ingredient cost that is based on the National Average Drug Acquisition Cost (NADAC), or on an adjusted Wholesaler Acquisition Cost (WAC) when no NADAC is available. The second provision is adopting a professional dispensing fee of $7.

PPA is opposing this proposal because the $7 professional dispensing fee fails to accurately account for overhead expenses and is among the lowest in the United States – most other proposals call for dispensing fees of $10 or more. One of the only states with a lower 36 • Pennsylvania Pharmacist • May/June 2017

proposed professional dispensing fee, Washington, is now facing a lawsuit over its proposal.

Moreover, pharmacy stakeholders repeatedly asked for transparency throughout this process and requested to see the Pharmacy Cost Dispensing Study (including filing a formal Rightto-Know request that has yet to be answered), but DHS continually failed to accommodate these requests.

Opposing the Proposed Cuts to Pharmacy PACE Reimbursement In November of last year, Governor Wolf signed Act 169 of 2016 into law, which included provisions to modernize and rebalance the PACE reimbursement methodology in compliance with the Center for Medicaid and Medicare Services (CMS) Final Outpatient Drug Rule.

This new reimbursement formula pays pharmacy using National Average Drug Acquisition Cost (NADAC) and only partially offsets that cut in product through increasing the professional dispensing fee from $4 to $13. In total, this rebalancing amounted to a $23.6 million cut to pharmacies throughout Pennsylvania.

Governor Wolf’s original 2017-2018 Executive Budget proposed slashing the PACE professional dispensing fee from $13 back to $4 without changing the ingredient cost benchmark in the reimbursement formula back to what it was prior to the enactment of Act 169 of 2016. The administration then pitched these cuts as saving Pennsylvania $45 million to be used for merging the four health agencies.

Since that time, the Pennsylvania Department of Human Services (DHS) announced the proposal it plans to submit to CMS relating to pharmacy Medicaid reimbursement. Following release of this proposal, DHS and the Wolf Administration announced revised plans to cut the PACE professional dispensing fee from $13 to $7, as opposed to the initially proposed $4.

C

PPA is opposing this cut and is asking: Why should pharmacies be forced to pay for the proposed merger?

The proposed cut to the PACE professional dispensing fee (whether the initial 70% cut to $4 or the revised 46% cut to $7) contradicts the passage of Act 169 of 2016 and would cut an additional $45 million from pharmacy, totaling $68.6 million for the 2017-2018. The $45 million in cuts to pharmacy account for half of the $90 million in savings the Wolf Administration is booking under the merger of the four healthcare related agencies.

Further, pharmacies have been a strong advocate for and partner in the PACE program since its inception. Keeping pharmacies engaged in the care for Pennsylvania’s elderly population is crucial.

Other Priorities Expanding Pharmacist-Provided Immunization Opportunities Act 8 of 2015 lowered the age pharmacists can provide the flu vaccine to patients nine years of age and older, with parental consent.

PPA is now advocating for bills – House Bill 1089 and a soon to be introduced Senate Bill – that would change Pennsylvania law to permit pharmacists to provide all immunizations to patients nine years of age and older.

Thirteen other states have no age restrictions for pharmacists providing immunizations while thirty-six states allow pharmacists to provide all immunizations to children of younger ages than provided in Pennsylvania.

The approximately 9,500 certified pharmacist immunizers in Pennsylvania are available to safely and conveniently administer vaccinations and are in an ideal position to have a major impact on reducing vaccinepreventable illness.

Medication Synchronization Medication synchronization is when a pharmacist works with a patient – only at the patient’s request – to synchronize medication refills so that all of their medications can be picked up on the same day each month, instead of having to make multiple visits to the pharmacy.

RTL-111767-07-17_MIS 2017 PA Pharmacist Print Ad with crops.pdf

1

4/10/17

PPA is working with various stakeholders to allow Pennsylvania to join the 18 other states that have already enacted medication synchronization. Doing so would help increase medication adherence and stand as a major convenience to patients throughout Pennsylvania.

Pharmacy Technician Registration Pennsylvania is one of only five states that does not register or in some way regulate pharmacy technicians. Registering and tracking pharmacy technicians – thereby making pharmacy technicians subject to disciplinary action – is the norm throughout the United States and promotes patient safety.

This is why PPA is supporting legislation — House Bill 454 and Senate Bill 418 — that would provide for a basic registration along with a criminal history background check. *Visit http://www.papharmacists.com/ page/Issues for more information on other bills and issues PPA is currently monitoring. 

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Hear industry experts speaking on the key issues affecting independent pharmacies.

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For more information on how you can make a difference, http://www.papharmacists.com/FoundationInfo

ASSOCIATION NEWS

Nick Wytiaz, PharmD, Point-of-Care Pharmacist, West Penn Hospital PPA Educational Foundation Board member and contributor

Call for 2018 PPA Educational Foundation Grant Applications By contributing monthly to the PPA Educational Foundation, I am supporting valuable programs including research grants, student poster presentations and substance abuse education. Such programs help foster research, education, and the development of practice models that advance patient care and relate to ALL pharmacists. In order to ensure that these programs continue and new projects develop, we need financial support from pharmacists like you! Please consider becoming a monthly contributor in support of the Foundation, your profession, and ultimately, the patients we serve. "

The PPA Educational Foundation will award up to four grants in 2018 with a maximum amount of $1,000 per awarded grant. Grants may be used for projects which are targeted towards patient care by pharmacists and innovative activity around pharmacy practice. The purpose of the grants is to encourage exploration of innovative and best pharmacy practices, especially those which focus on patientcentered services or which offer some patient benefit.

For 2018

The PPA Educational Foundation encourages the submission of grants that investigate, demonstrate, document, measure or otherwise explore the value of pharmacist involvement on the healthcare team and other innovative models of collaboration. Of particular interest to the Foundation, are the following aspects related to the business model of embedding a pharmacist in the PCMH/ACO: productivity, ROI, payment, and/or quality outcomes/measures. This focus does not preclude applications of another topic or project.

“I know it seems that organizations are always asking for your money and that it is not always possible (or prudent) to give to everyone. However, as a pharmacist and PPA member, I believe the PPA Educational Foundation deserves our attention. I was reluctant at first to give to the Foundation but once I realized that its mission and vision reflects my own, it was an easy decision!

The Foundation has available on its website a short recorded webinar (about 15 minutes) on the Foundation, the grant program, its goals and objectives, and the application and decision process. Watching the webinar is not required but may be helpful in providing any applicant with a greater chance of success by a full understanding of the process and expectations. Participation will also not be considered in the grant evaluation process and therefore is not a requirement or guarantee of success.

My Profession...My Practice...My Philanthropy

We encourage residents, new practitioners, seasoned practitioners, students, and academia members to apply! It can be a simple, easy way to support a new or ongoing venture of provision of patient care!

Advancing Patient Care

Educational Foundation

Information about Grant Opportunities, the 2018 Grant Announcement, and the Grant Application can be found on the PPA website under Foundation, Programs, and Grant Programs. 

Educational Foundation Advancing Patient Care

My Profession...My Practice...My Philanthropy “I know it seems that organizations are always asking for your money and that it is not always possible (or prudent) to give to everyone. However, as a pharmacist and PPA member, I believe the PPA Educational Foundation deserves our attention. I was reluctant at first to give to the Foundation but once I realized that its mission and vision reflects my own, it was an easy decision!

By contributing monthly to the PPA Educational Foundation, I am supporting valuable programs including research grants, student poster presentations and substance abuse education. Such programs help foster research, education, and the development of practice models that advance patient care and relate to ALL pharmacists. In order to ensure that these programs continue and new projects develop, we need financial support from pharmacists like you! Please consider becoming a monthly contributor in support of the Foundation, your profession, and ultimately, the patients we serve. " Nick Wytiaz, PharmD, Point-of-Care Pharmacist, West Penn Hospital PPA Educational Foundation Board member and contributor For more information on how you can make a difference, http://www.papharmacists.com/FoundationInfo

38 • Pennsylvania Pharmacist • May/June 2017

WE’RE BETTER TOGETHER Since our first store opened in 1952, we’ve been committed to independent pharmacy. As the years passed and the industry changed, we had to learn how to operate differently. We had to buy like the national chains while retaining the highest level of patient care.

That’s why we started a buying group—Smart-Fill—and that’s why nearly 700 other independents have partnered with us. As Smart-Fill has grown, so have our own stores. A third generation of pharmacists has now joined what has grown from a single store to our 21 family-owned pharmacies. We’re proud of our history as independent pharmacists, and we’re excited to be a guiding force in the industry today.

Why buy with Smart-Fill?

We’re experienced—like you.

If I’m thinking about wanting to implement a new pharmacy program, I can turn to Smart-Fill. Most of the time, they’ve already faced it in their own pharmacies.

Their experience gives us an edge.”

— Ashley Brehme, Pharmacist

We’re committed—like you.

When you’re choosing a buying group, you have to be able to trust them. They can do the hard sell up front and really promise you the world, but the proof is in the pudding.

Smart-Fill has been there for me when I’ve needed them.”

— Mitch Deines, Pharmacist

We’re independent pharmacists—like you.

When you have questions that are specific to your store, you need people who are in tune with you and understand the industry. With Smart-Fill owning 21 stores, you have a plethora of people that you can rely on. I believe that the team Smart-Fill has assembled is the best in the business.”

— Bob Beeman, Pharmacist

Interested in ways to increase your top-line revenue and improve adherence?

Download our free eBook on implementing a Med Sync program in your pharmacy: Smart-Fill.com/MedSync

Get competitive. Stay independent. www.Smart-Fill.com