The official publication of the Pennsylvania Pharmacists Association
HARRISBURG PA PERMIT NO 533
PRSRT STD U.S. POSTAGE
November/December 2012 z Volume 93 z Issue 6
2012 Annual Conference Highlights Congratulations to PPAâ€™s 2012 Award Recipients www.papharmacists.com
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PPA Board of Directors PPA Officers: President: Robert B. Frankil, R.Ph. President Elect: J. Scott Miskovsky, R.Ph. First Vice President: Eric R. Esterbrook, R.Ph. Second Vice President: Donna Hazel, R.Ph. Immediate Past President: Adam C. Welch, PharmD., MBA, BCACP Regional Directors: Central: Janet Getzey Hart, R.Ph. Northeast: Jonathan D. Ference, PharmD., BCPS Northwest: Mary E. Grisnik, PharmD. Southeast: David B. Cunningham, R.Ph. Southwest: Lauren Simko, PharmD. Academy Directors: Academy of Alternative Pharmacy Practice: Jamie McConaha, PharmD. Academy of Pharmacy Technicians: Jennifer L. Simpson, CPhT Academy of Chain Pharmacists: Stephanie Harriman McGrath, PharmD Academy of Community Pharmacists: Martin J. Kendra, R.Ph. Academy of Health System Pharmacists: Paul T. Kocis, PharmD., FASCP Academy of Long Term Care and Consultant Pharmacists: Donald R. Brindisi, R.Ph. Academy of Pharmacy Industry Association: Al Emmans Academy of Student Pharmacists: Tamiko Yamatani PPA Office Staff: CEO: Patricia A. Epple, CAE firstname.lastname@example.org Ext. 3 Communications Coordinator: Erika Butts email@example.com Ext. 2 Membership Coordinator: Corey Wenger firstname.lastname@example.org Ext. 1 Program Coordinator: Sara Powers email@example.com Ext. 4 Government Relations Manager: Donald L. Smith, III Ext. 6 firstname.lastname@example.org Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com email@example.com www.facebook.com/PAPharmacy www.twitter.com/papharmacists 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: Tara L. Pummer, PharmD., Chairman Hershey S. Bell, M.D.,M.S.,FAAFP Stephanie Smith Cooney, PharmD. Bernard Graham, PhD. Brian S. Plager, RPh., MBA Associate Editor: Erika Butts Editor/Manager: Pat Epple Published by: Graphtech Publishing Sarah DiCello, Publications Manager (717) 238-5751 firstname.lastname@example.org For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 email@example.com Creative Design: No Chipped Paint State Board of Pharmacy Members: Edward J. Bechtel, R.Ph. – Independent Community Gayle A. Cotchen, PharmD., MBA – Institutional Philip McCarthy – AG/Consumer Pauline Montgomery, R.Ph. – Independent Community Theresa M. Talbott, R.Ph. – Chain Community Mark J. Zilner, R.Ph. – Chain Community 2012 Board of Pharmacy Meeting Dates: July 17, August 21, September 18, October 23, November 20, December 13
Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care 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.
Message from the President . . . . . . . . . . . . . . . . . . . . . . . . 5 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Member News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 New Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Pharmacy Time Capsules . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Features Hinkle’s Pharmacy – A Part of the Columbia Community Since 1893 . . . 15 Financial Forum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Rx and the Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Pennsylvania Pharmacy Residents Spotlight . . . . . . . . . . . . . . . . 20 PPA Member Profile: Julie M. Gerhart, RPh, MS . . . . . . . . . . . . . . . . . . . . . . . . 24 Profiles in Pharmacy Innovation: Shannon Antypas PharmD. . . . . . . . . . . . . . . . . . . . . . . . 25
Association News Member Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 2012 Annual Conference Highlights . . . . . . . . . . . . . . . . . . . . 30 Congratulations to PPA’s 2012 Award Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Rite of Roses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Working For You: Grassroots and PharmPAC . . . . . . . . . . . . . . . . . . . . . . . 38
Industry News Medicare Surety Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 NABP PMP InterConnect Celebrates One Year of Connecting Prescription Monitoring Programs to Combat Prescription Drug Abuse . . . . . . . 41 Should You Compound Hydroxyprogesterone Caproate? . . . . . . . . . 42 PPA Partners with AHRQ to Offer Free Evidence-Based Resources for Members and Patients . . . . . . . . . . . . . . . . . . . . . . . . 45 20,000 Pharmacies to Offer New Medicare Part D Rx Drug Plan . . . . . 46
Pennsylvania Pharmacist I November/December 2012 I 3
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Robert Frankil, RPh PPA President 2012-2013
Article Head Message fromGoes the President Here
hope that everyone who attended the PPA Annual Conference in Scranton had a great time. I did! The conference was well attended, had great CEs, a very impressive student business competition (congrats Pitt!) and some entertaining moments at the bar. For those of you who stayed up late Saturday night, you saw quite a show from the Brandon Antinopoulos singers and dancers. And we never knew Marty Kendra could move like that! Congratulations to all the award winners. The Bowl of Hygeia went to Richard Smiga; Pharmacist of the Year, Adam Welch; Distinguished Young Pharmacist, Jamie McConaha; Excellence in Innovation, John J. Pavis; George S. Maggio to Tom Bowser; Preceptor of the Year, Peter Kreckel; J. Allen Duffield/PIA to Ed Casey; George H. Searight to William Liepack; Technician of the Year to Jennifer Spengler; and the new Generation Rx winner was Tony Dougalas. You all serve as wonderful examples and role models for what a pharmacist can be! By now we will either have a new President or a second term for President Obama. Either way,
we should be entering a time of great profession. We have the optimism for an upturn in the opportunity to have a rewarding economy, and a more favorable career in many ways. And in many landscape for our profession. cases we can create the kind Now is the time to of environment to introduce yourself work in that we are “Continue promoting to any newly comfortable with, all the good of what and the sky is the elected officials in your hometown. limit with pharmacy! we do! We do it all And congratulate year long, not just in We can create any winners of rean independent October.” elections. Make a pharmacy and phone call or visit, practice how and get to know your legislator you please. We can create better. These are the people new programs in a clinical who will be voting on laws setting to expand patient care and regulations that will shape by pharmacists. We can create our profession. If you want the collaborative practice agreements immunization age to be lowered, if with physicians to care for special you want open access to networks, needs patients. And more! if you want to be recognized and And let’s all give thanks for the be compensated as a health care Steelers and Eagles still being alive provider, then make the call! for the playoffs (we hope!) I hope that you all did A happy and safe holiday season something special for American to all! Pharmacists Month, and did PS: I’m trying to get over 100 something special to promote followers on Twitter @bobbygolf!! z pharmacy. But don’t stop after October. Continue promoting all the good of what we do! We do it all year long, not just in October. As we approach the holidays, let’s all give thanks for being members of such a
Pennsylvania Pharmacist I November/December 2012 I 5
Departments Thank You to Our Corporate Partners These companies support PPA activities throughout the year.
Calendar of Events
NOVEMBER 7-10 ASCP – SENIOR CARE NATIONAL HARBOR, MD 19-19 NASPA FALL SYMPOSIUM TUCSON, AZ DECEMBER 2-6 ASHP MID-YEAR MEETING LAS VEGAS, NV 20 PPA BOARD OF DIRECTORS JANUARY 25-27 PPA MID-YEAR CONFERENCE CAMP HILL, PA 27 PPA BOARD OF DIRECTORS FEBRUARY 15-17 PPA GRASP PROGRAM HARRISBURG, PA MARCH 1-4 APHA ANNUAL MEETING LOS ANGELES, CA APRIL 3-5 AMCP ANNUAL MEETING SAN DIEGO, CA For additional events and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!
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Member News PPA Gift at White Coat Ceremony
PPA’s Second Vice President, Donna Hazel, presents Raymond Zerjav of Duquesne University with our symbolic PPA gift of a bookmark at the White Coat ceremony. PPA schedules one of our officers to attend every Pennsylvania school’s white coat ceremony and present each student with this gift.
Congrats to Duquesne for Receiving a NACDS Million Hearts Team Up, Pressure Down Campaign Grant The National Association of Chain Drug Stores (NACDS) Foundation announced the recipients of the Million Hearts Team Up, Pressure Down public education grants. The NACDS Foundation’s support will provide $35,000 in funding for community health fairs during the month of September, hosted by 15
schools and colleges of pharmacy nationwide. Team Up, Pressure Down is a pharmacy-based program started in September within the Million Hearts initiative, which was launched by the U.S. Department of Health and Human Services (HHS). The Million Hearts initiative, with key stakeholders including the NACDS Foundation, aims to prevent one million heart attacks and strokes over the next five years by raising public awareness about blood pressure control, cholesterol management and smoking cessation. Duquesne University was one of the 15 recipients selected from nearly 70 applicant schools and colleges of pharmacy. We are proud to have a Pennsylvania school represented.
NCPA Foundation Scholarship Program The NCPA Foundation takes great pride in helping up-andcoming new leaders realize their aspirations of pharmacy ownership. The McKesson Foundation is the newest sponsor of the Foundation’s scholarship program. In 2012, the NCPA Foundation and Partners in Pharmacy are awarding educational aid to high achieving NCPA student members. Trey L. Tietz, of Wilkes University was a recipient of this scholarship for 2012.
8 I Pennsylvania Pharmacist I November/December 2012
ACPA President’s Dinner
The Allegheny County Pharmacists Association held their 74th annual President’s Dinner this year on July 13, 2012, to honor outgoing President Dr. Lauren Simko, and to welcome incoming President, Dr. Jamie McConaha. The dinner was held in Pittsburgh, Pennsylvania at McCormick & Schmick’s restaurant. The 2012 yearbook was presented with various ads from family and friends of ACPA members, along with many companies providing their support. Missy Krause was instrumental in pulling the program together, and Gayle Cotchen delivered a summary of what Lauren accomplished during her term as president. The evening’s activities included the Invocation, Yearbook Dedication, Installation of Officers, President’s Address given by Dr. McConaha, and thank you response by Dr. Simko. PPA President Rob Frankil and his wife made the trip to Pittsburgh to present Lauren with her certificate of recognition from PPA.
Departments Two University of Pittsburgh students, Erin Burke and Ravi Patel, were present to represent the students as well as Duquesne University’s current Dean of the Mylan School of Pharmacy, J. Douglas Bricker. The evening was a wonderful gathering for the pharmacy profession and ACPA looks forward to celebrating the 75th annual dinner in 2013. ACPA would like to thank the staff at PPA for all of their support to enable ACPA to continue to offer the pharmacists of the Pittsburgh area many wonderful programs and assistance with continuing to grow their membership.
ACPA’s New Board Members ACPA has two new Board members both of whom are students from Duquesne University, Aaron Pellicciotti and Steve Shadid. Aaron Pellicciotti is a student at Duquesne University. He is the president of Phi Lambda Sigma and the current president of his graduating class. He attended PPA’s GRASP program in the spring of 2012 where he discovered how important it is to be an active leader and advocate for the pharmacy profession. Steve Shadid is also a student at Duquesne University. While
at Duquesne, Steve participates in several professional organizations, including: the Academy of Managed Care Pharmacy (treasurer), the Pennsylvania Pharmacists Association (ACPA delegate), the National Community Pharmacists Association, Phi Delta Chi professional pharmacy fraternity, and Phi Lambda Sigma pharmacy leadership society. He is also actively involved in Orthodox Christian Fellowship and Duquesne’s newly formed Interfaith Council, and is a member of the National Scholars Society, Phi Eta Sigma Honors Society, and St. Vincent de Paul Society. Steve is undecided about his future as a pharmacist but is excited to learn about the many career opportunities available and to discover the possibilities while on rotations next year.
Rite Aid Launches 50th Anniversary Celebration in Harrisburg In honor of Rite Aid’s 50th anniversary, the company announced the launch of RA50, a multi-faceted, sixmonth celebration designed to commemorate Rite Aid’s longstanding tradition of providing personal healthcare services, health and wellness products and community partnership.
“Rite Aid’s motto is ‘with us, it’s personal’ and for fifty years, our associates have proudly delivered on this promise by meeting the health and wellness needs of our customers and communities,” said Rite Aid Chairman, President and CEO John Standley. “RA50 embodies our core values and is the perfect way for Rite Aid to thank the many communities across the nation that have helped us grow and to continue our mission of helping those we serve live healthier, happier lives.” RA50 kicked off in Harrisburg on September 12, 2012. RA50 then moves on to Baltimore, Philadelphia, Pittsburgh, Scranton, Cleveland, Detroit, Portland, Ore., Los Angeles, Atlanta, Norfolk and New York City over the next ten weeks.
First Pharmacist Appointed to HHS National Vaccine Advisory Committee On September 11, 2012, Mitchel Rothholz, RPh, MBA was sworn into a four year term as an individual member of HHS’ National Vaccine Advisory Committee (NVAC). The purpose of NVAC is to advise and make recommendations to the Assistant Secretary of Health, Director of the National Vaccine Program, on matters related to program responsibilities, including the development and implementation oversight of the National Vaccine Plan. Rothholz was appointed in Continued on page 10
Pennsylvania Pharmacist I November/December 2012 I 9
Departments Member News
Continued from page 9
recognition of his more than 18 years of leadership work within the immunization and pharmacy community to increase our nation’s vaccination rates and for his work in facilitating the role of pharmacists in immunizations. Rothholz currently serves as the Chief Strategy Officer of the American Pharmacists Association and is a PPA member. He is a member of the Executive Committees of the AMA/CDC National Influenza Vaccination Summit (NIVS) and the AMA/CDC/ HHS National Adult Immunization Summit the Advisory Board of the Immunization Action Coalition, and served on HHS – NVAC’s Adult Vaccination Working Group. He has assisted numerous pharmacists in implementing immunization services, facilitated collaboration among immunization stakeholders, and has made numerous presentations to public policy makers and the media on pharmacy-based immunizations and immunizations across the lifespan.
PPA President Rob Frankil Featured on pharmacypodcast.com Rob Frankil, PPA President, was interviewed at the PPA Annual Conference in Scranton by Todd Eury of Pharmacy Podcast. You can listen to Rob’s live interview by visiting http://pharmacypodcast. com/. Rob’s interview was episode number 53 in the listing of podcasts. For more information
about pharmacypodcast.com, please visit the “About Us” section on their website.
Members in Print Mayes College Dean Andrew M. Peterson, PharmD, PhD’09, was the coauthor on the 3rd edition of Pharmacotherapeutics for Advanced Practice (976 pages, Lippmcott Williams & Wilkins; ISBN-10: 0781757843). The 60-chapter text is authored by pharmacists, nurse practitioners, physicians and other healthcare practitioners. There are 10 University of Sciences faculty and eight alumni members as chapter authors, including Henry (Hank) Schwartz, PharmD, Director of Community Pharmacy Practice Experiences.
IPBG Partner and Family Featured in University of the Sciences Bulletin Magazine Carlos Rios, a partner in Independent Pharmacy Buying Group, was recently featured along with his wife, Cynthia Swantkowski Rios, in the Bulletin magazine of the University of the Sciences. Cynthia’s family has trusted the University of the Sciences with their pharmacy careers for more than a 30-year period. Cynthia’s father attended the school and opened pharmacies in Old Forge and Duryea, PA, along with Floyd Swantkowski. Cynthia also attended PCP where she met Carlos. Cynthia’s
PennsylvaniaPharmacist Pharmacist I November/December 1010I I Pennsylvania November/December 2012 2012
brother, Alan Swantkowski also graduated from PCP. Cynthia works as a volunteer pharmacist for Community Volunteers in Medicine.
Lancaster Country Pharmacist’s Association Scholarship Award Winners The Lancaster Country Pharmacist’s Association recently announced their 2012 Scholarship winners. There were so many high caliber students this year that the scholarship committee decided to award ten scholarships. All ten recipients will receive fifteen hundred dollars. Four of the students are PPA members and are listed below: Lancaster County Pharmacist Society – Erika Morgan, University of Pittsburgh School of Pharmacy. Lancaster County Pharmacist Society – Evan Slagle, Thomas Jefferson University School of Pharmacy. Wiley’s Pharmacy Scholarship – Jaclyn Beckett, Temple University School of Pharmacy. David Ference Award – Benjamin Andrick, Duquesne University School of Pharmacy. z
New Members P PA welcomes the following New Members who joined us from August 10th through October 2, 2012. Please make these new members feel welcomed and part of Pennsylvania pharmacy!
Philadelphia College of Pharmacy at USP
Ann Marie Porreca
Robert John Milby
Ian Kalter Yusra Khan
Eun Joo Kim
Wa Hin To
George Chunderlik Pittsburgh Ronald Dewalt Pittsburgh Igdaliah Jackson Eddystone Diana Regan Haddonfield Katie Ferguson Wilkes-Barre Ami Zellefrow Harrisburg Maxine Berman Lansdale Catharine Duffy Hellertown
Resident Gregory Castelli University of Pittsburgh Medical Center Pittsburgh Amy Haver North Huntingdon
Temple University School of Pharmacy
Sean Lasota Pittsburgh
Duquesne University School of Pharmacy
Ashley Adams Jessica Daley Kathryn DeLone Shawna Engle Megan Gapinski Nathaniel Hazlett
Kelsey Ripper PharmacyGPO Aliquippa
Angie Wentzel Cumberland Apothecary Camp Hill
LECOM School of Pharmacy
Lisa Costanzo West Grove
Michelle Mikus Ilana Portman Jennifer Zhao Christopher Marian
David Ficcadenti Landsdale
Luis Gonzalez Yardley
Stephanie Hunter Tyrone
Melissa Burrell Mili Patel
Edward Avanessians Ngoc Bui Kayla Cassada Seven Cheng Joyce Chong Joshua Chung Stephen Comitalo Cara Costelloe Heather Coyle Suji Cunningham Gina DeCarolis Ravi Desai Lilly Dessalegn Kalina Dixon Karen Do Lisa Dragic Erin Drewniany Brittany Dustman Mona Fassihi Michael Ferenz Indira Friel Terrence Gardner Aneliya Garrido Kelly Gasloli Duong Giang Katarzyna Gosek Bridget Grady
University of Pittsburgh School of Pharmacy Eric Abanquah Samantha Becker Tyler Halfhill Kyle Hejmanowski Eric Hilty Ian Ivancic Amanda Jaber Lauren McMullan Alyssa Miller Cody Moore Joseph Napora Lucetta Pontiff Lindsay Rosso Allison Supko Evan Williams Julia Zecchini Laura Bredenberg Christina Goldaine Hilary Navy Nicole Pezzino Wilkes University School of Pharmacy Bernard Klemchak Trina Patel Rachel Quinn Rachel Sprock Meagan Williams Clinton Yoder
Thank you to everyone who has helped recruit a member and for helping make PPA stronger!
Pennsylvania Pharmacist I November/December 2012 I 11
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Pharmacy Time Capsules 2012 (Fourth Quarter) 1987—Twentyfive Years ago:
Clinical Sciences Section formed within the American Pharmaceutical (now Pharmacists) Association Academy of Pharmaceutical Research and Science.
1962—Fifty Years Ago:
Legislation introduced (unsuccessfully) to allow the FDA to inspect pharmacy prescription files. Paul Parker at the University of Kentucky established first formalized Drug Information Service. Merrell removes Mer-29 (triparanol) from market for adverse eye events.
1937—Seventyfive Years Ago:
Do you know a pharmacist who is not a member of the Pennsylvania Pharmacists Association??? Invite them to join in order to strengthen the pharmacy profession in Pennsylvania and a chance to win $250 by having them put your name on the “recruited by” line on their application. Annual Pharmacists dues are only $250 per year. Which is equivalent to: • 2/10 of a percent of the annual pharmacist salary in PA • About 5 hours of work per year • Less than 68 cents per day Visit www.papharmacists.com to join online or find out more about the benefits of joining PPA!
Over 100 people were poisoned by S. E. Massengill Company’s Elixir of Sulfanilamide . This led to 1938 legislation requiring proof of safety as a condition for marketing. Loronzo L. Skaggs opened the first store of a new chain chain of self-service drugstores in the Midwest. Original name was “Pay-Less” later changed to Osco Drug.
1912—One hundred Years Ago:
International Pharmaceutical Federation (FIP) established as an international federation of national pharmacy organizations. The Journal of the American Medical Association(JAMA) reports the first diagnosis of death by heart attack.
By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH
One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org.z
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Community Pharmacy Spotlight
Hinkle’s Pharmacy – A Part of the Columbia Community Since 1893 By: Molly S. McBryan, 2013 PharmD Candidate at Wilkes University
ometown comfort, personal assistance and welcoming, professional employees are just a few of the many aspects one can expect when walking into Hinkle’s Pharmacy in downtown Columbia, PA. Hinkle’s Pharmacy has been a tradition in the small town of Columbia since 1893 when Samuel W. Hinkle and Luther W. Schroeder first opened the pharmacy and small soda fountain. John Hinkle III is the current owner of Hinkle’s pharmacy and accompanying restaurant. Hinkle followed his relative’s footsteps by attending and graduating from the Philadelphia College of Pharmacy at the University of the Sciences in Philadelphia, PA. He began working at Hinkle’s Pharmacy when he was 12 years old, but admits that he did not always know that pharmacy was the career choice for him. He eventually came to that realization in his second year of school due to his interest in math and science and appreciation of the small town lifestyle.
John Hinkle III
Throughout the years, the pharmacy has gone through expansions to include increasing the size of the pharmacy and front end store, as well as developing the soda fountain into a larger restaurant to include a full menu. The front end store has expanded to include a large selection of greeting cards and gift items. The
expansions did not interfere with the ideals the pharmacy wanted to uphold, which includes a small, independent pharmacy with a reputation where customer’s and patient’s interests are the number one priority. One sign that the pharmacy has definitely expanded Continued on page 16
Pennsylvania Pharmacist I November/December 2012 I 15
Features Community Pharmacy Spotlight
Continued from page 15
over the years is the number of employees. In 1893, the pharmacy only employed two people, but now that has increased to include a total of 70 people throughout the entire pharmacy, restaurant, front store and medical equipment department. John Hinkle III mentions that during expansion, they wanted space reserved for a compounding room with the necessary equipment to revive one of the older traditions of pharmacy practice. Hinkle’s Pharmacy expanded their compounding services by joining PCCA and becoming certified and trained in veterinary and hormonal products. Hinkle has a passion for compounding and not many pharmacies compound medications individualized for the patient anymore. Hinkle’s pharmacy has needed to evolve in other areas of pharmacy practice other than in the size of the building in order to continue to be successful throughout the countless years it has been in business. John Hinkle III states that this has been accomplished by increasing the technological capabilities of the computer systems, gaining accreditation through Medicare, and incorporating more services, such as offering durable medical equipment, diabetic shoe fittings and giving patients vaccinations. Currently, patients are able to receive the Zostavax, pneumococcal and influenza vaccinations at the
pharmacy by certified pharmacists by either stopping in or making appointments. Besides advancing the pharmacy to keep up with the evolving practice, John Hinkle III contributes a lot of the success to the town of Columbia. Hinkle states that he “really value(s) the personal relationship with people, we recognize them when they come in and they know who is working at the counter when they come in” and he has always “pushed [for] service and personal touch”. Hinkle loves the small town, independent feel of his pharmacy and enjoys knowing his customers and describes the pharmacy and town as a close knit family. He states that “the town has been good to us and we’re glad that we can be here and have that comfort feeling for people and it’s nice to see the same people”. However, it is getting more challenging with mail order and the idea that patients may be forced to use mail order rather than making a business decision to use a pharmacy of their choice. Most of the challenges of owning an independent pharmacy John Hinkle III attributes to challenges from the outside, such as regulations and third party reimbursements. His advice to pharmacy students who are interested in independent pharmacy ownership is to be familiar “beyond the pharmacy end of it”. He advises that students and young practitioners should know the business and insurance portions well, determine the demographics that are available to them and to diversify into other
16 I Pennsylvania Pharmacist I November/December 2012
areas of related practice. Hinkle advises prospective owners to “be prepared to work against some adversity” and be “well studied and talk to a lot of independents before you start to venture off on your own”. Organizations, such as the Pennsylvania Pharmacists Association and other national pharmacy organizations are important to John Hinkle III and the practice of independent pharmacy. He states that “just the sheer fact of having an organization behind you…and be[ing] able to learn through other people’s experiences and be[ing] able to have a group say is beneficial.” One of the challenges of being an independent is that being “out on your own often leads to a very difficult situation if you’re trying to get somewhere with an insurance company or organization”. Hinkle believes that the future of independent pharmacies looks more difficult due to an unfair advantage that insurance companies and larger chain stores are currently having. Hinkle’s Pharmacy has been able to make those changes necessary in order to continue as a successful independent pharmacy and full service restaurant. The pharmacy will continue to offer friendly, personal service to the people of Columbia, PA and to keep the traditions of independent pharmacy alive. John Hinkle III believes “it is more of what pharmacy in my mind always was; to be with the patients and [be an] active part of the triad with the doctors, patients and pharmacy work[ing] together”.z
Features PHARMACY MARKETING GROUP, INC.
Financial Forum By Don. R. McGuire Jr., R.Ph., J.D.
his series, Financial Forum, is presented by Pro Advantage Services, Inc., a subsidiary of 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.
Six Things You Can Do To Get In Shape Financially Have you looked at your finances lately? Thereâ€™s no wrong time to take a closer look at your financial health. Why not start today? Here are several things you may want to do: Define your goals, set a budget. The goal setting will motivate you, and the budget
(created with your goals in mind) can be reviewed and adjusted. Changes in your life may prompt you to save, spend and invest differently. Look at your debts. What is your monthly debt vs. your monthly income? Would you Continued on pag 26
Pennsylvania Pharmacist I November/December 2012 I 17
Features PHARMACY MARKETING GROUP, INC.
and the Law 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.
ontracts are a fact of life in the modern world. We are faced with all types of contracts in both our professional and personal lives. These include leases of real property, agreements to sell real estate or to buy a car, or even the terms and conditions that we click on a website in order to proceed to the whatever product or service that we want to purchase. Contracts provide stability and certainty in the business world, but occasionally the terms contained in them can come back to haunt us. A contract is defined as “a promise, or set of promises, for breach of which the law gives a remedy, or the performance of which the law in some way recognizes as a duty.”1 A contract can require a party to do some act and/or prohibit them from doing some other act. It can also set mutual expectations for quality and quantity of goods, price, delivery, etc. A contract
essentially sets out the rules that will govern a particular transaction. Contracts can be either oral or written, although the written contract is easier to review and interpret later. Except in some special circumstances, oral contracts are every bit as valid and enforceable as a written one. Don’t be fooled by thinking that all contracts must be written. When things proceed as agreed, which is usually the case, the stability of our commerce and society is enhanced. The problem, of course, occurs when things don’t go as planned. The key is to be informed before a contract is signed. The law of contracts has developed over centuries and the parts of a contract are legally well-defined. Many of the words and phrases are words of art, i.e., they have a particular meaning in the world of contract law. This makes it difficult for a pharmacist, or any layperson, to effectively and efficiently interpret a contract without the help of an attorney who is knowledgeable about contracts. It will not be an effective defense in a lawsuit
1 Williston, Contracts § 1
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over a contract to state that either you didn’t understand or didn’t read the contract that you signed. By signing the contract, you have agreed to the terms of that contract. Absent a showing of fraud or deceit (for instance, that the contract was altered after you signed it), the contract will be binding. The pharmacist should initially review a contract to assure that it accurately sets out what the parties have agreed to. However, when reviewing a contract, a pharmacist should be aware that the words in the contract are there for a reason and should not assume that they are fluff, boilerplate or other “mumbo jumbo”. The old adage about reading the fine print is true and is derived from previous experiences with contracts. The pharmacist should seek professional help for any confusing or unfamiliar terms. The time to clarify and change terms is before the contract is signed and not after. While there is a cost to obtain this help up front, it will usually be less costly than trying to get out of an unfavorable contract. As the attorney, there will be fewer tools available and much more Continued on page 26
3 difficult words for many patients
HELP PATIENTS TAKE THEIR MEDICATION AS PRESCRIBED The Adherence Estimator® provides a way to estimate the likelihood of a patient adhering to a newly prescribed medication for a chronic condition. After the patient responds to 3 quick statements, the Adherence Estimator will provide an estimate (low, medium, or high) of the patient’s likelihood of medication adherence to a newly prescribed medication. You’ll receive immediate, personalized feedback that can help support your efforts around adherence. Visit Rx for Health to find the Adherence Estimator, plus more tools and resources that support your efforts to improve medication adherence.
Try the Adherence Estimator at MerckEngage.com/RxForHealth/AP Be well
Adherence Estimator is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. US and non-US Patents Pending. Copyright © 2008 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved. Copyright © 2012 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved. NOND-1058468-0000 10/12 MerckEngage.com
Pennsylvania Pharmacy Residents Spotlight T hank you again for all the residency submissions we received.Â Because of the numerous Pennsylvania programs, we could not include all of them in our last issue â€“ we are publishing them in this issue and in the January/February issue.
but also an entire patient population. To fulfill this, I plan on working as an administrator in either a managed care or hospital setting. Since I am interested in both clinical and operational aspects of administering pharmacy care, I also plan on earning an MBA in the future as well. Drew Kirk, PharmD.
Kristin Bohnenberger, PharmD. School Attended: Wilkes University Nesbit School of Pharmacy, 2012 Project: My research project will investigate the extent of intentional modafinil overdoses in the United States and whether these trends in misuse have changed over time Pharmacy Practice Vision: I hope to be a clinical toxicologist working within a poison center or emergency department with the capacity to precept students. Stephanie A. Stoneham, PharmD.
School Attended: Virginia Commonwealth University, 2012 Project: My research project at Temple will explore the use of antipsychotics prescribed for acute delirium and continued at discharge. Pharmacy Practice Vision: Upon completion of my PGY1 residency, I would like to be a well-rounded pharmacist capable of providing inpatient clinical pharmacy services. Further, I anticipate pursuing a PGY2 in either internal medicine or critical care. My ultimate goal is to become a clinical specialist, obtain board certification, and work at an academic medical center.
School Attended: Wegmans School of Pharmacy at St John Fisher College, 2012 Project: I do not have a research question yet, but I am interested in doing outcomes research looking at the effect of clinical pharmacy programs on health care cost. Pharmacy Practice Vision: In 5 to 10 years, I see myself in a position where I can not only have a positive effect on the care of individual patients,
Nick Wytiaz, PharmD. School Attended: University of Pittsburgh School of Pharmacy, 2012 Project: Evaluation of outcomes of protocol vs. weightbased dosing of prothrombin complex concentrate (PCC) for warfarin reversal. Pharmacy Practice Vision: For my career, I hope to provide both direct patient care and clinical services in
20 I Pennsylvania Pharmacist I November/December 2012
an acute setting while being able to conduct research drawn from these experiences and practices. Currently, I am considering a PGY2 critical care residency after this year in order to gain additional experience and training. Ultimately, I would like to work as a clinical pharmacist in the hospital setting, while still maintaining some involvement in research, possibly through a position in academia. Nicholas C. Schwier, PharmD. School Attended: Wegmans School of Pharmacy at St John Fisher College, 2012 Project: This year I will be investigating whether or not virtual learning along with simulation learning is more effective than simulation learning alone, in a pharmacy school curriculum. The University of Pittsburgh uses simulation learning technology incorporated into their various health professions programs; we will be examining this theory amongst pharmacy students at the University of Pittsburgh School of Pharmacy. Pharmacy Practice Vision: After completing my PGY-2 in Cardiology, receiving BCPS certification, and an AQ in cardiology, I plan on pursing academia or be heavily involved in pharmacy student precepting while working in a large academic health center.
Features Leah Smith, PharmD.
Katie Ferguson, PharmD.
School Attended: Duquesne University Mylan School of Pharmacy, 2012
School Attended: University of Maryland School of Pharmacy, 2012
Project: How to Improve CMS Star Rating Measure of Utilization of ACEI or ARB in Diabetic Patients. Pharmacy Practice Vision: I hope to have established a position within a health plan enabling me to develop my interests in managed care. I am specifically interested in utilization management and quality measures related to a prescription drug plan; which is the focus of my research project. Eventually I would like to either develop into a management role or a teaching position focusing on managed care pharmacy within the pharmacy curriculum. Jessica Saunders, PharmD. School Attended: Hampton University School of Pharmacy, 2012 Project: I do not have a research project available to describe at this time, however it will be relative to managed care pharmacy. Pharmacy Practice Vision: In five to ten years I envision myself balancing several aspects of a pharmacy career. I primarily see myself practicing in managed care pharmacy, having found my niche within it where I can best serve. I also envision myself maintaining direct patient care via part time work in a clinic or community pharmacy. In addition, I plan to teach in some capacity, whether it be as a preceptor, lecturer, or a combination of both.
Project: For this upcoming year we will be investigating the prescribing of potentially inappropriate medications in elderly patients as defined by the STOPP criteria and 2012 update of the BEERS criteria. We will look to provide targeted interventions to avoid potentially dangerous adverse events for our elderly patients. Pharmacy Practice Vision: In my future of pharmacy practice I envision myself performing clinical services in an independent community pharmacy while serving as an adjunct professor for a school of pharmacy. I also look forward to advocating for the profession to allow pharmacists to expand on the services we are able to provide. Completing a community residency will allow me to further develop the clinical skills necessary to provide advanced patient care. Sarah Pupo, PharmD. School Attended: Wilkes University Nesbit School of Pharmacy, 2012 Project: My research project will evaluate overrides of highalert medications in our hospitalâ€™s emergency department. Pharmacy Practice Vision: I plan to practice as a clinical pharmacist in an inpatient setting and obtain boardcertification in pharmacotherapy. I hope to foster my interest in teaching by becoming an adjunct faculty member at an accredited college of pharmacy. Additionally, I would like to serve as a preceptor and mentor for students and residents, as well as new pharmacists.
Cassandra Dolecki, PharmD. School Attended: Lake Erie College of Osteopathic Medicine School of Pharmacy, 2012 Project: The viability of an outpatient, pharmacist-run injectables clinic associated with a health system. Pharmacy Practice Vision: I see myself working in an outpatient clinic focusing on disease state management, teaching in a pharmacy school as an adjunct faculty member, and precepting pharmacy students. Stephanie M. Seaton, PharmD. School Attended: St. Louis College of Pharmacy, 2011 Project: I am working on finalizing my research project proposal. The project will take place in a senior care clinic which is a level three medical home in Pittsburgh, PA. The project will help determine the impact of pharmacy services in highrisk elderly patients and transitions of care. High-risk patients can include, but are not limited to polypharmacy, frequent emergency department or hospitalizations, and co-morbid disease states. Pharmacy Practice Vision: My current career goal is to become a confident, effective practitioner as the ultimate resource for information about medications to treat geriatric patients that will enable me to have a viable interdisciplinary clinical practice. I seek a clinical faculty position and to conduct clinical practice outcomes research. I also plan to continue my pursuit for expertise in practice by attaining board certification. Continued on page 22
Pennsylvania Pharmacist I November/December 2012 I 21
Features Pennsylvania Residents Spotlight
Continued from page 21
Aundrea Robertson, PharmD. School Attended: Wilkes University Nesbit School of Pharmacy, 2012 Project: I plan on doing research on the use of calcium and sodium bicarbonate in patients with hyperkalemia in the emergency department. Pharmacy Practice Vision: Following my PGY1 Residency, I would like to continue my education with a PGY2 in critical care/emergency medicine or infectious disease. I would also like to work toward my BCPS certification in the next few years. Ideally, I would like to utilize my skills and interests to work as a clinical pharmacist in a community hospital setting. I look forward to working on interdisciplinary teams, performing research to improve institution practices, and educating pharmacy students. Sandra La, PharmD. School Attended: University of the Sciences, 2012 Project: I intend to do my research project on weight based dosing of heparin in obese patients. Pharmacy Practice Vision: I envision myself as a clinical pharmacist in an ambulatory care pharmacy.
the impact and feasibility of a pharmacist-driven cardiovascular clinic specializing in lipid and/ or hypertension management. As preventative medicine emerges as a major player in reducing the cost of overall healthcare, the question arises as to whether further pharmacistphysician collaborative practice agreements and point-of-care screening/testing clinics can optimize patient-specific outcomes, quality of life, and provide improvements in transitions of care. It will be the goal of this project to explore the possible roles pharmacy can play in optimizing cardiovascular care in the outpatient setting. Pharmacy Practice Vision: I hope to manage chronic disease states in collaboration with a healthcare team that desires to optimize patientspecific outcomes and maximize quality of life. I have a particular interest in ambulatory oncology, specifically managing chronic disease states of oncology patients in hopes of preventing and/or minimizing long-term adverse effects of chemotherapeutic agents and maintain disease state management while patients are actively undergoing chemo and/or radiotherapy. I have long-term ambitions of expanding the roles of ambulatory oncology pharmacy practice to possibly encompass disease state management and specializing in optimizing full medication regimens to best manage the complex drug interactions and side effects of emerging targeted therapies. Tiffany Chapman, PharmD.
Crystal D. Mayles-Heise, PharmD. School Attended: West Virginia University School of Pharmacy, 2011 Project: We hope to investigate
School Attended: South Dakota State University, 2011 Project: My medication use evaluation this year is to determine if the liposomal formulation of
22 I Pennsylvania Pharmacist I November/December 2012
injectable bupivacaine will positively impact patient outcomes when compared to conventional injectable bupivacaine hydrochloride in the postoperative setting. My major research project this year will be to evaluate the incidence of medication related adverse events in ICU patients utilizing a risk assessment tool to identify potential sources of medication errors within the ICU discharge summary. Pharmacy Practice Vision: In 5 to 10 years I envision myself working as an expert in medication use safety within a healthcare system or corporation that includes a clinical research component. As I move forward in my career I plan to continue to pursue opportunities to develop my skills and abilities in the research arena while maintaining my overall goal of improving patient safety. Brandon Snyder, PharmD. School Attended: Jefferson University School of Pharmacy, 2012 Project: My project will be looking at the development and implementation of an alcohol withdrawal protocol in a community hospital. I plan to retrospectively look at patients who were admitted to our hospital and received certain medications (i.e. thiamine, folic acid), and analyze their hospital stay with regard to alcohol withdrawal. I then plan to develop and implement an alcohol withdrawal protocol and determine if outcomes for patients treated with this protocol are better than those analyzed in phase 1 Pharmacy Practice Vision: In 5 to 10 years, I would like to see myself practicing as a member of an integrated healthcare team. It is
Features very important to me to work in an interdisciplinary environment; this type of practice provides the best overall care for our patients. As pharmacists we have a great opportunity to impact patient care with our knowledge of medications. Karen Soong, PharmD. School Attended: University of Pittsburgh School of Pharmacy, 2012 Project: I intend to pursue a project examining the effect of pharmacist intervention in patients who are on the maximum dose of non-insulin monotherapy who have not achieved their goal A1c within 3-6 months.
Megan A. Kloet, PharmD. School Attended: University of Florida College of Pharmacy, 2011 Project: My project will be focused on improving patient safety in the ICU. Pharmacy Practice Vision: Within the next five to ten years, I envision my career to be in the academic setting as a college of pharmacy faculty member. I would like to have a position that includes a mix of teaching, clinical practice in the ICU, and research. I also see myself continuing to be involved in professional pharmacy organizations on both a local and national level.
Pharmacy Practice Vision: In 10 years, I hope to be working at a VA hospital contributing to inter-professional clinical services, precepting pharmacy students, and helping to advance the profession. Lindsay D. McDonnell, PharmD.
Sarah Krahe Dombrowski, PharmD. School Attended: University of Pittsburgh School of Pharmacy, 2012 Project: I plan to investigate how community pharmacists can triage patients within dispensing workflow to assess their risk for non-adherence and then identify and provide appropriate care to further identify, prevent, and solve drug therapy problems. Pharmacy Practice Vision: I intend to obtain a clinical pharmacist position in a community pharmacy or ambulatory care setting. I am interested in exploring how community pharmacists can be integrated into patient-centered medical homes while being geographically separated from the physician. Ideally, I would like to see the expansion of the role of community pharmacists through the provision of direct patient care including access to the patient medical record and increased inter-professional collaboration.z
School Attended: The University of the Sciences, 2012 Project: Evaluation of the management of septic patients in the critical care unit at Jeanes Hospital Pharmacy Practice Vision: After my PGY1 residency, I envision myself going on to complete a PGY-2 residency in infectious diseases. I would then like to obtain a position as a clinical pharmacy specialist in a large urban teaching hospital and develop or manage an antimicrobial stewardship program within that hospital. I would like to also spend my free time in the ambulatory setting by working at an HIV clinic in Philadelphia.
Tony Hayslip, ABR/AREP 713-829-7570 Tony@RxBrokerage.com
Ernie Zost, RPH 727-415-3659 Ernie@RxBrokerage.com
Pennsylvania Pharmacist I November/December 2012 I 23
PPA Member Profile: Julie M. Gerhart, RPh, MS Title: Associate Director U.S. Academic & Professional Affairs-Pharmacy at Merck Education: University of the Sciences/ PCP Post Graduate Education: Master’s Degree in Biomedical Writing from PCP in 2005 What made you choose the profession of pharmacy? I always had a strong interest in health care professions and when I was a teenager I babysat for married pharmacists, who were also both Philadelphia College of Pharmacy graduates. They talked to me about pharmacy and they talked to me about the school. Both seemed like a good fit. I liked the idea that I could help people walking into my pharmacy every day. Who taught you the most about pharmacy and what did they teach you? I really think I am the product of every instructor who taught me along my pharmacy journey. My college professor Dr. Hussar was someone I talked to about issues in pharmacy and about choices throughout your pharmacy career. As I went through my pharmacy career different pharmacists I worked with gave me interesting perspectives on pharmacy. What always resonated with me throughout my learning experience is that pharmacy is always about the patient and their experiences. They seek our advice and they trust what we say, and it is always so important to let that guide each interaction with a patient. Can you please explain what you do in your role at Merck? In the pharmaceutical industry I help many teams within Merck understand
the practice of pharmacy. I can help provide details with what happens in pharmacy from the filling of prescriptions to billing. I also work on a team that evaluates and make decisions on supporting educational initiatives for pharmacists. I’ve also been involved in a multi-year project that resulted in the redesign of many Merck prescription medication bottle labels. I have had the good fortune to have had a variety of pharmacy practice experiences. In school I worked in a grocery store, pharmacy setting. I have worked in a setting that was a combination of a long term care pharmacy and community pharmacy and also practiced in a facility for psychiatric patients and have consulted on nursing and patient-centered texts. I have taken a nontraditional path that led me to my current position; all these experiences have helped me become a resource for pharmacy information for my colleagues at Merck. What was the most memorable experience of your career? In 1994 when I was on my rotation I witnessed a medication error that was very serious and I took a lot away from that moment. There is a proper way to handle medication errors. I remember sensing fear in the pharmacy staff when the error was discovered. It certainly was a teachable moment, and that teaching didn’t take place. I remember thinking it’s important to have a way to report and address medication errors that is not punitive. Your career in pharmacy can be shaped by how you address mistakes. During your career, what do you believe to be the single most significant advancement in pharmacy? I think the most significant
24 I Pennsylvania Pharmacist I November/December 2012
advancement in pharmacy is the broadening of pharmacist services to include vaccinations and MTM. Pharmacists are demonstrating every day their ability to provide services that were not considered part of the standard of practice for pharmacy 10 to 15 years ago. How has being a PPA member helped you professionally? PPA is a wonderful source of information, both through its members and through the organization itself. Member colleagues have practiced in a variety of settings that represent different facets of the world of pharmacy. I enjoy discussions with colleagues working in different settings and learning about what being a pharmacist means to them. PPA also serves as a great resource to its members. The website provides a wealth of information and links. The association keeps us up to date on current events in pharmacy on the state and national level, and it lets us know when there are legislative or regulatory issues that may affect how pharmacists practice. The connections we establish and the information that is shared through PPA are valuable no matter the practice setting. When you are not working you can be found doing what? I am a mom of an almost two yearold with Down syndrome. Evan has taught me so much. From him, I’ve learned that we are all capable of so much and that every milestone is one to celebrate. I find myself involved in lots of toddler activities such as swim lessons and trips to the zoo. I am also involved with organizations that focus on Down syndrome/special needs awareness and education. Professionally I am also a member of APhA, NCPA, and ASCP.z
Profiles in Pharmacy Innovation: Shannon Antypas PharmD. Education: University of Pittsburgh, 2009 graduate University of Pittsburgh Community Pharmacy Residency Site Description: Dr. Antypas works for a Rite Aid pharmacy in Imperial, PA. Imperial, PA is located in Allegheny County in Western Pennsylvania. Innovative and Other Services provided: Rite Aid pharmacy has started to incorporate more clinical programs into their community pharmacy practice. Dr. Shannon Antypas has been given the opportunity to work with these new programs and to make more of an impact with improving patient care. She states that the initial “breakout into more patient care” for the pharmacy has been with the ability of pharmacists to offer immunizations.
determine if those medications are suggestive of a particular disease state. If a certain disease state is expected, then the program will look at the clinical guidelines for that disease and determine if the patient should be on an additional medication. For example, a diabetic patient may need to be initiated on statin therapy. According to Dr. Antypas, “pushed claims give us a moment to focus on the patient and contact the patient…and the physician.” The second outcomes program is the comprehensive medication review. The comprehensive medication review is similar to a medication therapy management session. The sessions last approximately 30-45 minutes and involve a review of the patient’s complete medication regimen. Dr. Antypas appreciates the fact that she is able to use skills that she acquired during school and her residency and feels that “it is great to be a retail pharmacist [and] to have some clinical experience too.”
Two brand new programs Rite Aid is utilizing are Outcomes programs for which certain patients can qualify. The first is called targeted intervention program or TIPS. TIPS processes a claim made and “pushes” an How Dr. Antypas prepared for practice: intervention recommendation to the After graduating the University of pharmacist and then the pharmacist Pittsburgh in 2009 with a PharmD., Dr. can decide if it is appropriate for the Antypas decided to particular patient. continue growing For example, one “pushed claims give us in her profession intervention the a moment to focus on by completing program may a community suggest could the patient and contact pharmacy be related to the patient…and the residency through cost efficiency physician.” the University of for patients; it Pittsburgh. may recommend switching the patient Why Dr. Antypas chose to advance her to a less expensive medication with practice: Dr. Antypas “knew there was the same mechanism. Another example more [she] could do for [her] patients” of an intervention may involve and was “excited to get involved”. She other medications that the patient is believes that people in the community currently prescribed. The program will would benefit from services look at multiple medication claims and
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community pharmacies can offer. She states that patients do not always know how to navigate the healthcare system; “it can be challenging.” Pharmacists are a resource for patients and can “help them navigate [the system]” and “optimize therapy.” Advice for others: “Stay involved in pharmacy organizations, such as PPA”. Furthermore, “stay involved with school as well, become a preceptor or be active in developing the school curriculum.” Dr. Antypas believes that “students are a great resource too. [They are] being exposed to new curriculum” and are familiarized with many of the new advancements and innovations in pharmacy. z Contact Information: Email: email@example.com Phone Number: 724-695-7317
Pennsylvania Pharmacist I November/December 2012 I 25
Features Rx and the Law
Continued from page 18
work to do in trying to “undo” a contract than in reviewing it prior to execution. As noted at the beginning, we are all faced with many types of contracts in our lives and not all of them will justify this type of expense. However, when it comes to our profession and our businesses, contracts are an area
where an ounce of prevention is definitely worth a pound of cure. © 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.z
Put all your tax information in one place as it comes in. Put your W-2, your 1099-INT, your 1099-DIV, and all forms in one folder for your preparer (or yourself). See how many allowable deductions you are eligible for, and whether you could pay taxdeductible expenses before the end of the year to save a bit more. Work on wealth protection. Annually, you should … a) calculate your net worth, b) review your will and estate plan, and c) review your level of risk management. Are you adequately insured? Too much tax exposure? A professional opinion couldn’t hurt. We all need a reminder every once in a while to give ourselves a financial “check-up”. Consider this yours. Take a closer look at where you’re at, where you’d like to be, and how you’ll get there. Be sure to look at all the factors, and consider speaking with a Financial Advisor if you don’t already have one.
Provided by courtesy of Pat Reding, CFP of Pro Advantage Services Inc., in Algona, Iowa. For more information, please call Pat Reding at 1-800-288-6669. Registered representative of and securities offered through Berthel Fisher & Company Financial Services, Inc. Member NASD & SIPC Pro Advantage Services, Inc./ Pharmacists Mutual is independent of Berthel Fisher & Company Financial Services Inc. Berthel Fisher & Company Financial Services, Inc. does not provide legal or tax advice. Before taking any action that would have tax consequences, consult with your tax and legal professionals. This article is for informational purposes only. It is not meant to be a recommendation or solicitation of any securities or market strategy.z
Continued from page 17
benefit from refinancing your home? Could you improve your credit score? Set a plan in motion. Consider making today the day you take care of any nagging, lingering debt – once and for all. Max out your 401(k) or IRA contributions. If you are saving for retirement, there’s no excuse for not doing this, other than simply not having the money to put in the account. Consider making a bigger investment in your future today. If your tax status has changed, revise your W-2. Did you get married or divorced recently? Is there a new addition to the family? If your withholding status has changed, it must be updated. Did you buy a house, or get a big raise or tax refund last year? Did a dependent move out of the house? If so, you need to update your withholding status. It’s easy to forget this small step, but it’s significant. Don’t procrastinate any longer!
26 I Pennsylvania Pharmacist I November/December 2012
Article Head Member Services Goes Here Your Member Benefits just got better!
Buy/Sell Overstocked Prescription Drugs
ennsylvania Pharmacists Association members are now eligible to take advantage of savings with special offers and discounts for theme parks and attractions nationwide including Six Flags®, Water Country USA, Dorney Park, Wild Water Kingdom, HersheyPark, and Paramount’s Kings Dominion! Discounts are also available for attractions in Orlando, FL including the Walt Disney World® Resort, Universal Studios® Orlando, Sea World®, Busch Gardens® Orlando Dinner Shows & more! But the savings don’t stop there! You can also save on admission to popular attractions in California, Las Vegas, New York, and other parts of the country. Through this corporate discount program, you have the opportunity to purchase discount tickets year round. Tickets ordered in advance can be mailed directly to you allowing you to have your tickets in-hand before you leave for your trip; saving you time and money! Go to www.TicketsAtWork.com.
Click on the “Login” Box at the top of the homepage. You will then be prompted to create a username and password, and enter our company code PAPHARM. Once enrolled you will have access to discounts on theme parks and attractions nationwide! Or place your order over the phone by calling customer service at 800-331-6483. Enjoy the savings!
Business owners can take advantage of our affiliation with MatchRX. com. MatchRX is a web-based marketplace developed exclusively for independent pharmacists, enabling registered members to buy and sell overstocked prescription drugs at 10–90% off WAC. Members who use the site regularly save $2,000-$5,000 per month. It’s free to join, free to post, and you’ll only incur a fee when someone purchases an order from you. For more information, visit www.MatchRX.com and type “PPA” in the referred by field upon registering. If you need any assistance in the meantime, feel free to contact them at 877-590-0808.z
Pennsylvania Pharmacist I November/December 2012 I 27
Independent Pharmacy Buying Group Pays Your PPA and NCPA Dues So You Don’t Have To!
What Did Your Buying Group Do For You In the Past Year? Independent Pharmacy Buying Group (IPBG) members receive: • • •
Membership Dues for PPA and NCPA Paid in Full (not just a percentage off of your dues) Paid Membership Fee to DeaLookUp.com Pharmacy Audit Assistance Service (PAAS) Yearly Fee Paid 100% of all rebates received from Federation Pharmacy Network (FPN) contracts returned to our members Up to $1,200 for attending AmerisourceBergen’s Wholesale Expo in Las Vegas Free Seminars on Accreditation and Competitive Bidding, FSA Certification, and Fraud, Waste and Abuse Compliance
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PPA 2013 Mid-Year Conference Staking Your Claim For the Future Radisson Penn Harris Hotel & Conference Center, Camp Hill, PA January 25-27, 2013 The future of pharmacy practice and innovation is now. PPA invites you to join us by “Staking Your Claim For The Future” of pharmacy. How will you personally stake your claim to enhance patient care and public health? The programming at the 2013 PPA Mid-Year Conference will assist you with determining your plan for staking your claim for the future of pharmacy.
HIGHLIGHTS: Annual Student OTC Competition PPA will be holding the always popular Student OTC Competition. A team from each school of pharmacy will compete for the traveling championship trophy and attendees will obtain CE credit. Come cheer on your favorite school!
Student Posters to focus on Innovative Practice Students will present/display their posters on the theme “Focus on Innovative Pharmacy Practices,” during the Beer & Banter reception. As much as possible, posters should include information about innovations and any observations/recommendations for change or enhancement, especially for pharmacy practice. More information is available on the PPA website. This program is sponsored by PPA’s Educational Foundation.
Know Pain, Know Gain Competition The PPA Educational Foundation is hosting a Patient Pain Counseling Competition for Students, which will offer 1 hour of CE credit to all attendees. For more information, visit our website and click Foundation/ Other Programs.
Social Events Join us for the following social events to network and catch up with old friends during the conference weekend: Welcome Reception & Kick-off Celebration, Beer & Banter Reception, and New Practitioner & Student Peer Mentoring.
Continuing Education Programs Student Programming Technician Programing The PPA Educational Foundation Auction And more!
MORE INFORMATION COMING SOON: WWW.PAPHARMACISTS.COM/MIDYEAR
Association News – Annual Conference Highlights
2012 Annual Conference Highlights PHARMONOPOLY “ A Focus on the Pharmacists’ Role in the Patient Centered Medical Home” Hilton Scranton, Scranton, PA Thank you for attending PPA’s 2012 Annual Conference, September 20 -23, 2012. More than 350 attendees enjoyed the continuing education programs, social events and networking with your fellow Pennsylvania pharmacy peers. Additional photos from the conference are also available on the PPA website and on the PPA Facebook Fan Page.
Annual Golf Outing Glen Oak Country Club PPA’s Annual Golf Outing took place on Friday, September 21, 2012 at the Glen Oak County Club in Clarks Summit, PA. Special thanks to Jerry and Michele Musheno and all of the members of the golf committee for helping put together this wonderful golf outing. Thanks to RDC as well for their coordination of the golf tee sponsorships. The winning team that day consisted of Erin Burke, Matthew Roesch and Corey Wenger, but a good time was had by all golfers on the course. The second place team included Al Emmans, Scott Miskovsky, Larry Doud and Robert Wilmott. Other golf outing winners included, Closest to the Pin on #9, Rob Frankil; Closest to the Pin on #17, Corey Wenger; Longest Women’s Drive on #5, Erin Burke; Longest Men’s Drive on #15, Art Brunn; and Longest Putt on #13, Ed Gromelski.
30 I Pennsylvania Pharmacist I November/December 2012
Association News – Annual Conference Highlights Exhibit Hall Thank you to the companies who exhibited with us this year! Congratulations to James Dillon, winner of PPA’s overall grand prize drawing in the exhibit hall and congratulations to all those who won exhibitor prizes! Our exhibitors this year included: • AmerisourceBergen
• Pharmacists Mutual Companies
• Amylin Pharmaceuticals
• Pharmacy Podcast
• Berry Plastics Corporation
• Philadelphia College of Pharmacy
• Cardinal Health
• PPA Government Affairs
• Duquesne University School of Pharmacy
• PPA Membership
• En-Vision America
• PRS Pharmacy Services
• Financial Designs, Inc./Mass Mutual
• R.J. Hedges & Associates
• H. D. Smith
• Rite Aid Pharmacy
• Health Business Systems
• Rochester Drug Cooperative Inc.
• Independent Pharmacy Buying Group
• RX30 Pharmacy System
• Jefferson School of Pharmacy
• S & L Solutions LLC
• Keystone Pharmacy Purchasing Alliance
• Sanofi Pasteur
• Kinray Inc.
• LECOM School of Pharmacy
• Temple University
• Merck & Co.
• University of Pittsburgh School of Pharmacy
• Merck & Co. Vaccines
• Value Drug Company
• Montgomery County Pharmaceutical Association
• Wilkes University School of Pharmacy
• Wal-Mart Health & Wellness
Pennsylvania Pharmacist I November/December 2012 I 31
Association News â€“ Annual Conference Highlights Achieving Independence CompetitionSponsored by QS/1 This year, five schools of pharmacy participated and the competition was intense. Each team presented interesting concepts for creative new directions for pharmacies. Special thanks to QS/1 for their sponsorship of this special event. Ultimately, while applauding the achievement of all teams, the judges selected one winning team. The 2012 winning team was the University of Pittsburgh.
32 I Pennsylvania Pharmacist I November/December 2012
Association News – Annual Conference Highlights Awards & Leadership Reception & Dinner The 2012 PPA Awards & Leadership was an evening of celebration of pharmacy in honor. PPA recognized our newly elected leader and Board members and honored those whose work on behalf of the pharmacy profession has been exemplary. PPA Past Presidents and Past Bowl of Hygeia recipients were also recognized. Please review the list of award winners in the next article.
Member Get a Member Contest Members have the chance to win $250 by recruiting a new PPA pharmacist member! It’s simple: During the MemberGet-A-Member competition, you can win $250 by recruiting a new pharmacist and have them insert your name in the “recruited by” box on the printed or online application form. For every application that has your name on it, you will be entered for a chance to win. Congratulations to Mallory McCormick and Coleen Kayden, our winners who were drawn at random and announced at the 2012 Annual Conference. Recruit new members now until August 31st, 2013 and you could win too!!
Community Chest All members that encouraged first-times conference attendees to join PPA for the 2012 Annual Conference were entered into a drawing for the change to win a complimentary registration to the 2013 Annual Conference in Gettysburg, PA or to the 2013 Mid-year Conference in Camp Hill, PA! The winner of the contest was Adam Wood. Thank you to all of those members who encouraged a first-time attendee to join us at the conference!
PPA would like to extend a big thank you to our corporate partners whose year-round contributions are crucial to PPA’s success and stability and our service to our members! Thank you so much!
PPA also thanks the following companies whose sponsorship has helped to provide key funding for this year’s conference.
• Independent Pharmacy Buying Group • Pharmacists Mutual Companies • Rochester Drug Cooperative, Inc.
• Financial Designs, Inc./ MassMutual Financial Group • FirstLab • Pfizer, Inc.
• Lancaster County Pharmacists Association • Montgomery County Pharmacists Association • NACDS • RDC’s coordination of the golf tee sponsorships • Rx Systems for providing note pads • QS/1 sponsorship of the Achieving Independence Competition and Reception • Saturday Breakfast: Medicare’s Limited Income Net
• H.D. Smith • Keystone Pharmacy Purchasing Alliance • Value Drug Company Silver Level • AmerisourceBergen • Kinray • McKesson Bronze Level • R.J. Hedges • S.L. Solutions LLC
Platinum Level • Rite Aid Pharmacy
Special Thanks to the 2011-2012 Conference Committee Summer Bruchwalski, Tanya Dougherty, Al Emmans, Kimberly Ference, Robert Frankil, Rosemarie Halt, Nishaminy Kasbekar, Jacqueline Klootwyk, Nicholas Leon, Sean Lynch, Jamie McConaha, Julie Olenak, Bruce Sigman, Lauren Simko, Leigh Webber, Adam Welch, Adam Wood and Wendy Zern. Their ideas and hard work helped coordinate a wonderful conference!
Pennsylvania Pharmacist I November/December 2012 I 33
Association News â€“ Annual Conference Highlights
34 I Pennsylvania Pharmacist I November/December 2012
Association News – Annual Conference Highlights
Congratulations to PPA’s 2012 Award Recipients
earn more about these awards and each award recipient at the PPA website, by clicking on the Awards tab at the top. Start thinking of people to nominate for next year’s honors!
Richard Smiga, R.Ph. – 2012 APhA Foundation & NASPA Bowl of Hygeia Award supported by Boehringer Ingelheim HIPPA Privacy and Security Officer and CEO, Care Capital, Mechanicsburg, PA
John J. Pavis, R.Ph. 2012 Excellence in Innovation Award Sponsored by UpsherSmith Laboratories Pharmacist, Newhard Pharmacy, Northampton, PA
Jennifer Spengler, CPhT – 2012 Pharmacy Technician of the Year Lead Compounding Technician, Catasauqua Compounding Center, Catasauqua, PA
Adam Welch, PharmD, MBA, BCACP – 2012 Pharmacist of the Year Associate Professor at Wilkes University School of Pharmacy, Wilkes-Barre, PA
Jamie L McConaha, PharmD, CGP – 2012 Pharmacists Mutual Companies Distinguished Young Pharmacist Award Assistant Professor at Duquesne University Mylan School of Pharmacy, Pittsburgh, PA
Peter Kreckel, R.Ph. – 2012 Preceptor of the Year Pharmacist, Broad Avenue Pharmacy, Altoona, PA
Thomas Bowser, R.Ph. – 2012 George S. Maggio Memorial Award Owner, Shankel’s Pharmacy, DuBois, PA
William Liepack, R.Ph. – 2012 George H. Searight Community Service Award Retired Pharmacist, RX Blue Star Solutions, Evans City, PA
Pennsylvania Pharmacist I November/December 2012 I 35
Association News – Annual Conference Highlights Student Awards 2012 Achieving Independence Winner: University of Pittsburgh School of Pharmacy 2012 Appropriate Medication Use Winners: Temple University School of Pharmacy and the University of Pittsburgh School of Pharmacy Ed Casey, R.Ph. – 2012 J. Allen Duffield Pharmaceutical Industry Award Clinical Education Consultant, Pfizer Inc., Laurel Springs, NJ
Anthony C. Dougalas, R.Ph. – 2012 Cardinal Health Generation Rx Champions Award sponsored by the Cardinal Health Foundation Pharmacist, The Medicine Shoppe, Mountain Top, PA
2012 Membership Challenge Winner Temple University School of Pharmacy
Team Up. Pressure Down. Coaching Patients to Take Control. A Free One Hour (0.1 CEU) On Demand CPE Activity Available At:
www.GoToCEI.org Citing strong evidence of effectiveness, the U.S. Preventive Services Task Force in May 2012 recommended team-based care -- uniting the efforts of physicians, pharmacists, nurses and other health care professionals -- to improve blood pressure control. Participate in a free, one hour On Demand CPE activity to learn more about Team Up. Pressure Down. Coaching Patients to Take Control., a Million Hearts™ educational program that offers support and resources for health care professionals working to help Americans improve medication adherence and more effectively manage their blood pressure.
The Collaborative Education Institute is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. UAN 107-999-12-078-H04-P 0.1 CEU/1.0 Hr (For complete CPE information, go to www.GoToCEI.org)
36 I Pennsylvania Pharmacist I November/December 2012
This CPE activity is FREE to participating pharmacists through the Million Hearts™ initiative.
Rite of Roses T
he traditional Rite of Roses Ceremony was held at the 2012 Annual Conference—in remembrance of those colleagues who have passed from our midst “It’s sometimes hard to during the past year. It is a most understand why these solemn occasion at the Annual things have to be; Conference when we pause in Our sad hearts seek the memory and pay tribute and answer, but it’s not for us to respect to those pharmacists who see; have been committed to the annals We can only trust in God of time, who have contributed and know that in some way; of themselves for the welfare of It’s all part of his great others and who have passed on plan we’ll understand some into eternity. day.” It is incumbent upon us to honor the commitment of those who were dedicated to their profession – through the health, safety, and welfare of all human 1 5/23/12 9:53 AM Page 1 BS_PennAd_Beatty12_color_Layout beings.
In memory of: Richard Berardi, Director of Pharmacy at Temple University Hospital David Ference, Pharmacist with Ganse Apothecary in Lancaster Terry Frey, retired independent pharmacist from Red Lion James Kirkwood, pharmacist from the Harrisburg area Nicholas Masino, of Port Richmond Pharmacy Henry Rubino, owner of Rubino’s Pharmacy in Philadelphia Eugene Sebastianelli, former independent owner from Jessup Sid Soltoff, of Bell Edge Pharmacy Ronald Stern, owner of Brooks Pharmacy in Philadelphia
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“My goal is to create value for independent pharmacists. As a participant in the industry for many years, I have observed and been a part of many dramatic changes in independent pharmacy. At Buy-Sell, I work diligently to protect the value of my clients’ businesses, assist them with evaluating those businesses and implement an effective exit strategy plan. I then utilize our company’s large database of active buyers and the expertise of my professional colleagues to help identify the right buyer for your pharmacy, while structuring a transaction that works for all parties. The services we provide are well documented and our list of satisfied clients who will vouch for our professionalism is lengthy.”
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Pennsylvania Pharmacist I November/December 2012 I 37
Working For You: Grassroots and PharmPAC
he term “grassroots” is thrown around as often as the words “Republican” and “Democrat.” There are always groups that celebrate their political victories by giving credit to their grassroots movement taking ahold of an issue and pushing it to victory. On the flip side, political defeats are often described as a failure of the grassroots network to coalesce around an issue. What does “grassroots” really mean? More importantly, what does “grassroots” mean to pharmacy? Simply put, we can define grassroots as individuals with similar interests or backgrounds banding together to advocate for common political purposes. Thus, as organized pharmacists, the Pennsylvania Pharmacists Association (PPA) is a grassroots group that shares most political objectives of pharmacy. Regardless of minor nuances, pharmacists can find common ground in their desires to protect and promote the profession and the patients they serve. The most effective way to accomplish the goals of organized pharmacy is to have an active grassroots network of pharmacists. This is vital because legislators listen to their constituents. Every legislator either sees or has seen a local pharmacist or has been to a pharmacy in their constituency. In one way or another, every legislator has had to address
issues that are important to your profession. For example, giving consumers the ability to access their local community pharmacies allows them convenient access to the medication expertise and counseling of pharmacists. The significance of allowing patients the freedom of choice to visit their community pharmacy has time and time again shown to be valuable. Legislators understand that an engaging, happy group most likely will help them to continue to stay in office. So, what does it take to have an active grassroots network? It’s simple – all you need is a wellinformed group of pharmacists and pharmacy students who are willing to explain and advocate PPA’s positions to their legislators and their patients. This can be done through in-person meetings, letters, emails, phone calls or attendance at local events. At PPA’s Legislative Day, time and time again attendees shared stories about how their legislative visits produced positive results. Those who visited their legislators had the opportunity to speak personally about issues that affect their everyday livelihoods. The message: grassroots advocacy works! Another strong component that PPA has worked very hard to combine with our grassroots network is PharmPAC, the
38 I Pennsylvania Pharmacist I November/December 2012
Pennsylvania Pharmacists Associations Political Action Committee. PharmPAC helps give pharmacy a seat at the table and also helps to support legislators that support pharmacy. Contributing to PharmPAC is an investment and pharmacists will contribute because they believe in PPA’s advocacy goals. Consider this: you invest in your retirement because you want to protect your future and ensure that you have a stable income after you retire. You invest in PharmPAC because you believe in the pharmacy profession and you want to ensure its protection and voice now and for years to come. Your colleagues before you paved the way for better standards of care, better education and outreach and better outcomes for patients. It is important that you maintain and improve the profession during your generation and for the next generation. Your participation is vital! This all may sound dramatic to you; however, consider that in 2011 our PharmPAC contributions increased significantly. This correlates to the number of phone calls and email we received from legislators and their staff wanting to speak with us about our issues. As we continue to promote the profession to our political allies, our positions will continue to be heard. We WILL continue to have a
Association News seat at the table. Legislators and the general public should automatically think of PPA whenever a pharmacy related issue arises. PPA has been able to accomplish what few other associations have: a bond between PharmPAC and our grassroots network. Consider that many associations struggle to form a bond between the two, often having conflicting directions, philosophies or personalities. PPA has been able to bring the two components together for one cause and one single purpose: to protect the interests of pharmacy. We are not where we want to be yet, but then again when we continue to raise the bar higher, we will always find more ways to improve. With your help, we will continue to serve the interests of pharmacy and provide tangible membership benefits. Continued participation in our grassroots network and PharmPAC will push PPA in a positive direction. There are zero pharmacists in the legislature. If you are not advocating for your profession, there is a good chance someone else is. Remember, if you don’t have a seat at the table, you’re most likely on the menu.
students an opportunity to learn and understand the federal and state government and its impact on pharmacy. Students also will learn tips on how to communicate effectively and sharpen leadership skills. Due to the hands-on nature of this program, there is space for a maximum of 21 students. Initially, three spaces will be specifically allocated for students from each of the seven schools of pharmacy for
a total of 21 students. All spaces will be filled on a first-come, first-serve basis. Don’t miss out on the opportunity to GRASP the information you need to help mold a positive future for pharmacy – sign up TODAY! If you have any questions or would like to sign up, please contact Don Smith at email@example.com or (717) 234-6151, ext. 102 for details.z
2012 Wilkes GRASP attendees at the mortar and pestle at the capitol.
Students: GRASP The Opportunity! The Government Relations Advocacy for Student Pharmacists (GRASP) program will be held February 15-17, 2012 in Harrisburg, PA. This program provides
Pennsylvania Pharmacist I November/December 2012 I 39
Medicare NABP PMP InterConnect Surety Bonds Celebrates One Year of Connecting Prescription I Monitoring Programs to Combat Prescription Drug Abuse n 2009 the Centers for Medicare and Medicaid Services (CMS) implemented Surety Bond Requirements for suppliers of Durable Medical Equipment, Prosthetics and Supplies (CMS6006-F). This ruling requires that each existing supplier must have a $50,000 surety bond to CMS. Pharmacists Mutual Insurance Company, through its subsidiary Pro Advantage Services, Inc. d/b/a Pharmacists Insurance Agency (in California), led the way to meet this requirement by negotiating the price of the bond from $1,500 down to $250 for qualifying risks. To see if you qualify for a $250 Medicare Surety Bond, or would like information regarding our other products, please contact us: Call 800.247.5930 Extension 4260 E-mail firstname.lastname@example.org Contact a Pharmacists Mutual Field Representative or Sales Associate http://www.phmic.com/ phmc/services/ibs/Pages/Home. aspx z
Nine States Currently Sharing D a t a
he National Association of Boards of Pharmacy® (NABP®) is pleased to announce its one-year anniversary of sharing prescription monitoring program (PMP) data through its NABP PMP InterConnectsM program. The NABP InterConnect allows authorized users in participating states to request patients’ prescription data and receive the information from other participating states’ PMPs. Sharing prescription drug data among states is an effective tool for reducing prescription drug abuse and doctor shopping and is a key element for early detection, intervention, and prevention of substance abuse by patients as well as diversion of controlled substances by health care providers. During the first year of operation, nine PMPs joined NABP InterConnect and are now fully connected to allow data sharing. These include PMPs in Arizona, Connecticut, Indiana, Kansas, Michigan, North Dakota, Ohio, South Carolina, and Virginia. In addition, three other states’ PMPs are in the final stages of implementation and testing and are expected to go live soon. Several other states have indicated to NABP that they intend to participate in NABP InterConnect in the future. When these states become fully operational, 22 states will be sharing data via the NABP InterConnect. z
Pennsylvania Pharmacist I November/December 2012 I 41
Should You Compound Hydroxyprogesterone Caproate? Editor’s note: The following article was written by Gayle Cotchen, PharmD, Lead Pharmacist, Magee-Womens Hospital of the University of Pittsburgh Medical Center (UPMC) and a graduate of Duquesne University’s School of Pharmacy. All information presented is presented based on her education and experience as a pharmacist. She does not write on behalf of the Pennsylvania State Board of Pharmacy, and nothing presented in the article should be taken as a position of the Board or any of the Board members, the Bureau of Professional and Occupational Affairs, the Department of State, or the Commonwealth of Pennsylvania.
n compliance with the Food and Drug Administration’s enforcement policies for compounded drugs, pharmacists should dispense the commercial product Makena® when either Makena® or hydroxyprogesterone caproate injection is ordered or prescribed. An exception exists if hydroxyprogesterone caproate injection is ordered/prescribed and the patient has a medical condition that necessitates compounding it, such as an allergy to a preservative or another inactive ingredient in Makena®. Pharmacists compounding hydroxyprogesterone caproate after June 15, 2012 should use the prescription or order to document the reason compounding was necessary (unless the prescriber has already included such documentation). If compounded hydroxyprogesterone caproate would not provide a significant
difference compared to Makena® and there is no reason that the compounded product is medically necessary for the particular patient, then dispense Makena®.
Background information: On March 30, 2011, the FDA issued a statement that pharmacies would not face a legal challenge for compounding hydroxyprogesterone caproate even though the FDA had approved the Makena® new drug application in February, 2011. (For a timeline, please see the table at on the next page.) However, on June 15, 2012, the agency updated that statement to indicate that the factor the FDA “considers in determining whether a drug may be compounded is whether the prescribing practitioner has determined that a compounded product is necessary for the particular patient and would provide a significant difference for the patient as compared to the FDA-approved commercially available drug product... emphasizing that the FDA is applying its normal enforcement policies for compounded drugs to compounded hydroxyprogesterone caproate… and that the compounding of any drug, including hydroxyprogesterone caproate, should not exceed the scope of traditional pharmacy compounding.”
42 I Pennsylvania Pharmacist I November/December 2012
Why did the FDA reverse its previous statement? The agency may have been influenced by pressure from the March of Dimes and multiple professional organizations reacting to the significantly high price of Makena®, which was initially sold at $1,500 per injection while compounding pharmacies sold the compounded version for less than $100 per injection. Charging such a high price for a medication needed weekly for up to 21 weeks was not viewed favorably, especially considering that the medication helps to safeguard the fetus; the indication for Makena® is “reduce the risk of preterm birth in women with a singleton pregnancy with a history of singleton spontaneous preterm birth.” Why is it important to reduce the likelihood of preterm birth? It is the #1 cause of neonatal mortality. And, the incidence has increased in the United States from 9% to 12% over the past 20 years. What about patients who can’t afford Makena®? Makena Care Connection includes a program that offers the drug at no or reduced cost for uninsured patients; and, a program that reduces co-pay costs for patients whose insurance covers Makena®. Additional information is available at 800-847-3418.z
Industry News TIMELINE MONTH/YEAR
Ther-Rx Corporation formed as a subsidiary of K-V Pharmaceutical Company.
FDA approved Makena IM solution as an orphan drug for the reduction of the risk of certain preterm births in women who have had at least one prior preterm birth.
March of Dimes’ president sent correspondence to Ther-Rx president requesting significant reduction in list price of Makena, adjustments to patient assistance program, method for reporting to stakeholders on patient assistance program, and rationale for the pricing.
FDA issued statement that pharmacies will not face legal challenge for compounding hydroxyprogesterone caproate.
March of Dimes posted statement regarding Makena price: “disappointing and unacceptable.”
K-V Pharmaceutical Company reduced the price of Makena over 50% to $690 per injection.
FDA received info from K-V Pharmaceutical Company regarding the potency and purity of samples of bulk hydroxyprogesterone caproate active pharmaceutical ingredients (APIs) and compounded hydroxyprogesterone caproate products.
FDA released statement indicating that the agency: had reviewed data submitted by K-V Pharmaceutical Company and would conduct an on-site review of the laboratory analyses, and had begun its own sampling and analysis of compounded hydroxyprogesterone caproate products and the bulk APIs used to make them.
FDA issued statement that “The compounding of any drug, including hydroxyprogesterone caproate, should not exceed the scope of traditional pharmacy compounding.”
FDA issued letter to Wedgewood Pharmacy regarding hydroxyprogesterone caproate stating that “In certain circumstances, it may be appropriate for a pharmacist to compound a small quantity of a drug that is only slightly different than an FDA-approved drug that is commercially available. In these circumstances, FDA will consider whether there is documentation of the medical need for the particular variation of the compound for the particular patient.”
References are available upon request.
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Getting Started is Easy! 1. GET CONTRACTED To participate, complete an OutcomesMTM Network Participation Agreement by clicking on “Pharmacy,” then “Getting Started.”
2. GET TRAINED To be eligible to provide MTM services and receive professional fees, complete the OutcomesMTM Personal Pharmacist™ training program by selecting “Begin Registration and Training.”
3. GET PAID
MORE THAN 5 MILLION PATIENTS NATIONWIDE have OutcomesMTM coverage, a number that continues to grow.
To get paid for MTM services, view your pharmacy’s list of eligible patients and begin documenting and billing MTM claims.
To learn more about OutcomesMTM scan the QR code or visit
outcomesmtm.com 505 Market Street, Suite 200, West Des Moines, IA 50266-3861 877.237.0050 email@example.com
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Pennsylvania Pharmacist I November/December 2012 I 43
Together, Building for the Future
There’s ground breaking news at Value – literally we’re breaking ground on our new distribution center June 2012. This state-of-the-art facility will increase the level of service we provide our members and expand our geographic reach beyond our current 8 state distribution area. This new distribution center will be located at 195 Theater Drive, Duncansville PA. This Project is scheduled to be completed in mid 2013.
We have just completed the Phase I of our new centralized web-based ordering system! ValueDrugHub is user friendly! Its functionality provides many upgrades to our members experience and we will continue to make enhancements in Phase II and Phase III later this year. Value Specialty Pharmacy, our NEW one-of-a-kind closed door specialty pharmacy is up and running. We are servicing over 300 Value Specialty Pharmacy Care Sites and growing every day. Contact us today to be a part of this exciting cooperative,
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toll free: 855-265-8008 fax: 814-283-2211 www.vsprx.com
PPA Partners with AHRQ to Offer Free Evidence-Based Resources for Members and Patients T he Federal Agency for Healthcare Research and Quality (AHRQ) has launched a nationwide initiative to raise awareness of comparative effectiveness research, a type of patient-centered outcomes research, and to encourage its use. AHRQ provides pharmacists, other clinicians and patients free resources and tools that objectively summarize current clinical evidence on various treatment methods to inform health care decision making. PPA is partnering with AHRQ to provide our members quick access to these materials and to announce new products as they become available. Comparative effectiveness research informs health care decision making by comparing the evidence on the effectiveness, benefits and harms of different treatment options for common health conditions. Many of the research studies compare medication therapies used to treat a wide range of conditions, including cancers, cardiovascular diseases and related conditions, diabetes, arthritis, and mental health disorders. In conducting systematic reviews, researchers synthesize the available evidence on drugs, medical devices, tests, surgeries,
language and contain an overview of the condition in addition to the comparative effectiveness information. These unbiased resources can help pharmacists: • Identify issues to discuss with patients • Talk about side effects • Analyze treatments and assess benefits and harms for patient outcomes
or ways to deliver health care. The research findings are translated into practical resources, including: • Clinician research summaries (most are two pages) • Plain-language patient brochures (in English and Spanish) • Accredited CME/CE modules (including several accredited for pharmacists) • Faculty slide sets All of these tools are designed to encourage and support shared decision making between clinicians and patients, with a goal of better care and outcomes. Clinician materials provide clinical bottomline information, citing research gaps, when applicable. Patient materials are written in plain
Examples of currently available titles include: • Treating Cholesterol With Combination Therapy • Comparing Medications for Adults With Type 2 Diabetes • ACEIs, ARBs or DRI for Adults With Hypertension • First- and Second-Generation Antipsychotics for Children To view or download AHRQ resources, visit www. EffectiveHealthCare.ahrq.gov. To order free printed copies of the clinician research summaries or patient brochures, including bulk quantities, call the AHRQ Publications Clearinghouse at 1-800-358-9295 and provide the code C-02. For more information about this initiative, contact Victoria McGhee in AHRQ’s Atlanta Regional Office at 404-836-2303 or firstname.lastname@example.org
Pennsylvania Pharmacist I November/December 2012 I 45
20,000 Pharmacies to Offer New Medicare Part D Rx Drug Plan R xAlly and SmartD announced that 22,000 RxAlly member pharmacies, including independent pharmacies, regional chains, and Walgreens, will begin accepting a new federally-qualified Medicare Prescription Drug Plan (PDP), SmartD Rx, on January 1, 2013.
What is SmartD Rx? • SmartD Rx is available through a first-of-its-kind pharmacy
alliance, which features one of the largest Preferred Networks to help seniors maintain a trusted, personalized relationship with their community pharmacist and lower their prescription costs • SmartD Rx is offered in all 50 states, the District of Columbia and Puerto Rico • This new plan offers $0 copays for preferred generic medications at Preferred Network pharmacies, low
Why do our clients stay with us?
premium options and the convenience and cost savings of 90-day prescription refills at retail pharmacies. • These licensed plan representatives will be available to help consumers navigate the nuances of Medicare Part D and provide on-the-spot answers to questions that may arise about Medicare’s prescription drug plans. z
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46 I Pennsylvania Pharmacist I November/December 2012
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How does your
Coverage Benefits Our Professional Liability Policy is specifically designed as excess coverage, yet it can become your first line of defense when no other coverage is available.
Go to www.phmic.com, and choose the Pharmacist Liability Application under the Online Services tab.
• Additional protection for you above that provided by your employer. • Covered 24 hours a day anywhere in the United States, its territories and possessions, Canada or Puerto Rico. • Covers compounding and immunizations (if legal in your state).
For more information, please contact your local representative:
• On-staff pharmacist-attorneys are available to counsel policyholders. • Risk management assistance that may reduce pharmacy professional exposure.
800.247.5930 ext. 7100
Cliff Lange , LTCP
800.247.5930 ext. 7131 724.538.5230
Steve Hanks, CLU, LUTCF, CLTC, ChFC
800.247.5930 ext. 7122 717.394.0405
*Compensated Endorsement Not licensed to sell all products in all states. Form No. PM PhL 196
Published on Nov 7, 2012