RAN October 2022

The Importance of the Community Pharmacist

By Mary Lau, RAN CEO

THERE IS SO MUCH MORE TO PHARMACY THAN MEETS

the eye. Pharmacists are medication experts that play a vital role in the quality of patient care. When patients need to be further educated on the medicine prescribed by their diagnosticians, community pharmacists are the first line of clinical defense and become the main healthcare professional for their patients.

A patient will have multiple doctors with multiple disciplines but usually has one specific community pharmacy, and possibly one compounding pharmacy. They rely on their pharmacist to guide their medical treatments towards success and ultimate health.

Pharmacists are highly educated in treating disease states and how the drugs interact with different parts of the body. Pharmacists are trained on how different drugs pass the blood brain barrier. Their education in pharmacology culminates as a doctor of pharmacy. Pharmacist now carry the

Mary Lau

title Pharm D.

In 2022 there was a study of over 1000 adults across the United States called the “Healthcare Insights” that showed that consumers want their doctors to have a holistic view of medical care. They are looking for mental emotional and even in physical health. And if you have been to a doctor lately you have probably seen advertisements in their offices for supplements, proper eating habits, correct amount of sleep and advising you to drink more water. Communications across the spectrum of all

providers is vital as doctors specialize in various disciplines. Homeopaths and naturopaths look at the body a little more holistically, but they all, no matter the discipline, need to coordinate with the patient’s pharmacist. No other healthcare provider can see the whole healthcare picture and look for a possible better alternative or even highlight contraindicated medicines and treatments.

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INSIDE

Organized Retail Crime

Update: Board of Pharmacy Meeting

2

3

Nevada State of Pharmacy Update 2022 .. 4

Legislator Spotlight: Jeff Stone

DEA National Rx Takeback

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8

Lights On, Doors Open: When it Matters Most ...... 9

IN THE NEWS: ORGANIZED RETAIL CRIME

RENO: The US Attorney for Nevada has announced the sentencing of 44-yearold Gennaro Canta who ran a million-dollar retail theft ring between October 2014 and August 2016. He bribed drug addicts to do the theft then hired others to sell the stolen items online.

Reported by News 4 Reno

LAS VEGAS: Two men

have been charged for more than 30 burglaries in the Las Vegas Valley. Police report the men were in and out of the businesses in one to two minutes, and were targeting cash drawers, tip jars and small electronics.

Reported by the Las Vegas Review-Journal

ROSEVILLE: Four young men have been detained

Community Pharmacist

A continued communication between the pharmacist and the diagnostician is vital for the overall well-being of all patients. It is interesting that quite often a hospital pharmacist is more quickly recognized as playing a role in a particular patient’s health but the community pharmacist still isn’t understood to the point they should be.

Hospital pharmacists are part of a multidisciplinary team. They deal with ICU and general medical floors check prescription correctness and, if necessary, contact the diagnostician. There is an advantage to being in one location with the patients’ providers. Community pharmacy works toward the same outcomes but from a “remote” location. Once the patient leaves the hospital,

they are referred to their community pharmacist.

A good indicator of the importance of pharmacy is the passage of the Public Readiness and Emergency Preparedness Act which was passed by Congress to assist the public during the pandemic. Pharmacies took immediate action to provide a centralized community location for COIVD testing and then later COVID vaccinations. Pharmacist

and the retail pharmacy medical clinics provided vital care to meet the medical needs during this pandemic. Prescriptions, immunizations, testing facilities, were all ramped up for the public. Through the pandemic those services have proven vital and need to continue.

With the use of advanced technology and properly trained staff,

for retail thefts in Roseville, CA and are facing charges for organized retail theft.

Reported by CBS News Sacramento

PALO ALTO: Four have been arrested for organized retail theft, stealing 100 pairs of Lululemon leggings worth more than $12,000.

Reported by NBC Bay Area

WALNUT CREEK: Five have been arrested in connection to an organized retail theft at the Apple Store in Walnut Creek. As the investigation progressed, police discovered three more suspects in connection with the Apple Store crime and then proceeded to arrest them.

Reported by KRON 4 San Francisco

Continued from page 1

a pharmacist is able to manage the health care spectrum for their patients and is readily available to support them with vital advice and information. It can be as simple as someone on a blood thinner doesn’t understand they cannot take an aspirin but may be able to take Tylenol or as complex as managing chronic disease states.

Medical care has been moved into a complexity that doctors, hospitals, clinics and pharmacies (not forgetting labs x-ray facilities other areas of medical care) sometimes find it difficult to just do their job. With the insurance rules, primary care physicians can take months to get to see, the requirement of tests, Medicare and Medicaid reimbursement structures coupled with Pharmacy

Benefit Managers, it’s enough to make their head spin. Complexities of the business has out-priced most of the independent side of the industry and with the new ESG standards affecting operations the cost of doing all businesses is increasing and medicine is no exception.

Point being: Community pharmacies are there to serve the public and promote public health. The pharmacist are healthcare professionals and are able to guide their patients through the complexities of multiple providers. The tools are their technicians, clerks, fulfillment centers, technology, etc. Our members are proud community health providers. This newsletter will further highlight this noble business.

■

Update: Board of Pharmacy Meeting

By Liz MacMenamin

THE BOARD OF PHARMACY MET IN LAS VEGAS ON September 7–8. This is one of the eight yearly meetings where the board must present disciplinary cases as well as review and implement new regulations that will affect the operations of a community pharmacy. These operational regulations can have a tremendous impact on the ability of our pharmacies to deliver health care to patients in Nevada. This meeting was a clear example of disconnect between the regulators and the patient needs in Nevada.

During the pandemic, the governor implemented emergency waivers to make certain that you, as a patient, were able to have continuity of health care services during such a frightening time. The waiver allowed the pharmacy to employ additional pharmaceutical technicians and pharmaceutical technicians in training to support the additional workload.

Governor Sisolak also called on the community pharmacy to help provide testing for COVID, and

our pharmacies stepped up to help the citizens in Nevada. Once the FDA approved a vaccine, the governor again called on the community pharmacy to jump into action to deliver the vaccine to constituents in Nevada. The community pharmacy rose to the occasion and did a magnificent job of protecting the public while also providing Nevadans with their muchneeded medications.

Our community pharmacies were able to do this because of the flexibility they were given in their staffing ratios. This increase of staffing ratio was in place for the last two years with no risk to public health and safety, and, in fact, the public had even better access to the pharmacist during this time when the pharmacist was able to focus on the patients and the technicians could focus on the many other tasks. By allowing these staffing determinations to be made at the discretion and professional judgment of pharmacists working to provide our community with medication and health care, pharmacies throughout the state could staff according to their

customers’ needs rather than legally comply with an antiquated regulation.

The governor rescinded the emergency waiver at the end of July 2022, requiring the pharmacy to reduce the support staff to a pharmacist in the community pharmacy to pre-pandemic levels. The industry came to the board to ask for an emergency regulation to allow for more support staff due to the release of a new booster for the COVID vaccine and the annual flu clinics during the impending flu season, and begin the process of a permanent regulation that better reflects how modern technology and current events have changed the needs of the pharmacy customer. This board, of which none of

the members practice in the community pharmacy setting, decided to deny the continuation of the increased staffing ratio. The industry presented these board members with standards of thirty-seven (37) other states that do not restrict the pharmacy staffing levels, and this was of no consequence to this board. The industry also discussed the expectation of the increased numbers of patients that they will be seeing in the pharmacy during the release of the newly approved boosters and the annual influx of patients requesting flu inoculations. The board president, who works for the prison system and previously was an instructor at Rosemond Pharmacy School, stated that she “just did not believe that this was an emergency.”

RAN is continuing to work on this issue because we know it is critical for our pharmacy members. We anticipate the demand for pharmacy services to increase with the COVID booster and annual flu shot. Please help us to spread that word that customers who are frustrated with

Liz MacMenamin

Nevada

State of Pharmacy 2022 Update

In 2020 the pharmacy industry in Nevada employed more than 5,000 workers in nearly 500 establishments

As of 2020 there were 2,613 licensed pharmacists and 4,681 registered pharmaceutical technicians eligible to work in a Nevada pharmacy

Nevadans have 8.3 pharmacists per 10,000 residents; however, Nevada's rural areas are only served by 4.1 pharmacists per 10,000 residents

In 2019 Nevada pharmacists filled more than 31,476,183 prescriptions

As of September 2022, an estimated 3,117,200 COVID shots have been administered by pharmacy staff in the State of Nevada

Legislator Spotlight: Jeff Stone

By Liz MacMenamin

THERE HAVE BEEN MANY CONVERSATIONS OVER THE LAST few years regarding the heroism of pharmacists on the front lines serving their communities every day. October is American Pharmacist Month and, as someone who has worked very closely with the industry for several years, more than I care to enumerate here, I am pleased to highlight a pharmacist who not only has served the community as a health care provider but has also gotten involved in serving his community through public service.

I recently spoke with Jeff Stone, a pharmacist, realtor, and candidate for Nevada Senate, about the reasons he got involved

in public service. The first thing that impressed me was the fact that he stated he is running for public office as a “continuation of his career as a pharmacist” to be of service to the public.

Mr. Stone will be the first pharmacist in many years to be elected to serve in the Nevada legislature. His expertise in the health care field will be an asset to the elected body in the upcoming session. His mantra is: get interested, get involved, show up and work to change the things you believe need to be changed.

Shortly after completing his education, Jeff Stone relocated to Temecula, California to open his first small business. It was there he felt his first call to public

service and served on the Temecula City Council for 12 years. He was later elected to serve on the Riverside County Board of Supervisors for 10 years. In 2014 Mr. Stone ran for the California State Senate where he served for 5 years before resigning to accept an appointment by President Trump as the Western Regional Representative of the U.S. Department of Labor in 2019.

Jeff Stone has been a licensed pharmacist for more than 40 years of experience, opening 6 pharmacies and employing nearly 40 personnel. When asked about the importance of a small business

owners getting involved in the political process, he stated, “If members of our profession do not get involved, then we succumb to bad laws authored by people who do not understand what we do and the challenges that we face.” He applauds the small business owners that put themselves out there to be a part of the solution.

Mr. Stone is the Republican candidate for Senate District 20 and stated that his priorities in

the upcoming session will be to improve access to health care; secure voter integrity; reduce inflation and the impact it has had on Nevada citizens; and improve issues in education issues and the current criminal justice system.

RAN (Retail Association of Nevada) has supported Mr. Stone’s campaign and wishes him well in the General Election. ■

Jeff Stone

SOUTHERN NEVADA CHAMBERS OF COMMERCE SPONSOR BALLOT INITIATIVE TO DIVIDE CCSD

The Vegas Chamber, Henderson Chamber of Commerce, Latin Chamber of Commerce, Urban Chamber of Commerce, Las Vegas Asian Chamber of Commerce, and Boulder City Chamber of Commerce all sup port the “Community Schools Initiative” that would split up the Clark County School District if approved by voters in 2024. The initiative’s goal is to reform Nevada’s “outdated and underperforming K-12 education system” by enabling cities and municipalities to form school districts that would be “smaller and more responsive to the needs of the communities they serve.” The initiative will be on the November 2024 ballot if enough valid signatures are collected.

Las Vegas Review-Journal

NEVADA TO RECEIVE $14 MILLION IN MULTISTATE JUUL LAWSUIT

Following a two-year, multistate probe into JUUL Labs Inc., the e-cigarette company has agreed to pay $438.5 million to 34 states and territories, including Nevada, which

Nevada News

will receive $14 million. The investigation examined if the manufacturer targeted minors, as well as claims regarding the product’s nicotine content, risks, safety, and effectiveness as a smoking cessation aid. “For years, JUUL Labs knowingly marketed its product to underage users, directly working to expose minors to nicotine use and abuse,” said State Attorney General Aaron Ford in a statement. “This settlement will help Nevada’s youth by curbing these harmful marketing tactics and holding the company accountable for its breach of public trust.”

Nevada Current

SNWA, AGENCIES DECLARE COMMITMENT TO WATER CONSERVATION

The Southern Nevada Water Authority, the Metropolitan Water District of Southern California, and three water providers in Colorado announced a cooperative commitment to dramatically enhance water conservation initiatives and cut water demands. The initiatives are in response to drought and chronic misuse, which have resulted in less water in the river and historically low levels in the nation’s two largest reservoirs.

Water managers in Nevada, Southern California, and Colorado stated that they will collaborate to extend programs to boost outdoor water efficiency, replace non-functional turf with drought- and climateresilient landscaping, and increase water recycling programs.

Las Vegas Review-Journal

CCSD’S LEGISLATIVE AGENDA CENTERED ON ADDRESSING TEACHER SHORTAGE

The Clark County School District Board of Trustees unanimously voted to seek a broadbased bill in the upcoming session of the Nevada Legislature to improve teacher wages and working conditions, make it simpler for the Nevada Department of Education to verify teaching licenses from other states, cover potential new teachers’ application fees, and strengthen the state’s education colleges. The Board, rather than draft legislation, wants to see state lawmakers shape a statewide policy. “If the largest school district in the state gets behind this, this is something that they will actually address,” said Board Member Lisa Guzman.

Las Vegas Sun

GOV. SISOLAK SEEKS TO CODIFY ORDER PROTECTING PATIENTS INTO LAW

Nevada Gov. Steve Sisolak said that, if reelected, he will seek to have an order he issued protecting in-state abortion doctors and out-of-state patients codified in law during the next legislative session.

“Governors are the last line of defense in protecting reproductive freedoms,” he said. “The buck stops with us.” Following the Supreme Court’s decision to overturn Roe v. Wade in June, Sisolak signed an executive order declaring that Nevada won’t assist other states in prosecuting residents who fly to Nevada for abortions. It also assures that medical licensing boards and commissions do not reprimand or disqualify doctors who perform abortions. Meanwhile, Republican gubernatorial nominee Joe Lombardo, said that he may overturn Sisolak’s executive order but has refused to take a definitive position.

ABC News

CLARK COUNTY COMMISSION TO REQUIRE TRAFFIC SAFETY FOR CANNABIS LOUNGE REGULATIONS

As Clark County begins

MAJORITY OF AMERICANS LIVE WITHIN DRIVING DISTANCE OF A COMMUNITY PHARMACY

According to researchers in a national study published in the Journal of the American Pharmacists Association, about 88.9% of the U.S. population resides within 5 miles of a community pharmacy. The findings indicate that majority of Americans have access to drug stores, though researchers noted that 5 miles can mean different things to different people. Driving distance is not a reliable indicator of pharmacy accessibility because not everyone owns a car or has access to public transportation. Furthermore, while 96.5% of people live within 10 miles of a community pharmacy, merely 48.1% reside within one mile of a drugstore.

Pharmacy Times

U.S. FACES ADDERALL SHORTAGE

After a labor shortage at Teva Pharmaceuticals, the country’s largest supplier of attentiondeficit/hyperactivity disorder (ADHD) medication, Adderall, a number of pharmacies across the country are

National News

experiencing difficulty filling prescriptions. The company announced to expect a delay for the next 2 to 3 months. A survey conducted by the National Community Pharmacists Association from July 25 through Aug. 5 found that 64% of 360 independent pharmacies reported having difficulty obtaining Adderall.

NBC News

CYBERCRIMINALS STEAL ONLINE PHARMACY ACCOUNTS USING BOTS

According to researchers from Australiabased cybersecurity firm Kasada, cybercriminals are increasingly deploying bots to steal access to online pharmacy accounts. The company stated it first discovered credentialstuffing attacks against online pharmacy accounts in April 2022 and spotted tens of thousands of stolen online pharmacy accounts since then. Some of the hacked accounts contained prescriptions for highly regulated and addictive medications such as Adderall and Oxycodone. Kasada’s experts estimate that one cybercriminal could earn more than $25,000 per month from selling stolen pharmacy accounts.

CNET

LOWE’S CEO PROMISES $55 MILLION IN INFLATION INCENTIVES FOR HOURLY EMPLOYEES

Lowe’s Home Improvement announced that the company will offer $55 million in inflation incentives to its hourly frontline employees. The bonuses are intended to assist hourly front-line employees during this period of rising inflation, according to CEO Marvin R. Ellison. “I’d like to thank our associates for their continued hard work and dedication,” he said. Lowe’s currently has over 300,000 employees in the US and Canada, though it’s unclear how many will be receiving the incentive.

KOLO TV Reno

INSTACART BUYS E-COMMERCE TECH STARTUP ROSIE Rosie, an e-commerce technology startup focused on independent and small retailers and distributors, has been acquired by Instacart. Rosie’s digital tools intended to assist grocers in managing their online and in-store operations are now available through the Instacart platform. The acquisition is part of Instacart’s efforts to boost its value for businesses as it battles competition on

many fronts and prepares to go public. Terms of the deal were not disclosed.

Retail Dive

KROGER INTRODUCES SMART WAY

Kroger has introduced their new private label brand, Smart Way. As consumers are turning to more private label store brands, Kroger combined 16 legacy private label companies into the new brand. The orange-andwhite label shows the company in lowercase letters, as well as slogans such as “saving in the right direction” and “smart ways to save every day.” Smart Way is currently Kroger’s nonperishable budget brand, while Heritage Farms is its fresh and dairy budget line.

Grocery Dive

WALMART CONTINUES BEEFING UP MEAT SOURCING

Walmart announced an agreement to acquire a minority share in Sustainable Beef LLC. As part of the agreement, the retailer will assist the rancher-owned company in establishing a beef processing facility in North Platte, Nebraska. The project is slated to break ground this month, with an expected opening date of

Lights On, Doors Open: When it Matters Most

By Steven C. Anderson, FASAE, CAE, IOM

President and CEO, National Association of Chain Drug Stores

IWANT TO THANK MARY LAU AND THE ENTIRE RETAIL ASSOCIATION of Nevada leadership and team for the chance to celebrate American Pharmacists Month with you.

To the pharmacists, pharmacy technicians, pharmacy interns, and other team members of Retail Association of Nevada members: your dedication and effectiveness on behalf of Nevadans are secondto-none, and you are immensely appreciated.

At the beginning of the COVID-19 pandemic, NACDS ran a national television ad that pledged pharmacies would be there for the American people as they have throughout history. We pledged to be there –“lights on, doors open.” You kept that promise.

Without you, there simply is no way that our nation would have achieved such results in access and equity for COVID-19 vaccinations, testing, and other services. You may have heard the amazing statistics, yet we will never stop repeating them.

The fact that 90 percent of Americans live within five miles of a pharmacy allowed more than 260 million COVID-19 vaccination doses to be administered at a pharmacy. That is two out of every three shots. Further, more than 40 percent of those vaccinated at pharmacies are from racial and ethnic minority groups, and half of pharmacy COVID-19 vaccination sites are located in areas with high social vulnerability.

The results that you achieved on behalf of Nevadans and on behalf of America deserve respect and appreciation. These results also validate future action to help ensure access and equity in health and wellness services into the future.

NACDS praises the work of the Retail Association of Nevada to advance policies to help ensure payment for pharmacy services and to help optimize the role of pharmacy technicians – all for the ultimate benefit of

patients and consumers. Together, we can make a tremendous difference. NACDS is committed to extending at the federal level the pharmacy flexibilities under the Public Readiness and Emergency Preparedness Act (PREP Act) that have empowered pharmacy’s COVID-19 response. This will afford the opportunity to seek permanent enactment of these flexibilities at the state level. Further, we are helping to lead the charge to enact federal legislation that would create reliable payment pathways within

Medicare for pharmacy services including vaccinations, testing and treatment for COVID-19 and other illnesses.

This bill is the Equitable Community Access to Pharmacist Services Act, H.R. 7213 – backed strongly by the Future of Pharmacy Care Coalition. NACDS also is committed to advocating for fair and sustainable pharmacy reimbursement. This includes important reforms related to pharmacy benefit manager issues –an area in which results and momentum continue to build. It also includes comprehensive reform of pharmacy direct and indirect remuneration (DIR) fees that jeopardize pharmacies’ viability and patients’ access to pharmacy care. We need to expand on the federal DIR fee transparency rule that was finalized earlier this year and achieve a conclusive resolution to this immense threat to pharmacy.

NACDS also is committed to advancing

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Steven C. Anderson

“NACDS praises the work of the Retail Association of Nevada to advance policies to help ensure payment for pharmacy services and to help optimize the role of pharmacy technicians – all for the ultimate benefit of patients and consumers.”

Retail Association of Nevada • www.rannv.org

Important Information for SIG Members

NRS requires all existing members of a self-insured group to be notified of all new members. NRNSIG new members are listed below.

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NRNSIG members who wish to register a negative vote on a new group member, please write NRNSIG at 575 S. Saliman Road, Carson City, NV 89701, indicating which member and the reason(s) for the negative vote.

Retail Association of Nevada

Membership Information: Find out more about RAN’s self insured group. Call Pro Group, 800-859-3177, or the RAN office at 775-882-1700 (toll free in Nevada 800-690-5959).

Don’t forget to check out our website, www.RANNV.org.

“Workers’ comp that works for you”

Board of Pharmacy Meeting

these lines and wait times should contact the Board of Pharmacy, Helen Long, the board president, or Governor Sisolak’s office to reiterate the importance of giving this flexibility and control back to the

Nevada News

the process of creating regulations to allow for public cannabis lounges, the Commission has voiced concerns about the need for traffic regulations to ensure lounge visitors

pharmacists.

October is “Pharmacist Month” so please thank your pharmacist for working, not only during the pandemic, but now trying to provide our community with needed

Continued from page 7

who are under the influence of legal cannabis do not get behind the wheel. Proposals under consideration include, requiring businesses to educate customers about

National News

late 2024. The partnership, according to Walmart, is the company’s latest effort toward improving access to high-quality, inexpensive beef. It will also assist the beef industry and cattle producers in the country. Grocery Dive

Continued from page 8

WALGREENS BOOTS ALLIANCE ACQUIRES CARECENTRIX

Walgreens Boots Alliance announced that it has finalized its majority stake acquisition in athome care technology company CareCentrix.

the role of retail health and wellness – in the pharmacy, throughout the store, and through interdisciplinary care and partnerships. In the most recent example of this, NACDS participated in the White House Conference on Hunger,

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medications but also flu shots, COVID testing and booster with less than half the staff they had to work with during the time of the emergency waiver. Remember, it is not the fault of the pharmacy (the

appointed regulators are the ones that are not allowing this) so please be patient with the pharmacists and their staff, they are doing an incredibly stressful job with less help. ■

the dangers of driving while under the influence, making businesses liable for customers who leave high and crash their cars, and preventing cars from being towed when parked

at a lounge so customers feel comfortable using ride share services.

KTNV Las Vegas

Lights On, Doors Open

Nutrition, and Health that convened in September. NACDS is recommending an approach to these issues that leverages the ability of retail health and wellness services to address chronic health conditions.

Lights on, doors open – and unsurpassed access

Walgreens now owns 55% of CareCentrix thanks to the $330 million investment, which gives the pharmacy giant the option to purchase the remaining stock at a later date. The investment broadens Walgreen’s

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presence in the health sector, particularly in primary care, specialty pharmacy, post-acute care, and home care.

Health Care Dive

During American Pharmacists Month and beyond, NACDS is honored to stand with the Retail

Association of Nevada in recognition and in representation of the most accessible – and among the most trusted – health and wellness professionals in Nevada and across the nation. ■

www.rannv.org • Retail Association of Nevada ◆ 11 and equity: that is how you helped to save America during the pandemic and that is how you can help ensure Americans’ best days lie ahead.

Mary F. Lau President/CEO

Bryan Wachter

Senior Vice President

Elizabeth MacMenamin

Vice President of Government Affairs

Piper Brown Vice President, Finance and Administration

Megan Bedera Editor

Sue Arzillo, Alphabet Soup Inc. Newsletter Design & Layout

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Nevada News is published by the Retail Association of Nevada, a nonpartisan, nonprofit corporation founded in 1969 representing the Retail Community, the Chain Drug Council and the Grocery Industry Council.

Retail Association of Nevada