20Ways Summer Hospital 2019

I M P R O V I N G PATIENT CARE &

PHARMACY COST C O N TA I N M E N T Summer 2019

Health System

•

Infusion

20 Unique Products & Services

Discover 20 products and services that will help your pharmacy improve patient care or contain costs.

340B Resources & Software Industry Expert Q&A, Market Leaders Buyer’s Guide, and More page 38

8 Thought Leaders

Eight Video Series Including Visante, Verity Solutions, Rees Scientific, Acentrus Specialty, and More page 22

4 Case Studies

Liberty Software, GSL Solutions, Charles River, and Comprehensive Pharmacy Services

Contents WAY 340B RESOURCES & SOFTWARE SOLUTIONS

Verity Solutions – Your True Partner for 340B Program Administration and Compliance

#1 340B Management Systems

We’re turning 340B teams into A-teams.

As the industry’s most trusted third-party administrator for the 340B drug discount program, we can help optimize drug cost savings and meet HRSA compliance requirements for

Verity Solutions is an awardwinning provider of 340B software and services.

hospitals, clinics and pharmacies.

© 2019 Verity Solutions Group, Inc.

FOR 340B HOSPITALS AND HEALTH CENTERS Split Billing | Contract Pharmacy | VHUBTM for Contract Pharmacies | Compliance Manager | Purchase Analytics

YOUR TRUE PARTNER FOR 340B PROGRAM MANAGEMENT We’re changing the game in third-party administration for 340B, with unmatched product innovation, ease of use, data transparency and support to help your team maintain compliance. We’re the only 340B solution to score an “A” in the 2019 KLAS Performance Report for 340B Management Systems and earn the title of Category Leader for two years running.

WAY

Pharmacy Point-of-Sale From Retail Management Solutions

Something Missing?

Bring all the pieces together with point-of-sale from RMS.

RMS

More than just point-ofsale, RMS works with your pharmacy to increase patient satisfaction, streamline pharmacy operations, and so much more.

Point-of-Sale is an essential component for your pharmacy.

Patient care, compliance, security, employee management, and of course, the bottom line.

These are just some of the considerations that today’s outpatient pharmacies contend with on a daily basis.

And it takes more than one system to fully meet all of these needs. Point-of-sale may be one piece of a much larger technology scheme, but without it, you’re leaving a big gap in pharmacy workflows.

RMS offers integrations to over 30 pharmacy management systems, multiple options for credit card acceptance (including validated P2PE solutions), and a full suite of point-of-sale products to help your organization excel at everything from meds-to-beds programs to management behind the scenes. We’ll help you bring all the working parts together with the industry’s leading pharmacy point-of-sale solution.

Contact us today to find out how RMS can make it all work for your pharmacy: www.rm-solutions.com

If you’re looking to collaborate with a vendor that can help you build a winning 340B program and contribute to your organization’s bottom line, contact us to speak with a 340B program advisor and learn how to get started.

www.verity340b.com | 1.800.581.1378 | info@verity340B.com

1.877.767.1060 | sales@rm-solutions.com | Follow us on Facebook, LinkedIn, and Twitter

page 17

WAY

Stryker Cactus Smart Sink and Cactus PharmaLock OR

A better, greener waste solution Cactus controlled substance waste management systems

Cactus Pharma Lock® OR System

Cactus Smart Sink® System

For more information, please call 800 253 3210.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Pharma Lock, Smart Sink, Stryker. All other trademarks are trademarks of their respective owners or holders. © 2019 Stryker | www.stryker.com | 9100-004-677 Rev none

Cactus_Print_AdResize_RXInsider_STR439.indd 1

page 21

4/29/19 4:08 PM

A waste medication disposal solution, bringing medical facilities into compliance with disposal requirements.

Stryker's Cactus Smart Sink System securely captures partially administered controlled substances and renders them non-retrievable and unusable.

Thought Leader Video Series

page 22-23

page 19

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N

1

Leading Compounding Innovation in 503B Outsourcing

THE PERFECT BLEND OF QUALITY AND INNOVATION

QuVa Pharma is a Leader In 503B Outsourcing Services Covering All 50 States. A Valuable and Reliable Extension of Your Pharmacy Operation.

Your Partner of Choice An ideal customer-supplier relationship is a true partnership. At QuVa Pharma we strive to understand each of our customer’s unique perspectives: what you need, what challenges you face, what success looks like for you. We closely monitor industry dynamics and leverage industry trends to your benefit. QuVa Pharma is a comprehensive resource for all of your 503B Outsourcing needs.

Become a QuVa Pharma Partner To Get Started, You Can Set Up a Profile at www.quvapharma.org/customerprofile Corporate Headquarters: QuVa Pharma, Inc., 1075 W. Park One Drive, Suite 100 Sugar Land, TX 77478

888-339-0874 QuVaPharma.com Customer.Service@QuVaPharma.com

Contents WAY

Protecting temperature sensitive pharmaceuticals Designed for use in pharmacy clean rooms with USP<797> compliance in mind.

Doors on one side of the pass-through cabinet electronically lock when doors on the opposite side are opened.

Available on i.Series iPR225 and iPR456 pass-thru refrigerators.

Meet compliance, maintain clean room air quality, and enhance pharmacy workflow with i.Lock™ Interlock Technology.

Fo r m o re i nf o rm a t i o n: i nf o .he l m e r.c o m / p a ss- t hru- i nt e rl o c k- re f ri g e ra t o rs © 2019 Helmer Inc. All rights reserved.

20Ways-Ad-2019-Summer.indd 1

340B RESOURCES & SOFTWARE SOLUTIONS

i.Lock™ Interlock Technology

Introducing Interlock Pass-Thru Refrigerators for Your Clean Room From Helmer Scientific

The Helmer i.Lock™ technology prohibits doors on both sides of the refrigerator from being opened simultaneously.

Case Study: Liberty Software’s Flexible Pharmacy Management Solutions Make 340B Compliance Easy and Productive

CASE STUDY Liberty Software’s Flexible Pharmacy Management Solutions Make 340B Compliance Easy and Productive Increasing patient safety and satisfaction, while maximizing pharmacy output is all part of the package with this comprehensive software system.

PRIMARY INTENDED OUTCOME In 1992, the United States federal government created the 340B Drug Discount Program, which requires drug manufacturers to provide outpatient medications to eligible healthcare organizations, hospitals, and other nonprofit groups at discount prices. The program aims to reduce medication costs for low-income or uninsured patients and provide them with a broader range of health care. In official language, the 340B program enables covered entities “to stretch scarce federal resources as far as possible, reaching more eligible patients, and providing more comprehensive services.”

Joshua Carzoli, PharmD, BCACP, 340B ACE, DPLA Director of Operations ~ El Rio Health

Increasing patient safety and satisfaction, while maximizing pharmacy output is all part of the package with this comprehensive software system.

The 340B program is more than a pharmaceutical delivery system, however. To receive drug discounts, healthcare organizations must be able to show proof of established relationships with those patients served, including maintenance of health records.

Patients must also receive care that goes beyond medication dispensing.

Keeping track of patients and their interactions is complicated and crucial to continued participation in the 340B discount program. Liberty Software specializes in pharmacy management software that simplifies workflow and auditing capability, while maximizing patient care for 340B compliance.

www.libertysoftware.com

4/19/2019 1:16:24 PM

page 25

WAY

WAY

340B RESOURCES & SOFTWARE SOLUTIONS

Parata and TCGRx – Solutions to Improve Medication Adherence and Drive Long-Term Revenue

Better Together.

Two industry leaders known for shaking things up are poised to offer the best of pouch packaging and vial filling.

Together, we’re Parata Systems, the new industry leader focused on bringing you pharmacy technology solutions to support business growth and better health outcomes.

Ready to spice things up? Discover how we’re better together at parata.com & tcgrx.com.

PlatinumPagesAdCampaign2019.indd 2

page 28-31

Pharma-Choice™ Brand of USP <797> and <800> Cleanroom Disposables by Acute Care Pharmaceuticals

Explore the technology, expertise, and people you can count on.

The nation’s leader in USP <797> and <800> compliant supplies specifically designed for your advanced environment.

page 27

page 33

1/23/2019 6:23:43 AM

20Ways MISSION To educate pharmacy management on products and services that serve to improve patient care or improve a pharmacy’s financial bottom line, while distilling and presenting this relevant information via 20 product profiles.

QUARTERLY ISSUES Spring 2019

Summer 2019 I M P R O V I N G PATIENT CARE &

PHARMACY COST C O N TA I N M E N T Summer 2019

Health System

•

Spring 2019

Infusion

20 Unique Products & Services

page 26

Issue Focus: Retail, Specialty, & LTC

Issue Frequency: Spring, Fall, & Winter

Circulation Per Issue: 28,500+ 18,000+ Owners (Independents) 1,500+ Long-Term Care Pharmacies 2,500+ Retail Chain Executives 2,500+ Industry Executives 2,000+ Trade Show Handouts

4 Case Studies

2 Case Studies

Liberty Software, GSL Solutions, Charles River, and Comprehensive Pharmacy Services

Health System • Infusion

Medicine Shoppe, QS/1, Six Case Studies: TCGRx, Temptime, and MedCall Manchac Technologies, Two Case Studies: Supplylogix

Liberty Software and Medicine Shoppe International

Community • Specialty • LTC

•

NT

IMPROVING PAT I E N T C A R E & PHARMACY P R O F I TA B I L I T Y Fall 2018

Community • Specialty • LTC

Infusion

and services that will help your pharmacy improve patient care or increase profitability.

Eight Video Series Including Visante, Rees Scientific, Pharmacy Consulting Broker Services, Rite Aid, and More

page 22

Health System

16 Preceptors Recognized

by Seven Colleges Including UCONN, West Coast University, SIUe, and More Premier, FisherBroyles, page 36 Eight Video Series Including Solutions, CVS Health, Mission Critical Delivery and More The Compliance Team, page 20 Eight Video Series Including Visante, Verity Solutions, Rite Aid, TCGRx, Rees Scientific, and More

8 Thought Leaders

page 38

Winter 2018

by 14 Colleges Including 23 Preceptors Recognized University, and More URI, NEOMED, Manchester page 42

page 42

8 Thought Leaders

• LTC Community • Specialty

23 Preceptors Recognized 16 Preceptors Recognized 8 Thought Leaders 8 Thought Leaders 6 Case Studies 2 Case Studies

Will Call Technology

Eight Video Series Including Visante, Verity Solutions, Rees Scientific, Acentrus Specialty, and More

C O N TA I N M E

20 Unique Products 20 Unique Products & Services and services Discover 20 products improve pharmacy &profitability.

Serv that will help your ices Discover 20 products patient care or increase

Industry Expert Q&A, Market Leaders Buyer’s Guide, and More

Industry Expert Q&A, Market Leaders Buyer’s Guide, and More

Issue Focus: Hospital & Infusion

Issue Frequency: Summer & Winter

Circulation Per Issue: 12,200+ 6,500+ Hospital Directors 2,200+ Clinical Consultants 2,500+ Industry Executives 1,000+ Trade Show Handouts

Winter 2019

Community • Specialty • LTC

Discover 20 products and services that will help your pharmacy improve patient care or increase profitability.

Discover 20 products and services that will help your pharmacy improve patient care or contain costs.

Fall 2018

VING I M P R OI M P R O ARE V I N G PAT I E NPTA C TIENT CAR E & P H A R M A C Y& P H A RI LMI A TCY Y C O S T B P R O F I TA

20 Unique Products & Services

340B Resources & Software

2019 CIRCULATION

Winter 2018 / 2019

IMPROVING PAT I E N T C A R E & PHARMACY P R O F I TA B I L I T Y

page 20

and Apexus

Health System • Infusion & Community • Specialty • LTC

20 Unique Products & Services

Discover 20 products and services that will help your pharmacy improve patient care or increase profitability.

23 Preceptors Recognized

23 Preceptors Recognized by 14 Colleges Including URI, NEOMED, Manchester University, and More page 42

8 Thought Leaders

Eight Video Series Including Premier, FisherBroyles, Mission Critical Delivery Solutions, CVS Health, The Compliance Team, and More page 20

6 Case Studies

Six Case Studies: TCGRx, Medicine Shoppe, QS/1, Manchac Technologies, Temptime, and MedCall

Community • Specialty • LTC

Visit 20Ways ONLINE at RXinsider.com/20Ways

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N

3

Pharmaceutical Inventory Experts:

Cover (Vert).indd 1

Precise, Efficient, and Confident

Why Outsource Your Inventory Needs?

• • • • • • • •

Teams of experts conduct the inventory within a few hours.

Teams conduct inventories daily-not annually.

Minimal interruption to the pharmacy staff and operation.

Teams work seamlessly around the pharmacy staff ensuring that the “snapshot” is a true representation of the inventory on-hand.

Eliminate the need for overtime or coordination of staffing to accommodate inventory.

Expert valuation and pricing of the inventory by an independent party.

Competent inventory specialist that can work with finance and/or external audit firm to validate the inventory.

Collaboration with the pharmacy to provide an accurate report in a timely manner.

To learn more about Capital Inventory and how we can help you with our inventory services please contact 1-800-345-0849 or Info@capitalinventory.com.

9/27/06 3:00:09 PM

OUT WITH THE OLD. IN WITH THE NU. We used this image in 1988 and we’re willing to bet some of the biosafety cabinets (BSC) we made that year are still in operation. How much are we willing to bet? A brand new cabinet - built, shipped and installed for free.

If you think you’ve got the oldest NuAire biosafety cabinet working today, enter to win at nuaire.com/old

®

The Safer Choice for Your Pharmacy NuAire, Inc. | 2100 Fernbrook Lane | Plymouth, MN 55447 | www.nuaire.com

Contents WAY AmerisourceBergen

We Put Patient Safety First

Because a life is touched by every preparation we produce.

PharMEDium prefilled syringes–simple, safe, convenient.

© 2019 PharMEDium Services, LLC All rights reserved. P20410_Rev1

PharMEDium – Providing the Highest-Quality Sterile Compounded Services

WAY

Unit Dose Done Right

100% of PharMEDium CSP batches are tested according to 503B industry guidance standards for assurance of quality and safety.

Medi-Dose, Inc. / EPS, Inc. Delivers Bar Coding, Packaging, and Labeling Pharmacy Solutions

Unit Dose Bar Cod , ing, Pharmac Nursing y & Supply Experts!

• Ultraviolet Inhibitant • Moisture Resistant • Reduces Cross Contamination • Ideal for Meds Covered by USP 800 • Tamper-Evident • Cold Seal • 6 and 12-month Beyond-Use Dating • 1-D and 2-D Bar Coding • Flexible Label and Report Formatting • Multiple Sizes to Fit Your Meds and Storage Needs

Simple. Reliable.

800.523.8966

No dilution, reconstitution, or complex calculations needed before administering.

MediDose.com

Please visit PharMEDium’s Customer Resource Center at pharmedium.com for a current list of available services and new product announcements.

Unit Dose Done Right O 8.5 x 11.indd 1

5/18/16 10:23 AM

page 35 WAY 340B RESOURCES & SOFTWARE SOLUTIONS

Visante – Advancing the Business of Pharmacy™

Pharmacy & Business working together to optimize your results No one makes pharmacy and business work together like Visante. Our consulting work with Integrated Delivery Networks, hospitals and health systems combines a wealth of expertise with personalized and comprehensive support so you can optimize your pharmacy operations and deliver better patient care.

High-performing pharmacy is who we are • 340B Program • Specialty Pharmacy

• Comprehensive Pharmacy Assessments • Pharmacy Finance and Reimbursement

• Sterile Compounding & USP Excellence • Drug Diversion Prevention

• Pharmacy Stars TM Compliance Tools

Learn more at visanteinc.com, or contact us at solutions @ visanteinc.com or (866) 388-7583.

© 2019 Visante, Inc. All Rights Reserved.

page 47 WAY

Primary Engineering Controls From NuAire

THE SAFER CHOICE FOR YOUR PHARMACY

Visante makes pharmacy and business work together.

Our consulting work with hospitals and health systems combines a wealth of expertise with personalized and comprehensive support to optimize your pharmacy operations and deliver better patient care.

Provide quality Primary Engineering Controls at a competitive price with responsive service to lower your total cost of ownership, minimize downtime, and develop a long lasting relationship so you can concentrate on what matters, your work.

B I O S A F E T Y C A B I N E T S . H O R I Z O N TA L A N D V E R T I C A L L A M I N A R A I R F L O W W O R K S TAT I O N S .

C O N TA I N M E N T V E N T I L AT E D E N C L O S U R E S . C O M P O U N D I N G I S O L AT O R S . C U S T O M S O L U T I O N S .

Primary Engineering Controls by NuAire.

www.nuaire.com © Copyright 2019. NuAire, All Rights Reserved.

page 37

WAR ES & SOFT

340B RESOURCES & SOFTWARE SOLUTIONS Buyer’s Guide

URC 340B RESO

Q&A

E SOLU TION

Q. What is Program?

the 340B

Buyer’s Guide 340B Health 1101 15th Street NW, Suite 910 Washington, DC 20005 (202) 552-5850 www.340bhealth.org

ELEVATE340B 1210 S 300 E, Suite #1752 Draper, UT 84020 (385) 273-0604 www.Elevate340b.com

PatientCraft, LLC 306 Thunderbird Drive El Paso, TX 79912 (800) 682-5216 www.patientcraft.com

macy ident of Phar PharmBlue Equiscript ACI 340B Management r, Vice Pres Mille 1360 Truxton Avenue, Suite 300 40 Pennwood Place, Suite 300 824 W. en Franklin Street Stev lthCharleston, SC 29405 North Warrendale, PA 15086 Boise, ID 83702 ices, 340B Hea(877) 568-4115 (855) 779-4720 (208) 258-8139 Serv www.equiscript.com www.pharmblue.com www.aci340b.com

Apexus 290 East John Carpenter Freeway Irving, TX 75062 g Drug (888)Pricin 340-2787 www.apexus.com

S Q&A

to sell cturers Avella Specialty Pharmacy manufa requires drugSourceB et providers to safety-n The 340B program a discount 24416 N 19th Avenue at . Congress me patients outpatient drugs Phoenix, AZ 85085 low-inco numbers of rs to “stretch (651)provide 983-0677 serving high to allow these g more www.avella.com/sourceb created the program s as far as possible, reachin hensive resource Blue & Co, compre LLC. g more scarce federal free200 and providin500 N. Meridian fundSuite helpStreet, eligible patients from the program Indianapolis, IN 46204 diabetes, Savings IDS, .”

HIV/A (317) 633-4705 services as well our t medications www.blueandco.com clinics that serve and low-cos care and primary CaptureRx cancer, dental, ble citizens.

219 East Houston Street, Suite 100 most vulnera

eligible Q. Who is Program?

San Antonio, TX 78205 (888) 345-6424 the 340B forwww.capturerx.com

ed coverHealthcare ExceleraRx Corp Pharmacy Solutions, are drugs of Suite 2100 Summerkind Street NE, #260 an AmerisourceBergen Company What Q. Minneapolis, MN 55413 1300 Morris Drive1927(k) by section by (612)340B? 293-0378 Chesterbrook, PA 19087 as defined nt drugs www.excelerarx.com (877) 892-1254 under the 340B covered outpatie Act, are included All www.pharmhs.com nt clinic Security Feldesman Tucker Leifer Fidell LLP in an outpatie the Social of infused drugs400 as Suite QS/1 medications used 1129 20th ,Street NW, Program such , diabetes P.O. Box 6052 tion drugs Washington, DC other diseases or20036 most prescrip for cancer (202) 466-8960 and pills), and Spartanburg, SC 29304 www.feldesmantucker.com at home (insulin cy. (800) 845-7558 a retail pharma www.QS1.com dispensed by Healthclarity

RCTECH Solutions Inc 800 S Dakota Avenue #315 4293 Diamond Tampa, FL 33606 0B Terrace he 34 efits from tWeston, FL 33331 (800) 541-6923 Q. Who ben (877) 215-5675 www.healthclarityrx.com healthcare am? www.Rctech.org Progr the nation’s Liberty Software that support for is a critical RPh LLC 3205 E. Southlake Boulevard health centers andInnovations, 340B the360 can use Branding Avenue, Suite Southlake, TX 76092 Hospitals, clinics, 1401 net. me patients 60515 the Downers Grove, IL (800)safety 480-9603 numbers of low-inco and ensated care treat large (630) 963-0024 www.Libertysoftware.com re. offset uncomp from 340B to id and Medica www.rphinnovations.com savings Maxor National Pharmacyyments by Medica programs t underpa frequen Services Company patients through toScriptPro drugs, provides support 5828 Reeds Road tion 320 South alsoStreet ted prescrip 340BPolk discoun ion heavily Mission, KS 66202 Amarillo, TXinclude 79101 free or rtation and translat that (800) 606-7628 care.

(800) 658-6146 ment, transpo forms of medication manage and other www.scriptpro.com www.maxor.com

Codonics of “covered 17991 Englewood types Drive list of 16 Heights, specifies aMiddleburg SafetyOH ts.44130 The 340B statute drug price discoun are eligible for (800) 444-1198 ts include: www.codonics.com entities” that drug discoun eligible for 340B , vaccinations, Hospitals, net providers Secure340B Comprehensive Pharmacy Macro services Helix e Share Disproportionat P.O. Box 15257 ServicesChildren’s Hospitals, 2 National Data Plaza NE, 4th Floor • Hospitals: with Hospita Philadelphia, PA 19125 6409ls,Quail Hollow Centers Atlanta, GA 30329 ect inters l Road , Sole Critical Access Referra 340B (888) 732-3402 Memphis, TN 38120 (404) 965-3040 aid? ls, Rural Hospita Q. How does are and Medic Cancer www.secure340b.com (800) 968-6962 www.macrohelix.com l drug Hospitalswww.cpspharm.com d Health ams like Medic a nationa progrOptimizer Community Qualifie result Sentry DataofSystems, Inc. NewTech/340B the : Federally and the Ryan 410 Kay Lane 340B discount is 800 Fairway Centers Drive,cturers Suite 400 Curant Health The Look-Alikes, drug manufa • Clinics and FQHC s), 200 ent betweenDeerfield Beach, and Human FL 33441 Technology Court SE, Suite B Shreveport, LA 71115 Clinics, Lung of Health rebate agreem Centers (FQHC Smyrna, ent411-4566 Black and (800) GA 30082 (281) 292-9180 Departm Clinics, the IDS Family id coverage Secretary of ent Centers, White HIV/A state Medica www.sentryds.com (866) 460-8040 www.340boptimizer.com stic Treatm outpatient exchange for Disease Diagnowww.curanthealth.com Services, in Hemophilia of their covered Transmitted e under coverag Sexually B Indian those required Medicare Part Planning Clinics, Tribal/Urban discounts mirror losis Clinics, Health Centers drugs. The 340B Clinics, Tubercu 40 S UNative 2 0 1 9 In H E A LT H S Y S T E M • I N F U S I O N , M M E R Hawaiia Medicaid.

Health Centers

38

SUMMER

2019

I

H E A LT H

SYSTEM

O • INFUSI

page 49

340B RESOURCES & SOFTWARE SOLUTIONS

340B RESOURCES & SOFTWARE SOLUTIONS SUNRx 3220 Tillman Drive, Suite 104 Bensalem, PA 19020 (267) 525-3430 www.sunrx.com Trellis Rx, LLC 1175 Peachtree Street NE 10th Floor, Suite 1000 Atlanta, GA 30361 (800) 503-5420 www.trellisrx.com Verity Solutions 12131 113th Avenue NE, Suite 200 Kirkland, WA 98034 (425) 947-1922 www.verity340b.com Visante 101 East Fifth Street #2220 St. Paul, MN 55101 (866) 388-7583 www.visanteinc.com

Improve your Solid Oral Unit Dose needs with our comprehensive Bar Coding, Packaging, and Labeling Solutions – designed by healthcare professionals, for healthcare professionals.

Case Study: Reconciling Irreconcilable Differences: A Time Study on IntelliVault™

CASE STUDY Reconciling Irreconcilable Differences: A Time Study on IntelliVault™ From GSL Solutions Inc.

Industry Expert Q&A, 340B Resources & Software Solutions Market Leaders Buyer’s Guide, and more.

Background

Michael Kiso, Pharm D. RPh MBA Candidate 2020

Vizient 290 East John Carpenter Freeway Irving, TX 75062 (800) 842-5146 www.vizientinc.com

Pharmacists have been manually tracking and reconciling physical controlled drug inventory to a perpetual inventory log since 1971 at the institution of the DEA’s Title 21. The importance of tracking controlled substance inventory and dispensing history cannot be overstated, but has long been hampering the full potential of outpatient pharmacy operations. GSL Solutions Inc., a company well-known for the IntelliCab™ pharmacy will-call system found throughout military pharmacies and community pharmacies across the globe, has developed a new product, IntelliVault™. This unique product aims to replace the typical “gun safe” type open-faced and open-access controlled substance cabinet with a real-time discrete storage and tracking system based on Radio Frequency Identification (RFID). The IntelliVault™ system has successfully eliminated diversion and drug loss while optimizing pharmacy operations and reducing labor costs.

It achieves this through shifting time consuming, yet non-clinical labor away from pharmacists to pharmacy technicians. It also eliminates time required to reconcile inaccuracies associated with manual logs via three steps:

From GSL Solutions Inc.

1. Controlled Substance Stock Receiving • Technician coupling of controlled substance stock bottles with a SmartBasket™ with entry of lot number and expiration date.

• Multiple technicians receiving and filing stock simultaneously.

Walgreens 340B Complete® 102 Wilmot Road Attn: Ken Kring MS1244 Deerfield, IL 60015 www.walgreens.com/ businesssolutions/ payer/340BComplete.jsp

• Automatic reconciling of received stock with distributor drug invoice or form 222.

2. Drug Retrieval + Filling • Scanning the Rx label prompts a pharmacy technician to retrieve the controlled stock bottle with the Pick to Light™ System.

• Entry of lot number and expiration date at the receiving step allows for the oldest stock to be used first and allows for simplification of drug recalls.

• Returned to stock prescriptions will automatically be used on the next fills.

• Storing a given NDC in multiple SmartBaskets™ allows for multiple technicians to fill that same medication without the inventory worry of managing a "lead bottle."

3. Stock Bottle Back Count + Return to Stock • Once the technician fills the Rx, a blind back count ensures accuracy, accountability, and chain-ofcustody. Any discrepancies are reviewed by a pharmacist, who can utilize GSL’s reports to review any potential issues with their associated users.

• Software uses Pick to Light™ Technology to prompt technicians to complete return to stock in a matter of seconds.

www.gslcorp.com

page 50-53

page 38-41

N

WAY

Prep-Lock™ From IMI Guards Against Drug Diversion and Misuse INNOVATION IN

SECURE DRUG DELIVERY For 50 years IMI has manufactured innovative devices that help protect the delivery of drugs within the healthcare system. Pharmacists rely on Prep-Lock™ Tamper Evident Caps for ease of installation while clinicians appreciate the simplicity of removal for drug administration.

Prep-Lock Tamper Evident Caps for IV Syringes are the industry standard for guarding compounded sterile preparations from unauthorized access, diversion and misuse. IMI offers a variety of products that protect drug delivery including IV, Oral and Enteral devices.

Increase pharmacy productivity and safety with innovative and economical devices designed to protect your compounded sterile preparations.

CONTACT US FOR FREE EVALUATION SAMPLES

WAY WE HAVE SOME

Health Care Logistics – Your Small Friend, Indeed

H U G E NEWS!

GREAT PRODUCTS NOW FROM THE HCL FAMILY!

Discover an unmatched inventory of unique and hard-to-find solutions for nearly every facet of the healthcare industry.

LABELI N G TAPES! INT LOW-L OM RO CLEAN S E WIP

MADE IN THE USA

IM I

GOHCL.COM • 1.800.848.1633

1.800.344.2554 WWW.IMIWEB.COM

L-134 R4 Innovation_20 Ways 8.5x10.875.indd 1

4/30/19 9:39 AM

05_19_RX Insider New Products.indd 1

4/8/19 10:57 AM

page 45

page 55 SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N

7

Thought Leader Video Series What are the pharmacy experts saying?

RXinsiderâ&#x20AC;&#x2122;s Thought Leader Video Series are informative video series comprised of multiple interviews with thought leaders throughout the pharmacy profession. Explore niche subject matter and gain insight through hundreds of thought leader videos hosted on RXinsider.com.

For information, contact our sales team.

RXinsider

800.972.2083

sales@RXinsider.com RXinsider.com 1300 Division Road, West Warwick, RI 02893 Š 2019 RXinsider LTD. All rights reserved.

A New Approach to Formulary Management Faced with mounting pressure to manage costs and improve outcomes, the solutions you used to rely on now fall short.

Lumereâ&#x20AC;&#x2122;s evidence-based formulary management solutions help you: Identify clinical initiatives to reduce costly, unwarranted variation Uncover new therapeutic alternatives by comparing drugs with the same indication Fast track MUE initiatives with clinically driven analytics Monitor compliance with P&T committee decisions

enlightened healthcare

lumere.com | explore@lumere.com

Praxi Fill ™

Automated syringe ller

Syringe lling made easy!

PraxiFill™ is an automated syringe ller

Filling speed is up to 8 syringes/minute depending on syringe size.

Small footprint

intended to increase productivity of the syringe lling process by eliminating the tedious manual task of aspirating solution into the syringe and capping the lled syringe.

PraxiFill™ is designed to be used with MedXL pre-capped sterile syringes for increased efficiency and productivity.

Increase productivity

5cc,

10cc,

20cc

and

50cc

syringes

are available.

Easy to control with touch screen pad

Fast, accurate, repeatable lling and capping.

MIX - FILL - LABEL - USE

Praxi Label™

Semi-automated syringe labeller

Syringe labelling made easy!

PraxiLabel™ is a semi-automatic tabletop syringe labeler intended to increase labeling productivity as it

Small footprint

eliminates the work related injuries due to frequent hand and wrist

The labels are pre-graduated and may be printed on any heat transfer label printer.

movements involved in the syringe labeling operation.

Simple and fast change over between different sizes www.praximedsystem.com

Contents WAY

Letco Helps Compounding Pharmacies Stay Compliant and Profitable While Navigating USP and FDA Changes

USP compliance is critical care can’t pause for renovations.

Compounding can pull you in different directions, but you shouldn’t have to choose between regulatory compliance and patient care.

Letco’s team of experts can help you navigate the uncertainty surrounding USP and FDA guidance for hospital compounding. Our programs and products have been designed to help you use compounding to provide the best possible patient care without stretching your budget.

800-239-5288

letcomed.com

COMPOUNDING INGREDIENTS | ADVISORY SERVICES | SUPPLIES | SPECIALTY PRODUCTS | EQUIPMENT

AHP Offers an Evolving Unit Dose Portfolio to Support Efficient Bedside Scanning

Supporting Pharmacy Efficiency with a Growing Product Formulary

Liquid Unit Dose from American Health Packaging

American Health Packaging provides new unit dose products to support pharmacy efficiency and patient safety initiatives. Liquid Unit Dose cups, available through partner GPOs and wholesalers, facilitate dose-level scanning at bedside. Products come in multiple pack sizes to provide flexibility in managing local inventory.

The market leader in manufactured barcoded unit-dose oral solids to the health care marketplace, American Health Packaging provides nearly 500 oral solids and liquids products meeting the diverse needs of inpatient pharmacy.

Pull-tab labels promote ease of opening and product administration Thick gauge cups, excellent seal integrity aid in avoiding costly damage and clean up Differentiated labels provide visual guidance for distinguishing between look-alike, sound-alike products Cups and storage trays are designed to optimize limited shelf storage space

Letco understands the need to approach the market in a new and different way, to truly partner with compounding pharmacies and help them maximize profitability.

We’re Letco. Let us help.

Call or visit us online today

WAY

McKesson Morris & Item # Dickson #

Product Description

ABC 8-digit #

Cardinal Item #

10211921

5517206

3795689

584466

Fluoxetine Oral Solution, USP

10188404

5465380

3917226

363275

Fluoxetine Oral Solution, USP

Unit Strength

20mg/5mL 20mg/5mL

Cup Delivery

5mL 5mL

Cup Strength

20mg/5mL 20mg/5mL

Pack Size

NDC

40 cups

60687-0244-77

50 cups

60687-0244-67

10211783

5517214

3901766

584557

Levetiracetam Oral Solution, USP

100mg/mL

5mL

500mg/5mL

40 cups

60687-0249-77

10183100

5430343

3775822

238550

Levetiracetam Oral Solution, USP

100mg/mL

5mL

500mg/5mL

50 cups

60687-0249-67

10210354

5512413

3777034

568063

Ondansetron Oral Solution, USP

4mg/5mL

5mL

4mg/5mL

30 cups

60687-0252-86

10209414

5508114

3751294

560649

Phenytoin Oral Suspension, USP

125mg/5mL

4mL

100mg/4mL

50 cups

60687-0275-66

10211558 10212031 10191061

5515705 5520416

3935129

575878 584904

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

20mEq/15mL

30 cups

60687-0341-58 60687-0341-71

30mL 30mL

40mEq/30mL

50 cups

60687-0341-72

15mg/mL

10mL

150mg/10mL

40 cups

60687-0260-23

Ranitidine Syrup (Ranitidine Oral Solution, USP)

15mg/mL

10mL

150mg/10mL

50 cups

60687-0260-69

10182920

5427497

3772373

231159

Theophylline Oral Solution, USP

80mg/15mL

15mL

80mg/15mL

50 cups

60687-0258-71

15mL

20mEq/15mL 40mEq/30mL

50 cups

60687-0341-64

20mEq/15mL 20mEq/15mL

Ranitidine Syrup (Ranitidine Oral Solution, USP)

20mEq/15mL

20mEq/15mL

40 cups

Potassium Chloride Oral Solution, USP 10% Potassium Chloride Oral Solution, USP 10%

594978 231142

Potassium Chloride Oral Solution, USP 10%

15mL

20mEq/15mL

591016 465344

3772381

5521521

20mEq/15mL

15mL

321570 575894

3266467 3944592

5427489

5515713

Potassium Chloride Oral Solution, USP 10%

15mL

3263035 3935137

5525027

10212749 10191066

5486220

3909884

5487574

10214626 10182932

10211557

80 cups 40 cups

60687-0341-07 60687-0341-14

T10302 19.4

Hitting the Mark American Health Packaging is a leading manufacturer of serialized, barcoded unit dose products for hospital, institutional, and long-term care pharmacy.

americanhealthpackaging.com

|

800.707.4621

page 57

WAY

PYROSATE

®

RAPID ENDOTOXIN DETECTION KIT ed

NOW

ens FDA Lic

®

FDA

New Sensitivities Of 0.03, 0.125 and 0.25 EU/mL Final Product Release Easy-To-Use Method Rapid Test Results ASSOCIATES OF C A PE CO D, I N C.

ASSOCIATES OF C A PE CO D, I N C.

ASSOCIATES OF C A PE CO D, I N C.

Specialists in Endotoxin and Glucan Detection

Specialists in Endotoxin and Glucan Detection

Specialists in Endotoxin and Glucan Detection

ASSOCIATES OF C A PE CO D, I N C.

ASSOCIATES OF C A PE CO D, I N C.

ASSOCIATES OF C A PE CO D, I N C.

Bacterial Endotoxin Testing USP Chapter <85> Compliant Associates of Cape Cod, Incorporated 124 Bernard E. Saint Jean Dr., East Falmouth, MA 02536 USA 888.395.2221 • INFO@ACCIUSA.COM • WWW.ACCIUSA.COM

Licen

sed

Associates of Cape Cod — Delivering Rapid Endotoxin Testing Results for Compounding Pharmacies

Pyrosate® has been developed as an easy-to-use Limulus Amebocyte Lysate (LAL) gel-clot test that enables rapid testing and does not require special laboratory supplies.

page 65

WAY

Take the Worry Out of Medication Storage With Follett's Refrigerators and Freezers

Temperature consistency on every level

When it comes to product temperature accuracy, there is no room for error. Follett high-performance refrigerators provide precise temperature control for your valuable medications.

NEW Double door models follettice.com/double

Protect your valuable temperature-critical items with Follett’s industry-exclusive plenum air delivery system, which distributes air evenly at every level to keep the entire cabinet in-temperature.

See our full line at folletthealthcare.com or call 800.523.9361 for more information.

page 59

page 67

Case Study: Environmental Monitoring Matters – Going Beyond the USP <797> Standard

CASE STUDY Environmental Monitoring Matters: Going Beyond the USP <797> Standard

Erin Patton

Trade Show & Meeting Calendar

Senior Product Specialist ~ Charles River St. Louis, Missouri

Erin received her Bachelor of Science degree in biology from Xavier University and her Master of Science degree in cell and molecular biology from the University of Illinois, Urbana-Champaign. Erin has over 15 years’ experience in molecular biology research, microbiology QC, and regulatory compliance. As a Senior Product Specialist for Charles River’s Microbial Solutions division, Erin provides innovative rapid micro solutions for endotoxin testing, microbial identification, and microbial detection (Celsis® rapid bioburden and sterility testing).

PRIMARY INTENDED OUTCOME Compounded sterile products (CSPs) are individually made medications that are administered via injection, and include vaccines and epidural anesthesia.

Chapter <797> of the United States Pharmacopeia (USP) outlines the facility and operational requirements for compounding sterile drugs and specifically calls for the collection and monitoring of environmental data through air and surface sampling. These standards aim to ensure patient safety and reduce the real risks of contamination, infection, or incorrect dosing.

From Charles River

Charles River provides a range of environmental and product sterility testing that meets and exceeds compliance with USP regulations. Their laboratory services support drug manufacturing, monitoring, and testing, and can be tailored to a facility’s specific needs to ensure patient safety.

THE CHALLENGE Drug compounding creates relatively small batches of medications that are tailored to the needs of special populations, including patients with allergies or those who require nonstandard doses, such as children or the elderly. The compounding process is carried out under the oversight of state pharmacy boards, and enforcement of standards differs from state to state. Importantly, some compounded drugs are not regulated by the United States Food and Drug Administration for safety, effectiveness, or manufacturing quality. Serious adverse events have occurred, including a fungal meningitis outbreak in 2012, which was caused by a contaminated injectable drug. The facility that manufactured the drug was not in compliance with USP guidelines.

www.criver.com

page 60-63

page 68-71

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 11

NOW YOU HAVE A CHOICE!

0.5 mL each

1/2 SECOND SPRAY is all it takes!

UNIt DOSE – PAtIENt SAFEty An Innovative Non-Aerosol Unit Dose topical Anesthetic Spray • Meets Joint Commission Standard for the most ready-to-administer form available* • Fast onset • Short duration • Virtually no systemic absorption

SPRAy KIt – MUltIPlE USE 20% Benzocaine Oral Anesthetic • • • • • •

Eliminates pain and discomfort Fast onset (within 30 seconds) Short duration (15 minutes) Safe – available over the counter Best value among topical anesthetic sprays Great Wild Cherry flavor!

• Utilizes bar code medication administration (BCMA) to accommodate point-of-care scanning • Virtually eliminates adverse events resulting from preventable medication errors, ensuring the “5 Rights” are met: √ Right Drug √ Right Patient √ Right Dose √ Right Route √ Right Time • Single unit-of-use packaging eliminates the potential for cross-contamination • Increases billing accuracy and improves supply chain costs • Recyclable

Spray

ORDERING INFORMATION NDC#

AMERISOURCE CARDINAl MORRIS & BERGEN HEAltH MCKESSON DICKSON

ORDERING INFORMATION PRODUCt

0283-0610-11

10090081

CIN 4362547

1410125

086611

HurriCaine ONE® Unit Dose Non-Aerosol Spray Box of 2, 0.017 fl. oz. (0.5 mL) each

0283-0610-26

10090082

CIN 4363370

1411925

086629

HurriCaine ONE Unit Dose Non-Aerosol Spray Box of 25, 0.017 fl. oz. (0.5 mL) each

Spray – 2 oz. spray can and 1 disposable extension tube ............................................NDC 0283-0679-02 Spray Kit – 2 oz. spray can and 200 disposable extension tubes ...............................NDC 0283-0679-60 Extension tubes – Box of 200 disposable extension tubes ..................Product number 0283-1185-20

If HurriCaine ONE is not yet available through your wholesaler, request it by name and NDC Number. *Joint Commission Standard: MM.05.01.11, EP4

LLC

Extension tubes

For more information, call us at 1-800-238-8542, M-F 8:00 a.m. – 4:30 p.m. ET. www.beutlich.com HurriCaine ONE and HurriCaine® are registered trademarks of Beutlich® Pharmaceuticals, LLC. HOSV 666 0916

Contents WAY www.iso-med.com

CleanRoom/Medical Supplies CLEANROOM

MEDICAL SUPPLIES

Call for fast reordering:

800-797-1405

ADHESIVE MATS

STERILE CHEMO GOWNS

ADHESIVE TAPES

STERILE SLEEVE SYSTEM

CLEANROOM APPAREL

STERILE CHEMO GLOVES

CLEANROOM LABELS

STERILE CHEMO PREP MATS

CLEANROOM PAPER

STERILE COMPOUNDING SUPPLIES

CLEANROOM SWABS

STERILE 70% ISOPROPYL ALCOHOL

DISINFECTANTS & CLEANERS

TESTING SUPPLIES

MOPPING SYSTEMS

WIPERS

1220 Graphite Drive, Corona, CA 92881 USA | 800-797-1405 | sales@iso-med.com

ISO-MED, INC. – Your One-Stop Solution for USP Compliant Medical and Cleanroom Supplies

WAY

Temptime – Temperature Monitoring Solutions for Medication Shipments, Storage, and Pharmacy Facilities

FOR PHARMACIES

Automated, affordable solutions for real-time temperature monitoring Manually monitoring temperature can be time consuming and expensive—not to mention prone to error.

Providing an unparalleled selection of specialized products, globally trusted quality and service, and delivery convenience for meeting USP <797> and USP <800> standards.

Temperature Intelligence®

The EDGE family of wireless sensors and apps are designed specifically to help pharmacies:

• Remotely monitor medication storage 24/7 • Automate processes to improve accuracy • Get real-time notification of temperature excursions • Record and store data to meet pharmacy board requirements You’ll not only reduce operating costs, you’ll ensure the efficacy of the medications you dispense to patients.

Tap into the future of temperature monitoring at temptimecorp.com/edge A Zebra Technologies Company

ad-EDGE-RXInsider-Summer-2019.indd 1

4/24/19 3:30 PM

page 73 WAY

Q.I. Medical, Inc.™ Your Partner in USP <797> Pharmacy Compliance Providing quality assurance products to hospitals and pharmacies practicing sterile compounding, with a singular focus on pharmacy compliance.

Our long-standing regional distribution partners are able to provide exceptional in-person service and training.

page 79 WAY

Snap-N-Go® and Dilute-N-Go® From Pentec Health Speed and Simplify In-House Compounding

503

We deliver the efficiency and safety of single-dose medications with the automation of critical processes and the quality controls of pharmaceutical manufacturers.

We’re like an elevator.

We eliminate steps for pharmacists.

Less steps means our product is easier and faster to use. Yet, provides safety and accuracy to make your processes more effective and efficient. Pentec’s 503B combines validated automation and process quality controls to make concentrated, single-dose products you can trust. We offer the peace of mind of a manufacturer with the efficiency of an outsourcing provider – enabling safe accurate medication, when it’s needed, where it’s needed, the way it’s needed. Less waste means greater value. To learn more please visit pentechealth.com.

www.pentechealth.com *

TM

*

*Must be further diluted.

page 75

page 81

Closed-System Transfer Devices (CSTDs) Closed-System Transfer Devices (CSTDs) A comparison of CSTD manufacturers.

Is your pharmacy considering the implementation of CSTDs in 2019?

The following comparison matrix was developed as a complimentary service for

https://www.businesswire.com/news/home/20180111005529/en/Baxter-Launches-ArisureClosed-System-Transfer-Device

Case Study: Achieving Continuous Readiness for USP <797> and <800> for a Large Hospital System Regulatory bodies are paying increasing attention to hospital and health system pharmacies regarding sterile medication compounding. Enforcement of USP <797> and <800> revisions and regulations are slated to take effect on December 1, 2019, increasing pressure to be in compliance.

Topic

Proposed Changes To USP <797> Effective 12/1/19*

Facility Requirements

Category 1 & Category 2 Compounded Sterile Products (CSPs)

http://www.icumed.com/products/oncology/hazardous-drug-closed-systems-and-cstds/ chemolock.aspx http://www.equashield.com/wp-content/uploads/2015/12/021-Equashield-Closed-SystemTransfer-Device-CSTD.pdf

Case Study: Achieving Continuous Readiness for USP <797> and <800> for a Large Hospital System

CASE STUDY

References

Only Category 1 CSPs (with limited BUD) can be compounded if PEC is in an unclassified SCA/C-SCA. This includes RABs (i.e. CAI and CACI).

•

Replaces Low-, Medium- and High-Risk classifications

•

Category 1 – Compounded in a SCA

•

https://corvidamedical.com/about-new-cstd-halo/product-components/closed-syringeadaptor/

ü

BUD 12-hour room temperature/24-hours refrigerated

ü

Examples: LAFW, BSC including CAI or CACI located in a SCA or C-SCA

From Comprehensive Pharmacy Services

Category 2 – Must be compounded in a cleanroom suite ü

ISO classified area, not a SCA/C-SCA

ü

May assign full BUD

https://www.bbraunusa.com/en/products/b/onguard-closed-systemtransferdevicecstd.html

anyone in the beginning stages of research.

http://yukonmedical.com/products/arisure-closed-system-transfer-device/

Due to <USP 800> becoming enforceable

https://www.cdc.gov/niosh/docket/review/docket288a/pdfs/ aperformancetestprotocolforclosedsystemtransferdevices.pdf

in December 2019, CSTDs will be required

https://www.ncbi.nlm.nih.gov/pubmed/?term=Comparison+of+closed+system+transfer +devices+for+turnaround+time+and+ease+of+use

for hazardous drug administration and

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938267/

recommended for hazardous drug preparation.

A comparison of CSTD manufacturers.

Microbial Air and Surface Monitoring

http://www.ajhp.org/content/70/7/619.long

Minimum Personnel Requirements

Contributor Melanie Gaspar PharmD Candidate 2019 MCPHS University

Providing the tools and knowledge to accurately monitor temperature sensitive medications, ensuring that they have not been exposed to temperature events that could impact their effectiveness in treating patients.

•

Viable Air Sampling: Every 6 months

•

Viable Surface Sampling: Monthly

•

Media Fill: Every 6 months

•

Gloved Fingertip Testing (GFT): Every 6 months ü

Must be completed in conjunction with media fill testing

ü

Observed hand hygiene/garbing competency assessment: Every 6 months

*Note: these are not final and may change before December 1

In preparation for the December 1 deadline, a hospital system chief pharmacy officer, who previously partnered with Comprehensive Pharmacy Services (CPS), brought CPS in to do an initial assessment and evaluate USP <797> and <800> compliance across ten pharmacies in hospitals and infusion centers across a large hospital system.

01948_2019_20Ways_Summer_8.5x10.875_F.indd 2

4/25/19 2:10 PM

page 76-77 PUBLISHER RXinsider LTD RXinsider CEO: Gregory Cianfarani RPh DESIGN AND PRODUCTION Design & Layout Multimedia

Marketing and Operations

Lora Sosa Eric Simmons Jay DiNardi Samantha Pirraglia Jillian Melly

SALES AND BUSINESS DEVELOPMENT Chris Kolkhorst, Vice President chris.kolkhorst@rxinsider.com Shaun Russell shaun.russell@rxinsider.com Mike Rahme mike.rahme@rxinsider.com Email sales@rxinsider.com Phone 800.972.2083 Fax 646.329.9766 Website www.RXinsider.com

page 82-85 20Ways is an official publication of RXinsider

NOTICE OF POLICY 20Ways is published quarterly by RXinsider LTD, 1300 Division Road, Suite 103, West Warwick, RI 02893. Postmaster: Send address changes to 20Ways/RXinsider, 1300 Division Road, Suite 103, West Warwick, RI 02893. Notification of address change must be made six weeks in advance, including old and new address with zip code.

GENERAL SUBSCRIPTION INQUIRIES RXinsider LTD c/o 20Ways 1300 Division Road, Suite 103 West Warwick, RI 02893 20Ways Online: www.RXinsider.com/20Ways General Information: 20Ways@RXinsider.com Circulation: See page 3

Editorial - views expressed in articles or profiles in the 20Ways are those of the author(s) and do not necessarily reflect the policies and opinions of RXinsider, our editorial board(s), our advisory board(s), or staff. Advertising products, services and educational institutions advertised in 20Ways do not imply endorsement by RXinsider.

Copyright © 2019 RXinsider LTD. All rights reserved. Reproduction without permission is prohibited.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 13

USP <800> RESOURCES Leading Pharmacy Suppliers of USP <800> Compliant Solutions The USP <800> compliance deadline goes into effect December 1, 2019. These leading pharmacy suppliers offer product and service solutions to help your pharmacy and/or cleanroom achieve USP <800> compliance. Contact these companies directly for more details on how they will help you meet the mandate of USP <800> compliance.

www.RXinsider.com/USP800

Rees Scientific

Š 2019 RXinsider LTD. All rights reserved.

#1 340B Management Systems

We’re turning 340B teams into A-teams.

As the industry’s most trusted third-party administrator for the 340B drug discount program, we can help optimize drug cost savings and meet HRSA compliance requirements for hospitals, clinics and pharmacies.

© 2019 Verity Solutions Group, Inc.

FOR 340B HOSPITALS AND HEALTH CENTERS Split Billing | Contract Pharmacy | VHUBTM for Contract Pharmacies | Compliance Manager | Purchase Analytics

YOUR TRUE PARTNER FOR 340B PROGRAM MANAGEMENT We’re changing the game in third-party administration for 340B, with unmatched product innovation, ease of use, data transparency and support to help your team maintain compliance. We’re the only 340B solution to score an “A” in the 2019 KLAS Performance Report for 340B Management Systems and earn the title of Category Leader for two years running.

If you’re looking to collaborate with a vendor that can help you build a winning 340B program and contribute to your organization’s bottom line, contact us to speak with a 340B program advisor and learn how to get started.

www.verity340b.com | 1.800.581.1378 | info@verity340B.com

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Verity Solutions – Your True Partner for 340B Program Administration and Compliance Verity Solutions is an award-winning provider of 340B software and services. Hundreds of integrated healthcare systems, acute-care hospitals, community health centers, federallyqualified health centers, pharmacies, and other 340B-eligible covered entities throughout the U.S. rely on Verity 340B® to successfully manage their 340B program.

President & CEO: George Puckett Founded: 2002 Employees: 75 Toll-Free Phone:

(800) 581-1378 Phone: (425) 947-1922 Address: 12131 113th Avenue NE #200 Kirkland, WA 98034 Website: www.verity340b.com

Company Background

Since 2002, Verity Solutions has maintained an exemplary HRSA audit track record while partnering with covered entities to stretch scarce resources, foster compliance, respond to changing regulations, and optimize drug cost savings through the 340B drug discount program.

Verity Solutions is a privately-held corporation based in Kirkland, Washington, with remote employees stationed across the nation to best serve our widespread customer base.

Product Overview

Verity Solutions simplifies the complex process of maintaining 340B program compliance resulting in critical 340B cost savings for our customers. Our people and 340B solutions work together to help covered entities optimize their 340B savings and safeguard ongoing compliance and audit readiness. Our comprehensive solutions for split billing, contract pharmacy, specialty contract pharmacy, compliance management, purchase analytics, and pharmacy network management (VHUB™) all offer: • Agile Software Platform: Built and deployed with security, performance, scalability, ease-of-use, fault-tolerance, and agility as primary goals.

• Intuitive Application: Designed with our users in mind, we maintain ongoing feedback and collaboration with our clients. This collaboration steers our continual software and services development.

• Responsive Support: Designated account managers provide focused support, training, audit readiness, and regular business reviews to maximize your 340B program success and help you maintain compliance. n Highlights • Over 98% customer retention rate.

• 80% of our customer support cases resolved within two hours.

• 60-90 day implementation time.

• Access to test environment before and after live implementation.

• Software updates every two weeks driven by customer feedback, regulatory changes, and user needs.

Features & Options

n Verity 340B® Split Billing • Automatic split of replenishment orders into as many accounts as needed (340B, WAC, GPO, etc.) to meet your unique needs.

• Works with all major wholesale vendor order-entry and covered entity information systems.

• Supports HRSA and manufacturer audits and tracks all 340B purchases from multiple vendors.

• Matches pharmaceutical usage with wholesale order quantities to optimize savings.

• Innovative features such as Medicaid management tools with acquisition cost billing, orphan drug management, and central distribution support. n Verity 340B® Contract Pharmacy • Detailed reports and dashboards for a complete, audit-ready view into program performance and activity.

• Managed and automated 340B replenishment, including tools to enable retail pharmacy self-orders, minimizing costly inventory swell.

• No “true-ups” – no fees are exchanged until full package is replaced.

• Integrated tools for referral capture, with no-risk opt-in functionality and the ability to sort by value, provider, referral claims, and more to make it easy to act where you benefit the most.

In addition to our core solutions, Verity Solutions offers optional services that can add value to your existing 340B program as standalone options, regardless of which third party administrator you use: n Verity 340B® Compliance Manager A web-based solution with quick and simple set-up which stores your 340B program documentation and provides tools for you to fulfill your self-audit requirements. n Verity 340B® Purchase Analytics A cloud-based solution that provides tools to identify the optimal NDC mix for significant savings opportunities, with an average savings of 1013% of total drug spend.

Testimonial

“ T he system drives outcomes. We see those outcomes in the money we are saving by using this product … I am surprised Verity Solutions doesn’t charge twice as much. Just the savings in one dose of one drug pays for our whole monthly fee … I have recommended and would continue to recommend this product.”

— Manager, April 2019

Selected commentary collected about Verity 340B April 2019 © KLAS 2019 Visit https://klasresearch.com for a complete view.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 17

A better, greener waste solution Cactus controlled substance waste management systems

Cactus Pharma Lock® OR System

Cactus Smart Sink® System

For more information, please call 800 253 3210.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Pharma Lock, Smart Sink, Stryker. All other trademarks are trademarks of their respective owners or holders. © 2019 Stryker | www.stryker.com | 9100-004-677 Rev none

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Stryker Cactus Smart Sink and Cactus PharmaLock OR A waste medication disposal solution, bringing medical facilities into compliance with disposal requirements. Stryker's Cactus Smart Sink System securely captures partially administered controlled substances and renders them non-retrievable and unusable.

President & CEO: Kevin A. Lobo Founded: 1941

Employees: 33,000+ Stock Symbol: SYK Toll-Free Phone:

(800) 367-5690 (269) 385-2600 Fax: (269) 385-2300 Address: 2825 Airview Boulevard Kalamazoo, MI 49002 Website: www.stryker.com/us/en/index.html Phone:

Company Background

We are one of the world's leading medical technology companies. Our growth is based on a diverse array of innovative products and services in orthopaedics, medical and surgical, and neurotechnology and spine that help improve patient and hospital outcomes – which we achieve through the dedication of our more than 33,000 employees globally.

Product Overview

Stryker’s Cactus Smart Sink System is an easy-to-use, “green” waste solution for partially administered pharmaceuticals. It accepts unused portions or partial doses of controlled substances and provides for a secure alternative to a sink, toilet, red sharps container, or waste bin for drug waste. The Cactus Smart Sink System automatically secures and renders controlled substance waste unusable and non-recoverable while providing a secured bridge from traditional drug disposal to proper and responsible disposal.

This system utilizes two replaceable cartridges: one liquid cartridge for liquid waste and one solid cartridge for capsules, tablets, and patches.

Both cartridges allow for continuous disposal over time and are designed to last up to 90 days. The system utilizes automatic timers and weight indicators providing notice when cartridges are full or have expired. The system also allows you to choose a preferred expiration date by using the built-in timer selector switch.

The Cactus Smart Sink System helps bring medical facilities into compliance by providing a secured and environmentally friendly method of disposal.

• It facilitates properly witnessed wasting of narcotics in the open and near the drug dispensing systems where needed, improving safety and saving time.

• It allows for up-front waste documentation and facilitates this process to be completed immediately (when controlled substances are dispensed) rather than later.

• It reduces the opportunities for drug diversion by facilitating twoperson witnessed-wasting and by keeping partially filled vials and syringes out of red sharps containers, which have become a key source for drug diversion in medical facilities.

Cactus Exclusives

• Patented Proprietary Mixture: This patented technology uses

a combination of denaturants and deterrents to render drugs unusable and non-retrievable in accordance with the DEA standards for controlled substance disposal.

• Secure System: The Smart Sink and PharmaLock OR are fully

locking systems, complete with universal key sets. Additionally, the Smart Sink has an alarm system with both audible and visual alerts that notify the user when the lid is unlocked and when the cartridges have reached roughly 90% of their wasting capacity.

• Technology: Offers both audible and visual alerts that notify the user when the cartridges are roughly 90% full.

Product Specifications

n Cactus Smart Sink • Accepts both liquid and solid pharmaceutical waste. Solids are accepted in the form of tablets, capsules, and patches.

• Liquid cartridge solidifies drugs within 15 seconds with a wasting capacity of 3.6 L. • Solids cartridge features a uniquely designed pill maze and patch slot, rendering drugs acutely non-divertible with a max wasting volume of 2 L capacity (roughly 1,500 pills).

• Locking lid with a universal key set for added security.

• Audible and visual alarm system that alerts user when lid is locked.

• Audible and visual alerts to notify user when cartridges are full.

• Can be wall or countertop mounted.

• Comes with antimicrobial, wipeable exterior.

• Powered by either a battery or AC adaptor unit. n Cactus PharmaLock OR • Designed for liquids only pharmaceutical waste.

• Utilizes the same liquids cartridge as the Cactus Smart Sink.

• PharmaLock OR housing is antimicrobial and wipeable.

• Can be cart mounted or wall mounted.

• Comes with locking cage with universal key set.

• Antimicrobial housing can be removed when not necessary. n Cartridges • Solids utilizes a proprietary mixture of denaturants and deterrents to convert solids to a liquid state.

• Liquids uses a funnel system integrated with absorbent polymers that converts liquids to a semi-solid state.

• Tethered cap for spill prevention and security of full cartridges.

• Both cartridges begin to render drugs unusable and non-retrievable immediately without shaking, the addition of a solidifier, or any other additional steps by the user.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 19

Something Missing?

Bring all the pieces together with point-of-sale from RMS.

RMS

Point-of-Sale is an essential component for your pharmacy.

Patient care, compliance, security, employee management, and of course, the bottom line.

These are just some of the considerations that today’s outpatient pharmacies contend with on a daily basis.

And it takes more than one system to fully meet all of these needs. Point-of-sale may be one piece of a much larger technology scheme, but without it, you’re leaving a big gap in pharmacy workflows.

RMS offers integrations to over 30 pharmacy management systems, multiple options for credit card acceptance (including validated P2PE solutions), and a full suite of point-of-sale products to help your organization excel at everything from meds-to-beds programs to management behind the scenes. We’ll help you bring all the working parts together with the industry’s leading pharmacy point-of-sale solution.

Contact us today to find out how RMS can make it all work for your pharmacy: www.rm-solutions.com

1.877.767.1060 | sales@rm-solutions.com | Follow us on Facebook, LinkedIn, and Twitter

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Pharmacy Point-of-Sale From Retail Management Solutions More than just point-of-sale, RMS works with your pharmacy to increase patient satisfaction, streamline pharmacy operations, and so much more.

President & CEO: Brad Jones Founded: 1998 Employees: 40+ Stock Symbol:

Privately held Toll-Free Phone: (877) 767-1060 Phone: (360) 438-8276 Fax: (360) 438-8284 Address: 4535 Lacey Boulevard SE Lacey, WA 98503 Website: www.rm-solutions.com

Company Background

Retail Management Solutions is the industry leader in pharmacy point-of-sale. For over 20 years, RMS has provided pharmacies with powerful tools created exclusively for outpatient and retail pharmacy environments.

Founded in 1998 with a mission to help pharmacies understand and use technology-based tools to run a successful business, RMS is now one of the most respected point-of-sale providers in the industry. We listen to our customers, partners, and industry requirements to provide useful and timely point-of-sale based solutions.

RMS is committed to providing tailored products and services to make our customers the most profitable and customer-centric in the industry.

Product Overview

RMS offers a range of point-of-sale products that are both flexible and scalable to meet the needs of any organization. While our easy-to-use, till application is at the forefront of day to day activities in the pharmacy, RMS is proud to offer a host of robust features. n In the Pharmacy With over 30 pharmacy system integrations, prescription sales are fast, easy, and accurate. Signatures are captured at the time of sale for prescription acknowledgement, HIPAA, Safety Caps, etc. When it comes to methods of payment we cover all the bases. Starting with the basics, our credit card integrations offer all the latest functionality including FSA, EMV, NFC, and validated point-to-point encryption. As with our pharmacy system integrations, we offer flexibility in your choice of credit card processors. If payroll deduction is on your list of requirements, youâ&#x20AC;&#x2122;ll find it easy to charge sales for deduction from employee paychecks.

meds-to-beds programs. With EvolutionPOS V2, you can scan products and prescriptions, capture signatures, and collect payments with realtime processing. n Pharmacy Operations Select from multiple options built to streamline pharmacy operations.

Inventory management solutions open the door for advanced management of front-end products. Wholesaler interfaces allow automated price updates, streamlined purchasing and receiving, integrated shelf labels, and advanced product reporting.

Advanced customer management includes A/R functionality as well as a robust customer loyalty program which provides back end users a detailed picture of customer purchasing behavior. n Head Office For multi-location organizations, the Star-Link Enterprise Solution centralizes management of as many sites as you need. By centralizing reporting, employee management, product management, A/R, and more, you reduce workload, enforce organization policies, and standardize workflow across all pharmacy locations.

World Class Customer Support

All customers have access to the RMS support line 24 hours a day, seven days a week. The RMS customer center is available at any time to request support, access the customer knowledge base, and more.

Additional Information

Visit the RMS library at www.rm-solutions.com/rms-library for free e-books, whitepapers, blog articles, and more.

Key Customers

RMS is proud to partner with over 1,000 outpatient and retail pharmacy customers all over the United States.

n Meds-to-Beds Moving beyond workflow and compliance, RMS provides pharmacies with the ability to meet patient needs both in the pharmacy and at the patient bedside. Our EvolutionPOS V2 tablet puts the power and functionality of a traditional register into a portable form, ideal for SUMMER 2019

I

H E A LT H S Y S T E M â&#x20AC;˘ I N F U S I O N 21

T H O U G H T L E A D E R Video Series

THOUGHT LEADER VIDEO SERIES

THOUGHT LEADER VIDEO SERIES

The Health System Solution for Specialty Pharmacy

Advancing the Business of Pharmacy

Join Burnis Breland, Account Implementation Manager, George Zula, Vice President, and Matt Malachowski, Pharmacy Supervisor, UAB Hospital, as they discuss The Health System Solution for Specialty Pharmacy.

Join Kristin Fox-Smith, MPA, Tammy Zukowski, MBA, and Jim Jorgenson, MS, RPh, FASHP, CEO, as they discuss Advancing the Business of Pharmacy in a 12-part video series.

www.acentrusrx.com

rxinsider.com/videosTLS.php

www.visanteinc.com

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

THOUGHT LEADER VIDEO SERIES

Make it Personal by Discovering a Career With Rite Aid

Rees Scientific: Continuous Temperature Monitoring

Join Ryann Abrams, PharmD, Regional Pharmacy Recruiter, Steve Mataraza, Director, College Relations, Professional & Field Recruitment, and Heidi Peterson, PharmD, MBA, Director, College Relations & Professional Recruitment, as they discuss Making it Personal by Discovering a Career with Rite Aid in a 12-part video series.

Join Michael Mothersbaugh, Vice President, Jose Martinez, National Service Manager, Michael Hanssens, Director of Business Development & Marketing, and Sameer Vyas, Engineering Manager, as they discuss Rees Scientific: Continuous Temperature Monitoring in a 12-part video series.

Rees Scientific www.riteaid.com

rxinsider.com/videosTLS.php

22

SUMMER 2019

I

H E A LT H S Y S T E M â&#x20AC;¢ I N F U S I O N

www.reesscientific.com

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

The Nation’s Premier Pharmaceutical Returns Processor in the Pharmacy Market

Accreditation Commission for Health Care (ACHC)

Thierry Beckers, President & COO, Gil Kanner, Vice President, Supply Chain Logistics, Hilmer Beckers, Chairman & CEO, and Adam Bottie, Vice President, Sales & Business Development, discuss PharmaLink: The Nation’s Premier Pharmaceutical Returns Processor in a 12-part video series.

Join Josè Domingos, Matt Hughes, Renee White, Ralph McBride, Jon Pritchett, Megan Reed, and Greg Stowell as they discuss Accreditation Commission for Health Care (ACHC), for providers, by providers.

www.pharmalinkinc.com

www.achc.org

rxinsider.com/videosTLS.php

rxinsider.com/videosTLS.php

THOUGHT LEADER VIDEO SERIES

THOUGHT LEADER VIDEO SERIES

Pharmacy Consulting Broker Services: A Fully Licensed Pharmacy Broker & Consultant

Verity Solutions: Your Comprehensive 340B Partner

Join Daniel Lannon, CEO/Licensed Broker, as he discusses Pharmacy Consulting Broker Services in a 12-part video series.

T H O U G H T L E A D E R Video Series

THOUGHT LEADER VIDEO SERIES

Join George Puckett, CEO, Scott LaChute, VP, Operations, Mark Cassidy, CTO, and Todd Behrman, VP, Product Management Marketing, as they discuss Verity Solutions: Your Comprehensive 340B Partner in a 12-part video series.

www.pharmacycbs.com

www.Verity340B.com

rxinsider.com/videosTLS.php

rxinsider.com/videosTLS.php

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 23

i.Lock™ Interlock Technology Protecting temperature sensitive pharmaceuticals Designed for use in pharmacy clean rooms with USP<797> compliance in mind.

Doors on one side of the pass-through cabinet electronically lock when doors on the opposite side are opened.

Available on i.Series iPR225 and iPR456 pass-thru refrigerators.

Meet compliance, maintain clean room air quality, and enhance pharmacy workflow with i.Lock™ Interlock Technology.

For more information: info.helmer.com/pass-thru-interlock-refrigerators © 2019 Helmer Inc. All rights reserved.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Introducing Interlock Pass-Thru Refrigerators for Your Clean Room From Helmer Scientific The Helmer i.Lock™ technology prohibits doors on both sides of the refrigerator from being opened simultaneously, thus supporting good clean room practices, increasing productivity, and protecting sensitive refrigerated product.

President:

Bruce King

Vice President of Sales & Marketing: Lori Gabrek Founded: 1977 Employees: 300 Stock Symbol:

Private Company Toll-Free Phone: (800) 743-5637 Phone: (317) 773-9073 Address: 14400 Bergen Boulevard Noblesville, IN 46060 Website: www.helmerinc.com

Company Background

Helmer Scientific is a manufacturer and worldwide distributor of medical-grade cold storage and laboratory processing equipment.

We have over 35 years of experience in providing high-quality temperature controlled environments, with our products being used in over 100 countries throughout the world. Helmer originated in the blood bank market where precise temperature control is essential to the successful storage and transfusion of blood products. These same principles have been applied to the design and development of the Helmer pharmacy cold storage products.

Product Overview

Wall mounted pass-thru cabinets are helpful when technicians are transferring single doses outside of the clean room, however, these small cabinets present a challenge when trying to transfer out batches of product. Technicians must don PPE and enter the clean room with a cart to pick up and transfer out large batches which introduces unnecessary contamination into the clean room environment.

Interlocking Pass-Thru refrigerators are the perfect solution for improving the USP <797> clean room workflow. Here are some of the benefits of having a pass-thru refrigerator for your USP <797> clean room: • Cleaner, safer environment with less risk of contamination.

• Less foot traffic in and out of the clean room.

• Easy transport of inventory and finished products.

• Eliminate dirty carts entering the clean room.

• Dramatically reduced use of PPE with less technicians entering the clean room.

Pass-thru refrigerators allow clean room technicians to place large batches into the refrigerator without leaving the clean room. Outside technicians can then access the batches located in the refrigerator via the main pharmacy area without having to don PPE, saving on PPE expenses. Moreover, this means less foot traffic and no cart traffic in and out of the clean room leading to a more controlled environment.

The addition of interlock capability ensures both doors to the pass-thru refrigerator are never opened at the same time providing an added layer of clean room protection and control.

Features & Options

The Interlock Pass-Thru refrigerator is designed for use in the pharmacy and clean rooms. The interlock refrigerator is built for assisting in USP <797> compliance. The i.Lock™ technology allows doors on one side of the pass-through cabinet to electronically lock when doors on the opposite side are opened. This prohibits doors on both sides of the refrigerator from being opened simultaneously. The Interlock Pass-Thru refrigerator from Helmer Scientific will help you meet compliance, maintain clean room air quality, and enhance your pharmacy workflows. n Medical-Grade Performance • Heavy-duty, air-cooled refrigeration system helps exceed industry standards for medical-grade performance.

• Forced-air circulation maintains chamber uniformity and provides quick recovery after door opening. n High-Quality Cabinet Construction • Bacteria-resistant powder coated interior and exterior helps keep units clean.

• Designed to withstand 10 years of routine cleaning, even with harsh chemicals. n Customized Storage Options • Configure the inside of the pass-thru cabinet to meet your needs with roll-out baskets or stainless steel pull-out drawers.

• Choose from various sizes and capacity for your space and workflow.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 25

Better Together.

Two industry leaders known for shaking things up are poised to offer the best of pouch packaging and vial filling.

Together, weâ&#x20AC;&#x2122;re Parata Systems, the new industry leader focused on bringing you pharmacy technology solutions to support business growth and better health outcomes.

Ready to spice things up? Discover how weâ&#x20AC;&#x2122;re better together at parata.com & tcgrx.com.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Parata and TCGRx – Solutions to Improve Medication Adherence and Drive Long-Term Revenue Explore the technology, expertise, and people you can count on.

President & CEO: Rob Kill Founded: 2001

Employees: 400+ Phone:

(888) 727-2821

Address: 106 Roche Drive, Durham, NC 27712 Website:

www.parata.com | www.tcgrx.com

Company Background

TCGRx and Parata have combined to create the new industry leader focused on providing pharmacy technology solutions to support business growth, better health outcomes, and lower medical costs. Joined in 2018 as Parata Systems, the company offers the most comprehensive pharmacy automation portfolio with pouch and blister medication adherence packaging, high-speed automated robotic dispensing technologies, and pharmacy workflow solutions. Discover how we’re better together at parata.com and tcgrx.com.

Product Overview

n Improve Medication Adherence Simplify adherence for your patients and take the guess work out of when they need to take their medications. With a medication adherence program, synchronize daily medications into med pass times improving compliance, outcomes, and readmission rates. Once patients experience the ease and efficiency of adherence packaging, vials and scattered refills are replaced with patient loyalty and long-term revenue. We’re proud to offer the most extensive adherence packaging solutions – for both pouch and blister – with inspection and workflow additions to support your growth.

Stand-Out Solutions:

• SmartCardRx™ • ATP® 2 • ATP® Mini

• InspectRx® • Parata Perl® Pouch Inspector

n Drive Efficiencies to Impact Bottom Line We’re serious about pharmacy efficiency. That’s why we’ve taken best practices and real-world research – with more than a little feedback from pharmacists – to craft cost and space-saving strategies to drive efficiency and impact the bottom line. Your pharmacy’s inventory is its largest investment. Why not gain visibility and control of inventory to manage costs and offset increasing expenses of higher drug prices and specialty pharmaceuticals? Our solutions can reduce inventory carrying costs by more than 30% and expired medications by 80% – all while increasing inventory turns. The addition of our inventory management, enterprise software, light-guided high-density storage, and will call solutions allow for greater visibility and can help consolidate your pharmacy’s footprint by more than 50%.

Smooth Solutions:

• SpotLight™ Will Call System • Parata Pivot® Workflow Software • Beacon® Inventory Management System n Enhance Patient Experience and Access Everybody loves when you can make things easier for them – patients and employees are no exception. Expand your reach beyond the pharmacy counter and hours of operation without the traditional overhead costs with WellSpot™, our remote prescription pickup locker. Provide 24/7 prescription access for late discharge patients and all shifts of employees.

Improve transition of care and help increase script capture – all without increasing your physical pharmacy store hours.

Convenient Solutions:

• WellSpot™ Prescription Pick-Up Locker n Ensure Safety, Accuracy, and Efficiency You get the fastest counting technology in the market automating 5060% of oral solids and helping your team delight customers with timely service and a personal touch. We’re proud to offer the premier line of high-speed automation solutions to ensure safety, accuracy, and efficiency in every pharmacy setting. We make it – and make it better – because we’re driven to free your time so you can do what you do best – support your patients and lead your team.

Leading Solutions:

• Parata Max®

• Parata Mini®

n Optimize Your Operations Continually improve efficiency with our data wizards. We use the Internet of Things (IoT) to gather and interpret data from your pharmacy solutions. Our experts can work with you to analyze the story your data tells and optimize your pharmacy’s operations and business.

Prominent Solutions:

• PharmAlytics™

• Parata Pulse™

n Count On Support Our customers love our technology, but that’s not the only reason they choose us as a partner. Our in-house experts offer a wealth of experience – and we’re with you every step of the way. When you choose Parata automation, you have our support from signing the contract through maximizing your technology to grow your business. We have more than 25 years of experience with the best industrial engineers in pharmacy, and we‘re ready to put that expertise to work by offering pharmacy design services whether it’s a new build, remodel, or optimization project.

Helpful Solutions:

• Parata Performance Services

SUMMER 2019

• Parata Consulting

I

H E A LT H S Y S T E M • I N F U S I O N 27

CASE STUDY Liberty Software’s Flexible Pharmacy Management Solutions Make 340B Compliance Easy and Productive Increasing patient safety and satisfaction, while maximizing pharmacy output is all part of the package with this comprehensive software system.

PRIMARY INTENDED OUTCOME

Joshua Carzoli, PharmD, BCACP, 340B ACE, DPLA Director of Operations ~ El Rio Health

In 1992, the United States federal government created the 340B Drug Discount Program, which requires drug manufacturers to provide outpatient medications to eligible healthcare organizations, hospitals, and other nonprofit groups at discount prices. The program aims to reduce medication costs for low-income or uninsured patients and provide them with a broader range of health care. In official language, the 340B program enables covered entities “to stretch scarce federal resources as far as possible, reaching more eligible patients, and providing more comprehensive services.”

The 340B program is more than a pharmaceutical delivery system, however. To receive drug discounts, healthcare organizations must be able to show proof of established relationships with those patients served, including maintenance of health records.

Patients must also receive care that goes beyond medication dispensing.

Keeping track of patients and their interactions is complicated and crucial to continued participation in the 340B discount program. Liberty Software specializes in pharmacy management software that simplifies workflow and auditing capability, while maximizing patient care for 340B compliance.

28

www.libertysoftware.com

CASE STUDY

“Liberty Software revolutionized our workflow.

We love the layout, and we have seen a reduction or elimination of manual tasks.”

Joshua Carzoli, PharmD, BCACP, 340B ACE, DPLA Director of Operations ~ El Rio Health

THE CHALLENGE Josh Carzoli, PharmD, is Director of Operations at El Rio Health in Tucson, Arizona, a federally qualified health center comprising 11 locations and serving more than 105,000 individuals in that community. He joined El Rio in 2002 and has seen the pharmaceutical arm of the health center grow to span seven pharmacies that provide 600,000 prescriptions per year. Carzoli has a strong understanding of the 340B program, having trained as a peer-to-peer mentor and speaker.

In order to participate in 340B and continue receiving reimbursement, El Rio must meet a variety of exacting criteria and be recertified annually. “The two biggest requirements are meeting patient definitions and avoiding duplicate discounts,” Carzoli said. “We must have auditable records for every single medication we dispense to every patient, down to the tablet.”

THE DECISION El Rio’s previous pharmacy management software system was rife with frequent filing mistakes involving sound-alike or spelled-alike patient and drug names. These mistakes resulted in potentially dangerous dispensing errors. “It was death by 1,000 paper cuts. We filed alphabetically, and the previous system did not let us know if we had multiple patients in the same bag or alert us to check the patient’s identity,” Carzoli said. “The vendor was unable to make adjustments to safeguard our patients.”

In addition, El Rio’s volume was increasing. “The system we had simply could not keep up. We would have needed to continually add more staff.”

El Rio was also dealing with a manual prescription refill system that required a dedicated technician to spend an entire day listening to patients’ voice messages and typing prescriptions into the system. “Keeping our tech staff tied up with manual tasks like that meant that our most knowledgeable and expensive resources – our pharmacists – were spending time counting tablets and pouring liquids,” said Carzoli.

These needs for technological efficiency, increased safety, and improved patient satisfaction drove an exhaustive search for a better software solution. “We required more robust clinical checking and were looking for ways to improve our adherence and star rating,” Carzoli said. “We also wanted better messaging and education for our patients.”

El Rio’s information technology team was heavily involved in making the final decision, based strongly on their concerns around patient data safety and reliable functionality.

www.libertysoftware.com 29

CASE STUDY LIBERTY SOFTWARE ADVANTAGES Liberty Software’s pharmacy management software, based on the latest Microsoft platform, offers powerful options that build success: • • • • • • •

Flexible workflow Text & email patient alerts Patient refill options Advanced bin management Inventory control Audit reports Task management

“We were really impressed by Liberty Software’s willingness to embrace all of our challenges and suggestions for change,” Carzoli said.

THE RESULTS Switching to Liberty Software in 2015 improved El Rio’s efficiency, while providing more comprehensive patient care. “The same number of pharmacists now do more clinical review and have time to work directly with patients to identify their needs and improve their health care,” Carzoli said.

The new software included a custom bin management system that uses dates and slot numbers rather than patient names. “We went from having multiple wrong dispensations per year to a single one since using Liberty,” Carzoli said, “and that error only happened because a staff member overrode the safety system.”

Liberty Software was also willing and able to customize El Rio’s patient keypad, adding four prompt questions that patients must answer when receiving medication to verify their identity and the name of the drug. “This is another huge advancement in our technology that is responsible for dropping our safety events to virtually nothing,” Carzoli said.

In addition, the time wasting refill system has been replaced with an automated smart phone app and auto-refill features. “Now, patients enter an order and it goes directly into the system, to be safely processed right away.”

THE CONCLUSION One of the tenets of participating in the 340B drug program is the requirement for healthcare entities to provide patients with continuity of care. Every step, however, must be documented. “With Liberty Software, we can now access and review information seamlessly from our patients’ electronic health records,” Carzoli said, “This lets us make better clinical decisions while also meeting the program’s data collection requirements.”

Looking ahead, Liberty Software continues building tools that help El Rio continue to improve and grow. They have developed an API to better connect the larger EHR system with Liberty’s platform. “This will take us light years toward integrating bidirectional information movement between the systems,” Carzoli said. “This was another customization that was a dream of mine for some time. We asked for it and Liberty agreed to make it work.”

30

www.libertysoftware.com

PHARMACY SOFTWARE FOR

PHARMACY SUCCESS

Pharmacy Software helping community pharmacies enhance patient care, increase patient safety, and improve profitability.

FLEXIBLE PHARMACY WORKFLOW

MODERN PAYMENT PROCESSING INCLUDING EMV

ADVANCED BIN MANAGEMENT

PATIENT ADHERENCE AND PERFORMANCE DASHBOARD

MEDICATION THERAPY MANAGEMENT

DELIVERY AND REMOTE SIGNATURE MANAGEMENT

TEXT, EMAIL, AND VOICE PATIENT MESSAGING

SIMPLE DRIVE THROUGH SOLUTIONS

COMPOUNDING TOOLSET

INTEGRATED FACTS AND COMPARISONS

MEDSYNC AND REFILL MANAGEMENT

CLOUD POWERED MULTI-STORE MANAGEMENT

INVENTORY CONTROL MADE EASY

PRESCRIPTION READY BOARD

PROFIT AND INSURANCE AUDIT PROTECTION

EXTENSIVE REPORTING AND DATA MINING

FRONT END INVENTORY MANAGEMENT

View a demo now at www.libertysoftware.com or call us at 800-480-9603

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Pharma-Choice™ Brand of USP <797> and <800> Cleanroom Disposables by Acute Care Pharmaceuticals The nation’s leader in USP <797> and <800> compliant supplies specifically designed for your advanced environment.

Founded: 1997 Toll-Free Phone:

(888) 909-7700 (858) 675-9380 Address: 12225 World Trade Drive, Suite A San Diego, CA 92128 Website: www.pharma-choice.com Fax:

Company Background

Acute Care Pharmaceuticals has been servicing the healthcare industry for over 20 years, delivering exceptional products and service to healthcare providers nationwide. We offer a wide range of USP <797> and <800> compliant disposable products that are manufactured under the highest standards. With numerous GPO and IDN contracts, our goal is to make your buying experience simple and easy. Our Pharma-Choice™ brand of products are stocked at a variety of distributors including AmerisourceBergen, Cardinal, and McKesson where you can receive your special discounted GPO contract pricing.

Product Overview

Improve facility operations with Acute Care Pharmaceuticals’ PharmaChoice™ brand of products. The quality manufacturing of our PharmaChoice™ brand of cleanroom disposables demonstrates our commitment to the continued success of USP <797> and the future success of USP <800>. All wipers are manufactured to meet International Organization for Standardization Class 5 and USP <161> endotoxin limits for medical devices of 0.06 EU/mL. Our sterile alcohol is manufactured with USPgrade water for injection and is available in a variety of sizes.

From the inception of USP <797>, we have been a trusted provider for the majority of hospitals nationwide in cleanroom disposables. Our constantly expanding USP <797> product line includes: sterile alcohol, non-shedding/non-linting wipers, disinfectants, gloves, media test kits, apparel, mopping systems, and more.

Now that USP <800> is getting closer to an official launch date, we have taken the same approach to creating a comprehensive line of products developed with you in mind, because your safety and the safety of your employees matters. Our USP <800> products include: chemo gowns, chemo gloves, chemo spill mats, goggles, respiratory masks, sterile apparel, transport bags, spill response kits, and a two-step chemo neutralizing kit.

Our Pharma-Brand™ Line of Products Include

• PHARMA-SAT PLUS™ 70% IPA Polyester/Cellulose Low Endotoxin (Sterile and Non-Sterile) • PHARMA-SAT CANISTER™ 70% IPA Non-Sterile Polyester/ Cellulose • PHARMA-SAT PLUS™ 70% IPA, Poly/Cell, Low Endotoxin

• PHARMA-WIPE™ Polyester/Cellulose (Sterile and Non-Sterile) • PHARMA-WIPE PLUS™ Non-Sterile Polyester/Cellulose, Low Endotoxin • PHARMA-POLYESTER WIPE™ 100% Polyester • PHARMA-HOL® Sterile 70/30 Isopropanol/USP WFI (16 oz., 32 oz., and Gallons) • PHARMA-D SURFACE DISINFECTANT™ Sterile Quat, Virucide, Fungicide • PHARMA-SURFACE GUARD® Chemo Spill Wiper + Neutralizing Wiper, Two-Step Kit • PHARMA-MOP COVERS™ Polyester Universal Mopping System • PHARMA-MINI MOP COVERS™ Polyester and Poly/Cell • PHARMA-SAT MOP COVERS™ 70% IPA/30% DI Pre-Saturated Poly Covers • PHARMA-MAT® First Defense Against Contaminants in Your Cleanroom Environment • PHARMA-TACKY MAT FRAME™ Removes Up to 99% of Foot Borne Contaminates • PHARMA-CHEMO MAT™ Sterile Lint Less, Highly Absorbent, Non-Porous Backing • PHARMA-GLOVE™ Sterile Nitrile 12", Chemo Approved-AS™ Tested, PF • PHARMA-COAT® Lab Coat Polypropylene Elastic Wrist, No Pockets, White • PHARMA-COAT KNIT WRIST™ Lab Coat Polypropylene Knit Writs, No Pockets, White • PHARMA-CAP™ Polypropylene Bouffant Cap, White or Blue • PHARMA-SHOE COVERS™ Polypropylene Anti-Skid, Blue

Additional Product Modules

Along with our Pharma-Brand™ line of disposable cleanroom supplies, we also offer a multitude of additional USP <797> and <800> compliant supplies to ensure you have everything you need for your sterile environment.

Markets Served

• Hospital/Acute • Home Health Care • Surgery Centers

• Clinic • Retail • Long-Term Care

• Veterinary • Oncology

Ordering Information

Pharma-Choice™ brand of products can be purchased at various distributors including AmerisourceBergen, Cardinal, McKesson, or if not stocked at your distributor, directly from Acute Care Pharmaceuticals.

Acute Care Pharmaceuticals Sales Representatives can be reached at: P: (888) 909-7700 | F: (858) 675-9380 | E: info@acutecareonline.com Online Store: www.pharma-choice.com SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 33

AmerisourceBergen

We Put Patient Safety First

Because a life is touched by every preparation we produce.

PharMEDium prefilled syringes–simple, safe, convenient.

© 2019 PharMEDium Services, LLC All rights reserved. P20410_Rev1

No dilution, reconstitution, or complex calculations needed before administering.

Please visit PharMEDium’s Customer Resource Center at pharmedium.com for a current list of available services and new product announcements.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

PharMEDium – Providing the Highest-Quality Sterile Compounded Services

100% of PharMEDium CSP batches are tested according to 503B industry guidance standards for assurance of quality and safety.

President:

Scott Aladeen Founded: 2003 Employees: 1,000+ Stock Symbol: ABC (NYSE) Toll-Free Phone: (800) 523-7749 Fax: (847) 234-1363 Address: 150 North Field Drive, Suite 350 Lake Forest, IL 60045 Website: www.pharmedium.com

Company Background

For over 25 years, PharMEDium Services has served as a preeminent provider of choice for outsourced, ready-to-use compounded sterile preparations (CSPs). PharMEDium was among the first to voluntarily register our centers as FDA Registered 503B Outsourcing Facilities after Congress enacted the Drug Quality and Security Act (DQSA) in November 2013.

Since our inception and through the years as laws, regulations, and FDA guidance standards for entities engaged in anticipatory compounding of sterile preparations have evolved, PharMEDium has been anchored by the enduring values of patient safety, flawless quality, and outstanding customer service.

The company is committed to undisputed compliance with FDA’s 503B requirements, upholding the highest ethical standards in the industry.

As part of AmerisourceBergen, PharMEDium supports the healthcare industry by enabling increased product access and delivering powerful services like consultative support in medication management process improvements that result in enhanced patient safety, operational efficiencies, decreased medication waste, and simplified compliance.

Together, we are united in our responsibility to create healthier futures.

Product Overview

Purposely, PharMEDium does not compound sterile medications from bulk drug substances. Only FDA-approved* sterile drug vials, FDAapproved sterile diluents, and FDA-cleared sterile containers are used in PharMEDium’s 503B Outsourcing Facilities to provide for the highest levels of quality assurance and patient safety.

100% of our CSP batches are tested for pH, sterility, bacterial endotoxin, and potency. PharMEDium also includes stringent environmental and personnel monitoring as part of our batch release criteria. Our real-time stability verification is done both in-house and by independent FDAregistered laboratories. PharMEDium’s long-standing commitment to advancing patient safety and our daily goals to produce the highest-quality CSPs and business solutions makes all the difference to our health system partners and the patients they serve.

Hospitals and ambulatory surgery centers rely on PharMEDium Compounded Sterile Preparations (CSPs) for operating room anesthesia; pain management; labor and delivery services, emergency, and critical care medications.

Features & Options

PharMEDium has long been the industry leader in labeling and packaging of ready-to-use compounded sterile preparations.

Our labels are designed to help eliminate the potential for errors in the process of dispensing and administering medications. PharMEDium’s proprietary labeling includes additional design enhancements, including the use of color coding and Tall Man lettering. On PharMEDium prefilled syringe labeling, the drug name appears up to eight times, making it viewable from any clinical orientation.

Our packaging is designed to ensure the integrity of chemical composition and sterility of the preparation through the shipping and storage process.

PharMEDium CSPs are available in containers to fit all major infusion devices available today. Our ready-to-use syringes are compatible with the most commonly used anesthesia carts and automated dispensing cabinets, including mini-drawers for controlled substances.

Testimonial

“ PharMEDium is focused on enhancing the quality assurance and quality control programs we employ to meet the highest standard for the cGMP compliance required of 503B compounders. We know we are on the right path for our business partners which will enable us to continue to expand our relationships through mutual trust and confidence in the quality and reliability of the services we deliver.”

— Scott Aladeen, President, PharMEDium Services

GPO/IDN Affiliations

PharMEDium has a team of national account managers who serve as liaisons between PharMEDium, group purchasing organizations (GPOs), and integrated delivery networks (IDNs) so customers can take advantage of volume discounts and the ease of ordering direct from PharMEDium.

PharMEDium currently has GPO contracts with: Vizient, HPG, Premier, The Resource Group (TRG), ROI, Intalere, Kaiser, and Cardinal.

Ordering Information

Hospitals and ambulatory surgery centers considering PharMEDium are invited to visit our centers and learn about the processes that have been instrumental in helping us to attain and maintain our industry leadership position. Call (800) 523-7749 to order services or to learn how PharMEDium CSPs can benefit you. *FDA-approved drug products include otherwise legally marketed sterile drug products in finished dosage form. Such commercially available drugs are produced in FDA-registered facilities subject to FDA inspection.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 35

Pharmacy & Business working together to optimize your results No one makes pharmacy and business work together like Visante. Our consulting work with Integrated Delivery Networks, hospitals and health systems combines a wealth of expertise with personalized and comprehensive support so you can optimize your pharmacy operations and deliver better patient care.

High-performing pharmacy is who we are • 340B Program • Specialty Pharmacy • Sterile Compounding & USP Excellence • Drug Diversion Prevention

• Comprehensive Pharmacy Assessments • Pharmacy Finance and Reimbursement • Pharmacy Stars TM Compliance Tools

Learn more at visanteinc.com, or contact us at solutions @ visanteinc.com or (866) 388-7583.

© 2019 Visante, Inc. All Rights Reserved.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Visante – Advancing the Business of Pharmacy™ Visante makes pharmacy and business work together. Our consulting work with hospitals and health systems combines a wealth of expertise with personalized and comprehensive support to optimize your pharmacy operations and deliver better patient care.

President & CEO: James Jorgenson Founded: 1999 Toll-Free Phone:

(866) 388-7583

Address: 101 E 5th Street, #2220

St. Paul, MN 55101 Website: www.visanteinc.com

Company Background

Visante is a multidisciplinary, clinician-composed consulting firm specializing in all aspects of the business of pharmacy. We believe in moving the practice of pharmacy forward through innovative solutions that deliver lasting results. Far too often we’ve seen pharmacy and medication management underutilized or under-resourced, resulting in a negative impact on finances and patient care. We’re in the business of reversing that. We’re in the business of advancing pharmacy.

By diagnosing and solving complex problems, we help organizations more effectively deliver optimized and compliant medication related services. Our 60-plus consultants include experienced pharmacists, nurses, physicians, IT professionals, and business experts, all working together to ensure you get the right solutions for your unique needs. No matter what your specific challenge is, we always know what matters most – delivering safe, high-quality, cost-effective patient care so you can continue to grow.

Featured Services

n Comprehensive Pharmacy Assessment Optimizes Financial and Clinical Results

We put our extensive experience and knowledge to work to assess your current operations and help you take your pharmacy to the next level.

We have the right combination of skills to evaluate all the moving parts and recommend improvements that will help you provide better patient care while improving your bottom line. We listen and work closely with you to support your objectives, delivering a personalized pharmacy plan for optimal growth, including a complete evaluation of your current program; opportunity analysis for safety, clinical, operational, and financial improvements; strategic planning support based on identified opportunities; and program enhancement design and implementation. n 340B Solutions for Total Compliance and Lasting Success Visante’s independent, external audit support continues to provide transparency to your 340B processes, allowing you to recognize compliance gaps while also focusing on new opportunities within the program.

Visante provides: internal and external audit support, on-site HRSA audit support, and corrective action plan guidance in the event of HRSA audit findings; gap analysis and targeted recommendations, focusing on

long-term strategy in the mixed-use and contract pharmacy space to ensure program optimization; program implementation and development of internal oversight structure and maintenance; and split billing RFP guidance, implementation, and program re-designs.

Visante’s experienced team members are all Apexus 340B University graduates, many of whom have completed the Advanced Ops Certificate. n Sterile and Non-Sterile Compounding Compliance That Drives Safe, High-Quality, Cost-Effective Care

Safely compounded medications are essential to quality patient care.

Hospitals face the challenge of optimizing care while also meeting safety requirements and managing cost. We will prepare you for compliance with USP Chapters <795>, <797>, <800>, and <825>. We’ll also assist you in preparing for compounding related inspections by the CMS, FDA, DEA, and Joint Commission/DNV. Our consulting services include: USP <795>, <797>, <800>, and <825> gap assessment and facility design; 503A, 503B assessment, facility design, and implementation support; and home infusion compounding services.

When it comes to pharmacy compounding, we don’t settle for basic compliance – and you shouldn’t either. Our processes are designed to assist you and your team to be successful. n Drug Diversion Prevention Protects Your Patients and Yourself Drug diversion problems continue to escalate with opioid addiction at epidemic levels. Our program takes a comprehensive multidisciplinary approach to identify drug diversion risk points in your medication use processes. Minimize risk through assessment of pharmacy operations, informatics, automation, nursing, and perioperative processes to identify and strengthen points of vulnerability.

Our drug diversion experts have real-life experience in hospitals and health systems and understand the challenges hospitals face today and in the future. n Expand Your Specialty Pharmacy Services and Quality of Care A clearly defined specialty pharmacy strategy can help improve patient care and optimize your bottom line. Developing a specialty pharmacy strategy or expanding your existing services can be a complex process, but our team of experts guides you through each phase and delivers lasting ROI. Our specialty pharmacy consulting capabilities include: operational assessment and pro forma models; multi-year business and strategic plans; facility design including workflow and automation options; implementation and project management; accreditation support (URAC/ ACHC/CPPA); contract pharmacy strategy, if applicable; wraparound strategy to include consideration for site of care challenges (infusion); and home infusion and DME strategies and business planning.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 37

340B RESOURCES & SOFTWARE SOLUTIONS Q & A

& Q A

Steven Miller, Vice President of Pharmacy Services, 340B Health

Q. What is the 340B Drug Pricing Program?

The 340B program requires drug manufacturers to sell outpatient drugs at a discount to safety-net providers serving high numbers of low-income patients. Congress created the program to allow these providers to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” Savings from the program help fund free and low-cost medications as well HIV/AIDS, diabetes, cancer, dental, and primary care clinics that serve our most vulnerable citizens.

Q. Who is eligible for the 340B Program?

The 340B statute specifies a list of 16 types of “covered entities” that are eligible for drug price discounts. Safetynet providers eligible for 340B drug discounts include: • Hospitals: Disproportionate Share Hospitals, Critical Access Hospitals, Children’s Hospitals, Cancer Hospitals, Rural Referral Centers, Sole Community Hospitals • Clinics and Centers: Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, Ryan White HIV/AIDS Clinics, Black Lung Clinics, Hemophilia Diagnostic Treatment Centers, Family Planning Clinics, Sexually Transmitted Disease Clinics, Tuberculosis Clinics, Tribal/Urban Indian Health Centers, Native Hawaiian Health Centers

38

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N

Q. What kind of drugs are covered by 340B?

All covered outpatient drugs as defined by section 1927(k) of the Social Security Act, are included under the 340B Program, such as drugs infused in an outpatient clinic for cancer or other diseases, diabetes medications used at home (insulin and pills), and most prescription drugs dispensed by a retail pharmacy.

Q. Who benefits from the 340B Program?

340B is a critical support for the nation’s healthcare safety net. Hospitals, clinics, and health centers that treat large numbers of low-income patients can use the savings from 340B to offset uncompensated care and the frequent underpayments by Medicaid and Medicare.

340B also provides support to patients through programs that include free or heavily discounted prescription drugs, medication management, transportation and translation services, vaccinations, and other forms of care.

Q. How does 340B intersect with programs like Medicare and Medicaid?

The 340B discount is the result of a national drug rebate agreement between drug manufacturers and the Secretary of the Department of Health and Human Services, in exchange for state Medicaid coverage and Medicare Part B coverage of their covered outpatient drugs. The 340B discounts mirror those required under Medicaid.

The 340B program is ultimately a discount on the purchase price by qualified and registered covered entities of covered outpatient drugs. Pharmacists are the gatekeepers of managing drug inventory, storage, and distribution throughout the hospitals, health centers, clinics, and other participating entities. Pharmacists and pharmacy technicians partner with other organizational stakeholders to assure program compliance integrity, such as finance, billing, IT, and compliance departments.

Q. How does the government conduct oversight of the 340B program?

Q. What role does 340B Health play and who are your members?

340B Health is a membership organization of more than 1,300 public and private nonprofit hospitals and health systems in the federal 340B drug pricing program.

The organization formed in 1993 to increase the affordability and accessibility of pharmaceutical and clinical care for the nationâ&#x20AC;&#x2122;s poor and underserved populations. 340B Health monitors, educates, and serves as an advocate on federal legislative and regulatory issues related to drug pricing and other pharmacy matters affecting safety-net providers. Our membership consists of a broad spectrum of hospitals, including academic medical centers, community hospitals, childrenâ&#x20AC;&#x2122;s hospitals, and rural facilities.

The Health Resources and Services Administration (HRSA) oversees 340B. HRSA requires all covered entities to be recertified each year to assure integrity, compliance, transparency, and accountability. Providers and manufacturers are subject to audits to ensure they are in compliance with 340B program requirements.

Since 2012, HRSA has conducted more than 1,000 audits of 340B providers and 16 audits of pharmaceutical manufacturers.

BIOGRAPHY

340B RESOURCES & SOFTWARE SOLUTIONS Q & A

Q. What role do pharmacists play in 340B?

Steven Miller, Vice President of Pharmacy Services, 340B Health

Steven Miller is the Vice President of Pharmacy Services for 340B Health, a nonprofit organization of more than 1,300 hospitals and health systems participating in the federal 340B drug pricing program. In his role as Vice President of Pharmacy Services, he works closely with 340B hospitals and health systems to identify and resolve operational issues.

He also provides technical assistance and develops pharmacy tools and other materials for members to facilitate program understanding and compliance.

Visit www.340bhealth.org for more information.

SUMMER 2019

I

H E A LT H S Y S T E M â&#x20AC;˘ I N F U S I O N 39

340B RESOURCES & SOFTWARE SOLUTIONS Buyer’s Guide

340B RESOURCES & SOFTWARE SOLUTIONS Buyer’s Guide 340B Health 1101 15th Street NW, Suite 910 Washington, DC 20005 (202) 552-5850 www.340bhealth.org

ELEVATE340B 1210 S 300 E, Suite #1752 Draper, UT 84020 (385) 273-0604 www.Elevate340b.com

ACI 340B Management 824 W. Franklin Street Boise, ID 83702 (208) 258-8139 www.aci340b.com

Equiscript 1360 Truxton Avenue, Suite 300 North Charleston, SC 29405 (877) 568-4115 www.equiscript.com

Apexus 290 East John Carpenter Freeway Irving, TX 75062 (888) 340-2787 www.apexus.com

ExceleraRx Corp 2100 Summer Street NE, Suite #260 Minneapolis, MN 55413 (612) 293-0378 www.excelerarx.com

Avella Specialty Pharmacy SourceB 24416 N 19th Avenue Phoenix, AZ 85085 (651) 983-0677 www.avella.com/sourceb

Feldesman Tucker Leifer Fidell LLP 1129 20th Street NW, Suite 400 Washington, DC 20036 (202) 466-8960 www.feldesmantucker.com

Blue & Co, LLC. 500 N. Meridian Street, Suite 200 Indianapolis, IN 46204 (317) 633-4705 www.blueandco.com CaptureRx 219 East Houston Street, Suite 100 San Antonio, TX 78205 (888) 345-6424 www.capturerx.com Codonics 17991 Englewood Drive Middleburg Heights, OH 44130 (800) 444-1198 www.codonics.com Comprehensive Pharmacy Services 6409 Quail Hollow Road Memphis, TN 38120 (800) 968-6962 www.cpspharm.com Curant Health 200 Technology Court SE, Suite B Smyrna, GA 30082 (866) 460-8040 www.curanthealth.com 40

SUMMER 2019

I

Healthclarity 800 S Dakota Avenue #315 Tampa, FL 33606 (800) 541-6923 www.healthclarityrx.com Liberty Software 3205 E. Southlake Boulevard Southlake, TX 76092 (800) 480-9603 www.Libertysoftware.com Maxor National Pharmacy Services Company 320 South Polk Street Amarillo, TX 79101 (800) 658-6146 www.maxor.com Macro Helix 2 National Data Plaza NE, 4th Floor Atlanta, GA 30329 (404) 965-3040 www.macrohelix.com NewTech/340B Optimizer 410 Kay Lane Shreveport, LA 71115 (281) 292-9180 www.340boptimizer.com

H E A LT H S Y S T E M • I N F U S I O N

Parata/TCGRx 106 Roche Drive Durham, NC 27703 (888) PARATA1 (727-2821) www.parata.com www.tcgrx.com PatientCraft, LLC 306 Thunderbird Drive El Paso, TX 79912 (800) 682-5216 www.patientcraft.com PharmBlue 40 Pennwood Place, Suite 300 Warrendale, PA 15086 (855) 779-4720 www.pharmblue.com Pharmacy Healthcare Solutions, an AmerisourceBergen Company 1300 Morris Drive Chesterbrook, PA 19087 (877) 892-1254 www.pharmhs.com QS/1 P.O. Box 6052 Spartanburg, SC 29304 (800) 845-7558 www.QS1.com R&S Northeast LLC 8407 Austin Tracy Road Fountain Run, KY 42133 (800) 626-0208 www.RSNortheast.com RCTECH Solutions Inc 4293 Diamond Terrace Weston, FL 33331 (877) 215-5675 www.Rctech.org RPh Innovations, LLC 1401 Branding Avenue, Suite 360 Downers Grove, IL 60515 (630) 963-0024 www.rphinnovations.com ScriptPro 5828 Reeds Road Mission, KS 66202 (800) 606-7628 www.scriptpro.com

Secure340B P.O. Box 15257 Philadelphia, PA 19125 (888) 732-3402 www.secure340b.com Sentry Data Systems, Inc. 800 Fairway Drive, Suite 400 Deerfield Beach, FL 33441 (800) 411-4566 www.sentryds.com SUNRx 3220 Tillman Drive, Suite 104 Bensalem, PA 19020 (267) 525-3430 www.sunrx.com Trellis Rx, LLC 1175 Peachtree Street NE 10th Floor, Suite 1000 Atlanta, GA 30361 (800) 503-5420 www.trellisrx.com Verity Solutions 12131 113th Avenue NE, Suite 200 Kirkland, WA 98034 (425) 947-1922 www.verity340b.com Visante 101 East Fifth Street #2220 St. Paul, MN 55101 (866) 388-7583 www.visanteinc.com Vizient 290 East John Carpenter Freeway Irving, TX 75062 (800) 842-5146 www.vizientinc.com Walgreens 340B Complete® 102 Wilmot Road Attn: Ken Kring MS1244 Deerfield, IL 60015 www.walgreens.com/ businesssolutions/ payer/340BComplete.jsp

340B Resources & Software Solutions www.RXinsider.com

SUMMER 2019

I

340B RESOURCES & SOFTWARE SOLUTIONS Market Leaders

Visit RXinsider’s Virtual Trade Show to Research the Leaders in

H E A LT H S Y S T E M • I N F U S I O N 41

P H A R M A C I S T S W H O WA N T

AT I

JO

U

R

• NG

97

N PO

23

35

TOPICAL TREATMENT OF PRIMARY FOCAL HYPERHIDROSIS, PART 1

47

STANDARDIZATION OF COMPOUNDED MEDICATIONS

ATTEMPTING TO AVOID OUT-OFSPECIFICATION RESULTS AND PATIENT HARM IN STERILE COMPOUNDING

800-757-4572 | EXT 1 | www.IJPC.com

JO

U

R

NG

• DI

97

N

C

OF

Your First and Last Name, Pharmacy Name, and Address

ONAL

19 A

M

PLEASE INCLUDE:

AT I

IJPC

AR

Free Copy - RXinsider

• PH

SUBJECT LINE:

RN

AL

IJPC-Subscriptions@IJPC.com

E

U

EMAIL US FOR A SAMPLE COPY AT

N

JANUARY | FEBRUARY 2019

T

Your ofMind Mind® YourPeace Peace of ®

INTERNATIONAL JOURNAL OF PHARMACEUTICAL COMPOUNDING

IN

M AL CO

E

TIC

O UOur R C OCompounding MPOUNDING K N OW L E D G E , Knowledge,

TH

EU

U

M

C

OF

AR

19 A

ONAL

V. 2 3 N O .1

DI

IN E

RN

IJPC

AL

TH

E

N

• PH

IJPC

T

Peace of Mind Subscribe to IJPC

O

E

P I N T E R NU A T ITCI O NCAOLM J O U R N A L AL

PHARMACEUTICAL O U R C O M P O U N D I N G K N OW L E D G E ,

O U R C O M PYour OUN D I N G K N OW L E D G E , Peace of Mind®

COMPOUNDING Your Peace of Mind®

CompoundingToday.com

y rug Case Stud /Antibiotic Desc ps Ste eals Rev Antimicrobial act Imp ribing r-Pr pitals on Antibiotic Ove %

C A S E S T U DY

by 11.4 Study of 180 U.S. Hos Overuse and Reduce Use e to Combat Antibiotic U.S. Hospitals Can Tak

Polk’s Drugs transitions to next generation of pharmacy management with the help of QS/1®

THE CHALLENGE:

CASE STUDY

ers se Control ice of medicine, the Cent The Centers for Disea transformed the pract iotics warn that Though antibiotics have that 20-50% of all antib and Prevention (CDC) Prevention (CDC) warn te. ropria inapp or for Disease Control and r unnecessary care hospitals are eithe antibiotic of em prescribed in U.S. acute probl ing grow has contributed to the Polk’s Drugs is a csmall h.1 healtchain of pharmacies The misuse of antibiotics in TICS ANTIBIO serious threats to publi OF ALLbased become one of the most s Mississippi.tant nismSprings Theorga Ocean store, which opened IN U.S. resistance, which has ted with antibiotic-resis infec IBED are le SCR peop n to in that PRE about a ally. year2 Acco ago, rding is unique More than two millio it also includes annu s a death 0 approximately 23,00 acute care hospitals are gasresis station. each year, resulting in tance threatens the icrobial nization (WHO), antim either unnecessary tions infec of e the World Health Orga rang asing treatment of an ever-incre or inappropriate. effective prevention and .3For manager Jesse Murphy, PharmD, choosing sites, viruses and fungi caused by bacteria, para the right technology wasntcrucial to ensuring his geme Medication Mana a new pharmacy not onlycente opened Commission published rs, with a strong start, In response, the Joint itals and nursing care grow and operate as efficiently itals, critical access hosp but continued toto (MM) standard for hosp ing the need reduce hasiz emp , as possible. and requiring January 1, 2017 tive effec me beca h whic care settings, icrobials in all health d on use of inappropriate antim hip program that is base large health system antimicrobial stewards “Our greatest concerns as we look toward theAfuture hospitals to have an gains valuable insigh 4 infected with ture. are litera looking ts into ph for tific ways to improve our profiare armacy scien nt tability, curre inv t entor y managem -resistan rule iotic new antib proposed ent with supply-ch maintain (CMS) patient safety and implement technology, ices Serv caid ” int Medi elli and gence , tware ain care year sof ipate each s partic nism to r The Centers for Medi orga orde . in Murphy use said. itals to reduce antibiotic , (June 2016) requires hosp must appoint designated RESULTING IN and states that hospitals caid 5,6 Medi or care .

Medi 00 in rams Murphy proghelped ip has QS/1 IMATELY 23,0 2 address many APPofROX those antimicrobial stewardsh qualified leaders for those concerns. As the next generation ion of pharmacy DEATHS ANNUALLY. ting the Joint Commiss ms in mee syste h healt and managemen ital t software, ices To support hosp ensive Pharmacy ServSharpRx®’s powerful yet Hospitals and hea proposed rule, Compreh intuitive system made Solu a tion, lasting impression. “When standard and the CMS lth care systems in icrobial Stewardship the United States first of its kind Antim they showed me ial 35 million patients icrob their handle more than new Antim product, SharpRx, I was its (CPS) laun ched the gh throu itals each year. These larg 180 U.S. hosp of study nsive expa e operations are find Carrie Boec” kelman, RPh impressed and hoped to switch as soon as possible, based on an sav ing s asso , ing that the cost BCAC ciat P ed “It was obviously designed with the idea withthat ram. effectiv you Manager, Ambulatory Pharm e pha he said. rma Stewardship Pilot Prog cy supply-chain ma acy Services have a big impact nagement / let the software do the dc.gov

20-50%

Supplylogix Pharm acy Inventory Manag ement S O o TW lu N ti THA ons MORE N PEOPLE MILLIO

PRIMARY INTENDED OU

TCOME

on the work, and that’s can probably bottom line, as wel l as on patient care what impressed meSup . most.” plylogix offers a suit e of software produc Jesse Murphy, PharmD ts that enables pha competitive advant rmacies to gain ages. Pharmacies can leverage Supplyl tools to optimize the ogix's supply-chain ir inventory replen that would have hidden ishment, manage or would be difficult unssettings aleable retu pot ent ial losses from rns, and monitor the to do with other systems are very intuitive ir product movem and easy ent. to figure out with SharpRx.” Ngo, PharmD, BCACP THE CHALLE

www.c https:// UW Healt h Pharm August 15,~2016. acy Progra ms. Access ed al Antibiotic Stewardship Core Elements of Hospit https:// Contro l and Prevention.

Accessed April 4, 2017.

Center s for Diseas e elements.html Atlanta , GA: CDC; 2013. implementatio n/corethe United States, 2013. in Threats getsmart/healthcare/ nce tic Resista l and Prevention. Antibio ts/fs19 4/en/# 2 Center s for Disease Contro -508.p df o.int/mediacentre/factshee e/pdf/ar-threats-2013 4, 2017. http://w ww.wh _ sistanc April ed ardship /drugre Access l_Stew dc.gov www.c /6/New_Antimicrobia nce. (Updated: Apr 2015.) missio n.org/assets/1 Antimicrobial Resista 3 2017. https:// www.jo intcom World Health Organization. rd. Accessed April 24, dship in U.S. robial Stewardship Standa 4 tes Antibio tic Stewar Approved: New Antimic Promo and ions, Condit s/2016 -06-13.html es Hospital-Acquired Standard.pdf /2016-Fact-sheets-item its Discrim ination , Reduc atabase/Fact- sheets April 24, Proposed Rule that Prohib oom/M ediaReleaseD 5 Medicare. Accessed CMS.g ov. CMS Issues www.c ms.gov/Newsr antibiotic use or exit April 24, 2017. https:// for hospitals: Reduce tml Hospitals. Accessed : CMS’ proposed rule se-or-exit-med icare.h n Control & Clinical Quality s-redu ce-antibiotic-u Infectio ospital . le-for-h Review al 6 sed-ru Manager, Ambulatory Pharm Becker ’s Hospit ity/cms -propo spitalreview.co m/qual kersho acy Services ww.bec 2017. http://w

Intuitive and Easy-to-Use “SharpRx’s greatest benefit is how intuitive the system is,” Murphy said. “Some of the traditional pharmacy systems that have been around for many years may be very powerful, but a lot of that power comes at a cost of complexity.”

Melissa

1

Case Studies

SharpRx has a lot of the same power without ~ UW the Health Pharmacy complexity. “It was obviously designed with the idea that you let the software do the work, and that’s probably what impressed me most,” he said. “Things

CaseStudy_F.indd 1

001058_CPS_RxInsider_

www.supplylogix .com

Get the Most Out of Your Case Study You have invested in the development of a case study, don’t fall short on promoting it. RXinsider can help write and promote your case study to targeted practice settings throughout the pharmacy market via print, video, ebook, and web. Contact an RXinsider representative to learn more about our Case Study Promotional Services.

For information, contact our sales team.

RXinsider

800.972.2083

sales@RXinsider.com RXinsider.com 1300 Division Road, West Warwick, RI 02893 © 2019 RXinsider LTD. All rights reserved.

NGE

“I think an individualUW Heasitlth, could down with SharpRx an inte gra ted health system associated with the and, after a few minutes, fillsina prescription Wiscon easily.

University of Madison, serv es 600,000 patients That’s not 4/21/17 something 10:51 AM that we can say with each year in the Upp region of the country er Midwest .

Wit h other systems.” six hospitals and 15 disp

processes upward ensing sites, UW Hea s of 44,000 prescri lth ptions per month. services is related A large portion of to specialty pharma their cy items, including and HIV care, making diabetes, transpla their inventory cos nt, ts exceptionally hig standard retail pha h compared to rmacy.

INNOVATION IN

SECURE DRUG DELIVERY For 50 years IMI has manufactured innovative devices that help protect the delivery of drugs within the healthcare system. Pharmacists rely on Prep-Lockâ&#x201E;˘ Tamper Evident Caps for ease of installation while clinicians appreciate the simplicity of removal for drug administration.

Prep-Lock Tamper Evident Caps for IV Syringes are the industry standard for guarding compounded sterile preparations from unauthorized access, diversion and misuse. IMI offers a variety of products that protect drug delivery including IV, Oral and Enteral devices.

CONTACT US FOR FREE EVALUATION SAMPLES MADE IN THE USA

IM I

1.800.344.2554 WWW.IMIWEB.COM

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Prep-Lock™ From IMI Guards Against Drug Diversion and Misuse

Increase pharmacy productivity and safety with innovative and economical devices designed to protect your compounded sterile preparations.

President:

Jonathan Vitello Founded: 1969 Employees: 100+ Toll-Free Phone: (800) 344-2554 Phone: (954) 917-9570 Fax: (954) 917-9244 Address: 2981 Gateway Drive Pompano Beach, FL 33069 Website: www.imiweb.com

Company Background

IMI is celebrating 50 years of working closely with pharmacists and compounding professionals to create innovative sterile products that meet very specialized needs. Throughout this time, IMI has established long standing partnerships with some of the biggest names in healthcare.

Through these partnerships and directly, IMI is delivering the kind of high-quality and high-value products that pharmacy operations demand.

All IMI products are manufactured in the USA under the strictest quality standards at their FDA registered, ISO 13485 certified facility.

Product Overview

n Prep-Lock™ Tamper Evident Caps (for Sterile IV Luer Lock Syringes) Compounded sterile preparations (CSPs) are at their greatest risk when they leave the custody of your pharmacy. The Prep-Lock™ Tamper Evident Cap greatly reduces the risk of your CSP being compromised either accidentally or intentionally. It ensures that product integrity is maintained from the time it leaves the sterile hood until it is administered by an authorized clinician.

If your facility uses an outsource compounder, chances are you are already familiar with IMI’s tamper evident cap technology. You can easily incorporate the use of this cap for your in-house preparations which will provide standardization of all syringes throughout your hospital.

Installing the tamper evident cap in your compounding operation is highly efficient. Each sterile tray of 10 caps offers the pharmacist the ability to quickly install the cap with a simple twist of the syringe.

This helps to reduce the risk of touch contamination and enhances aseptic technique. Administering a syringe is very easy for the authorized clinician. Simply pull-off the outer sleeve of the tamper evident cap, unscrew the remaining luer lock cap, and discard.

A choice of three different colored caps and two outer sleeve styles allows the pharmacy the ability to color code either specific drug classes or processes.

n Prep-Lock™ Tamper Evident Cap (for ENFit® Syringes) The ENFit® connector standard (ISO 80369-3) for enteral feeding devices is a welcomed feature for mitigating potential misconnections.

IMI is pleased to offer a tamper evident cap for ENFit Syringes that further enhances patient safety.

These innovative caps help guard against drug diversion and misuse from the time the syringe leaves the pharmacy until the time it is administered.

The tamper evident cap is compatible with both standard and low dose ENFit Syringes. n Prep-Lock™ Tamper Evident Caps (for Oral Dispensers)

The Prep-Lock™ Tamper Evident Cap for Oral Dispensers offers the same kind of tamper evident protection found in the sterile IV syringe model.

It is the only tamper evident cap for oral dispensers available today. Since oral dispenser tips are unique to each dispenser manufacturer, the Prep-Lock Tamper Evident Cap for Oral Dispensers is offered in four different versions, for use with the Baxter EXACTAMED Oral Dispenser, the Comar® Oral Dispenser, the BD Oral Dispenser, and the NeoMed® Oral Dispenser. Unlike standard oral tip caps which can easily dislodge and fall off, the Prep-Lock Oral Cap provides a more secure capping of the oral dispenser.

Additional Product Lines

IMI offers a variety of sterile devices designed for the compounding pharmacist: • Prep-Seal™: Sterile Luer Lock Caps and Plugs • Prep-Fill™: Sterile Luer Lock Connectors • Rx-Vent™: Sterile Venting Needles • Rx-Tract™: Sterile Aspirating Needles

Trade Shows/Meetings Attended

IMI regularly participates at a variety of industry trade shows and conferences including:

• American Society of Health‑System Pharmacists (ASHP) • European Association of Hospital Pharmacists (EAHP) • National Pharmacy Purchasing Association (NPPA) • International Health Facility Diversion Association (IHFDA) • Hospital Pharmacy Conference (Health Connect Partners) Contact the event website or IMI for dates and booth numbers.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 45

Unit Dose Done Right

Unit Do se Bar Cod , ing, Pharma c Nursing y & Supply Experts !

• Ultraviolet Inhibitant • Moisture Resistant • Reduces Cross Contamination • Ideal for Meds Covered by USP 800 • Tamper-Evident • Cold Seal • 6 and 12-month Beyond-Use Dating • 1-D and 2-D Bar Coding • Flexible Label and Report Formatting • Multiple Sizes to Fit Your Meds and Storage Needs

Simple. Reliable.

800.523.8966

MediDose.com

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Medi-Dose, Inc./EPS, Inc. Delivers Bar Coding, Packaging, and Labeling Pharmacy Solutions Improve your Solid Oral Unit Dose needs with our comprehensive Bar Coding, Packaging, and Labeling Solutions – designed by healthcare professionals, for healthcare professionals.

President:

Robert Braverman

Founded: 1971 Employees: Private Toll-Free Phone: (800) 523-8966 Phone:

(215) 396-8600 (800) 323-8966 Address: 70 Industrial Drive Ivyland, PA 18974 Website: www.medidose.com Fax:

Company Background Medi-Dose/EPS was founded in 1971 when Milton Braverman, a former pharmaceutical company territory manager, saw the need for inexpensive, manual unit dose packaging allowing a hospital to convert from traditional dispensing. He developed the Medi-Dose System to package, handle, and dispense predetermined amounts of medication so they would be accessible for one regular dose. Comprehensive bar coding and labeling identification is accomplished using our innovative MILT 4 software. Because of the continued success of the MediDose System, Medi-Dose/EPS expanded its product line to include the TampAlerT System, offering tamper-evident liquid packaging without the need for heat tunnels and accessory sealing equipment, as well as a full line of supplies and disposable products designed specifically for the pharmacy and health care professional.

Product Overview Medi-Dose provides Tamper-Evidence as well as UV and Moisture Resistance for one-year beyond-use dating. Our MILT® 4 software maintains packaging logs and lets you design and print your Lid-Label® Covers with color, bar codes, tall man lettering, and graphics. You can format the labels any way you want, directly from your own computer and printer!

Medi-Dose works well in any pharmacy operation and can be used with all classifications of drugs (chemo meds, meds covered

by USP 800, compounded drugs, controlled substances, etc.).

It’s affordably priced for all pharmacy budgets. For the best in manual unit dose packaging, check out Medi-Dose!

Features & Options

n Packaging and Labeling Solutions

• Simple to use – no extensive training needed.

• 1-D and 2-D bar coding – including NDC, lot numbers, and expiration dating.

• Ideal for hazardous medications and USP 800 drugs.

• Tall Man Lettering and dynamic formatting options.

• Built-in NDC lookup database and extensive image library.

• Packaging logs and error reporting.

• Six-month and one-year beyond-use dating.

• UV and moisture resistance.

• Tamper-Evidence.

• 15 styles of blisters to accommodate virtually all meds.

• No machinery or space requirements.

• Inexpensive – no capital outlay required.

Product Specifications

n Accompanying Labeling Software

• MILT 4 • MILT 3.0 • MILT 2.6 • Medi-Dose 2000

Trade Shows/Meetings Attended ASHP Midyear, ASHP Summer, Joint Forces Pharmacy Seminar, National Pharmacy Purchasing Association, EAHP, IACP, and various state, regional, and pharmacy compounding conferences.

Ordering Information For additional information, please contact us at (800) 523-8966, visit our website at www.medidose.com, or email us at info@medidose.com.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 47

THE SAFER CHOICE FOR YOUR PHARMACY

B I O S A F E T Y C A B I N E T S . H O R I Z O N TA L A N D V E R T I C A L L A M I N A R A I R F L O W W O R K S TAT I O N S .

C O N TA I N M E N T V E N T I L AT E D E N C L O S U R E S . C O M P O U N D I N G I S O L AT O R S . C U S T O M S O L U T I O N S .

Primary Engineering Controls by NuAire.

www.nuaire.com © Copyright 2019. NuAire, All Rights Reserved.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Primary Engineering Controls From NuAire

Provide quality Primary Engineering Controls at a competitive price with responsive service to lower your total cost of ownership, minimize downtime, and develop a long-lasting relationship so you can concentrate on what matters, your work.

President & CEO: Richard Peters Founded: 1971

Employees: 250+ Stock Symbol:

Private (Family-Owned) Toll-Free Phone: (800) 328-3352 Phone: (763) 553-1270 Address: 2100 Fernbrook Lane Plymouth, MN 55447 USA Website: www.nuaire.com

Company Background For more than 45 years, NuAire has been committed to bringing you the highest-quality, most dependable pharmacy products on the market. We are universally recognized as one of the world’s leading providers of reliable equipment for the compounding pharmacy. You can depend on our products to feature brilliant but practical design, and we pay keen attention to every step of the production process, from fabrication to assembly to thorough testing. As a NuAire customer, you can also rely on us for outstanding value and dependable service – the cornerstone of our reputation as the leading provider of pharmacy products internationally.

At NuAire, we create our high-quality products with your success in mind. This means that if you purchase a piece of equipment from us, we want you to be completely happy while using it.

NuAire will work hand-in-hand with you in order to ensure that your experience using our product meets your standards, and if you encounter any issues or difficulties along the way, we’ll help you work through them until you are 100% satisfied. Our philosophy is that we succeed only when you succeed – we are committed to working hard to ensure you achieve your goals.

Product Overview n Biosafety Cabinets (BSC) • Class II, Type A2 • Class II, Type B1 • Class II, Type B2

n Redistricted Access Barriers (RABS) • Compounding Aseptic Isolators (CAI) • Compounding Aseptic Containment Isolators (CACI)

Features & Options The Safer Choice for Your Pharmacy. NuAire designs products specifically for the pharmacy environment. Smooth interior options make a great addition to any biosafety cabinet (BSC) allowing for enhanced cleanability. Add an Ergo-Tron arm to our airflow products to house a computer monitor with keyboard and mouse for your medication workflow or add a back wall cutout to a BSC to view documentation while compounding. Customize your product to enclose a TPN machine for a sterile environment. Our products are designed to lower your total cost of ownership and minimize downtime so you can concentrate on your work. Our products are second to none when it comes to quality, longevity, and service.

Testimonials

Product: NU-430 Class II, Type B2 Biosafety Cabinet Source: www.selectscience.net

“ Reliable hood for preparation of chemotherapy. We have never had a problem with performance. Does an excellent job of keeping the chemotherapy contained."

— Helena White, Cooperhealth System

Product: NU-PR797 Compounding Aseptic Isolator Source: www.selectscience.net

“ One of the friendliest and most knowledgeable companies I've dealt with in my pharmacy practice. Very helpful in my efforts to provide patients with safe, quality products for their care."

— Gerald (Jerry) Carlson, IU Health Blackford Hospital Pharmacy

GPO Affiliations Vizient, Intalere, E&I, Premier, MHA, GSA, and PCCA. Pricing Information For pricing and ordering information, or to learn more, please visit www.nuaire.com.

n Containment Ventilated Enclosures (CVE) n Laminar Airflow Workstations (LAFW) • Vertical Airflow • Horizontal Airflow SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 49

CASE STUDY Reconciling Irreconcilable Differences: A Time Study on IntelliVault™ From GSL Solutions Inc. Background

Michael Kiso, Pharm D. RPh MBA Candidate 2020

Pharmacists have been manually tracking and reconciling physical controlled drug inventory to a perpetual inventory log since 1971 at the institution of the DEA’s Title 21. The importance of tracking controlled substance inventory and dispensing history cannot be overstated, but has long been hampering the full potential of outpatient pharmacy operations. GSL Solutions Inc., a company well-known for the IntelliCab™ pharmacy will-call system found throughout military pharmacies and community pharmacies across the globe, has developed a new product, IntelliVault™. This unique product aims to replace the typical “gun safe” type open-faced and open-access controlled substance cabinet with a real-time discrete storage and tracking system based on Radio Frequency Identification (RFID). The IntelliVault™ system has successfully eliminated diversion and drug loss while optimizing pharmacy operations and reducing labor costs.

It achieves this through shifting time consuming, yet non-clinical labor away from pharmacists to pharmacy technicians. It also eliminates time required to reconcile inaccuracies associated with manual logs via three steps: 1. Controlled Substance Stock Receiving • Technician coupling of controlled substance stock bottles with a SmartBasket™ with entry of lot number and expiration date.

• Multiple technicians receiving and filing stock simultaneously.

• Automatic reconciling of received stock with distributor drug invoice or form 222.

2. Drug Retrieval + Filling • Scanning the Rx label prompts a pharmacy technician to retrieve the controlled stock bottle with the Pick to Light™ System.

• Entry of lot number and expiration date at the receiving step allows for the oldest stock to be used first and allows for simplification of drug recalls.

• Returned to stock prescriptions will automatically be used on the next fills.

• Storing a given NDC in multiple SmartBaskets™ allows for multiple technicians to fill that same medication without the inventory worry of managing a "lead bottle."

3. Stock Bottle Back Count + Return to Stock • Once the technician fills the Rx, a blind back count ensures accuracy, accountability, and chain-ofcustody. Any discrepancies are reviewed by a pharmacist, who can utilize GSL’s reports to review any potential issues with their associated users.

• Software uses Pick to Light™ Technology to prompt technicians to complete return to stock in a matter of seconds.

50

www.gslcorp.com

CASE STUDY BEFORE

Calculating the Operational Value of IntelliVault™ An Integrated-Delivery Network (IDN) hospital system in the United States conducted a time study in one of their several outpatient pharmacies to investigate the potential value and labor savings with a pharmacy workflow that utilizes IntelliVault™. The data collectors followed the lifecycle of a prescription from start to finish and recorded the amount of time to complete each respective workflow step. Average time to complete each workflow step was calculated and multiplied by the wage rate of each respective pharmacy employee type: “pharmacist (RPh)” or “pharmacy technician.” These labor costs were then summed to calculate the total cost to dispense a single controlled prescription in the Standard of Practice model.

The total labor costs for the IntelliVault™ integrated model was calculated using the average time data from the old Standard of Practice model but adapted in the following way to conceive the IntelliVault™-integrated model: a) shifting workflow steps from RPh to technician, b) eliminating workflow steps no longer needed with the IntelliVault™-integrated model, and c) reducing average time to complete several workflow steps based on historical average time data of other pharmacies who have a proven IntelliVault™-integrated workflow. The IntelliVault™-integrated model costs of labor were then summed in the same fashion as previously described and compared to the costs of labor from the Standard of Practice model. Figures 1-4 describe the pharmacy volume, changes in workflow steps and average time to complete, labor savings per controlled Rx dispensed, and total yearly labor savings from workflow adaptations, respectively.

The Results Figure 1. Rx Volume Data IDN Pharmacy Rx Volume Average Total Rx (Rx Per week)

1,500

C-II volume (Rx Per week)

175

C-III through C-V volume (Rx Per week)

132

Figure 2. Change in Workflow Step Time Requirements – Previous Standard of Practice vs. IntelliVault™-Integrated Model Previous Standard of Practice Workflow Step:

RPh Time (min)

Tech Time (min)

RPh Time (min)

Tech Time (min)

0.622

–

– (shifted to tech)

0.167 (reduced time)

2. Fill Rx

–

1.177

–

1.177

3. Back Count Stock Bottle

–

0.567

–

0.567

4. Make Entry on Control Card + Perpetual Inventory Log

–

0.587

–

– (eliminated)

5. Perform Rx QC

0.779

–

0.779

–

6. Back Count Stock Bottle

0.557

–

0.557

– 0.663

1. Retrieve Stock Bottle + Perform NDC Verification

7. Double Count Rx

0.663

–

– (shifted to tech)

8. Print Paper Work for Rx

0.267

–

0.267

–

9. Bag Rx and Paperwork for Will Call

0.391

–

0.391

–

–

– (eliminated)

–

0.463

–

– (shifted to tech)

0.167 (reduced time)

4.07

2.33

1.99

2.74

10. Review NDC Card + Perpetual Inventory Log for Completeness 11. Return Stock Bottle to Safe + Return NDC Card to File

TOTAL TIME (min)

www.gslcorp.com

IntelliVault™-Integrated Model

0.327

51

CASE STUDY AFTER

Figure 3. Labor Cost Data Comparison – Without vs. With IntelliVault™ Labor Cost Per Rx Dispense Without IntelliVault™ ($)

Labor Cost Per Rx Dispense With IntelliVault™ ($)

RPh

$5.45

RPh

$2.67

Tech

$0.91

Tech

$1.07

Total Avg Labor Cost Per Rx Dispense

$6.36

Total Avg Labor Cost Per Rx Dispense

$3.74

Figure 4. Total Yearly Savings Per Controlled Substance Dispensing Savings and Cost Analysis Δ Avg Labor Cost Per Rx

$2.62

Savings Per Year

$22,933.66

Data Analysis On average, there was a calculated labor savings of $2.62 per controlled Rx dispense in favor of an IntelliVault™-integrated system with total savings per year of approximately $23,000 based on the average monthly controlled Rx volume as shown in figure 1. A significant portion of the labor shifted from pharmacists to pharmacy technicians, as shown in figure 2, while still reducing total time to fill a prescription by 1.67 minutes.

Conclusions and Other Considerations From the data collection, we can see that the pharmacy has an opportunity for significant savings in labor.

This is largely due to the elimination of pharmacist entry and review of the manual perpetual inventory log and shifting controlled drug retrieval, filling, and return-to-stock away from pharmacists to pharmacy technicians. This allows for pharmacists to be more heavily integrated in clinical roles and counseling.

Additionally, this estimation in labor savings does not quantify nor qualify the time and risk required for reconciliation of inaccurate manual logs. The use of a now automated perpetual inventory via IntelliVault™ tracks changes in controlled drug inventory in real time without the potential for human-driven accounting errors and subsequent time spent counting and reconciling historical dispenses. Additionally, this estimation of labor savings does not account for the improvement in controlled freight receiving processes, which are automatically and electronically received and reconciled against distributor forms 222 and other controlled drug receipts with GSL Solutions’ AutoLog™ features. Pharmacists no longer need to manually enter the quantity of controlled inventory received into a manual perpetual log. Additionally, and not studied, a system like IntelliVault™ would speed up quarterly physical inventory and allow for shifting this labor from pharmacists to technicians. IntelliVault™ breaks the paradigm of spending overtime labor for this activity before or after opening to regular technician hours during normal operations.

Pharmacies have been utilizing manual logs since it was first required by the DEA in 1971. Computers and new robotics have digitized and evolved the world of pharmacy records and operations over the last 30 years, but no technology has yet tackled the improvement in controlled drug inventory storage and tracking. As the culture of pharmacy is rapidly advancing with clinical practice roles evolving at an astounding rate, pharmacist time is valuable and often limited. The integration of IntelliVault™ appears to be a natural progression to advance our archaic and outdated manual inventory log to a culture of automation.

It mandates improved accuracy and maintenance of chain of custody over the entire filling process. Utilizing pharmacists as accountants for controlled inventory is clearly a disservice to the education and level of expertise we hold in drug therapies. Integrating new technologies like IntelliVault™ allows pharmacists to better apply their valuable clinical knowledge to the care team and facilitate improved patient outcomes.

52

www.gslcorp.com

Safety, Accountability, Efficiency and Compliance See what others have already discovered WITH AUTOLOG™ B Y

G S L

S O L U T I O N S

CONTROLLED DRUG STORAGE, PRESCRIPTION FILLING, AND RETRIEVAL SYSTEM • Eliminates shrink and drug loss by replacing today’s “open face / open access” controlled drug storage cabinets • Replaces today’s error-prone and manual perpetual log book • Logs ALL transactions and user activities automatically • Replaces pharmacist labor with technician labor for C2 filling • Maintains complete chain of custody and pedigree from stock receiving to prescription filling and patient pick up

BEFORE

AFTER

• Payback from labor savings in as little as 1 year

™

B Y

G S L

MEDS-TO-BED

S O L U T I O N S

NEW SYSTEM TO SUPPORT STREAMLINED DISPENSING OF PRESCRIPTION MEDICATIONS AT PATIENT’S BEDSIDE • Physical chain of custody is maintained from filling of prescription through receipt by the patient • Easy integration to RN notification system and dashboard when prescription is ready • Signature Capture stores the patient’s signature confirming receipt of medications from their bedside • Real-time inventory of cabinet contents • Secure storage of patient’s home medications • Patient monographs printed on demand

STANDS ALONE OR INTERGRATES WITH INTELLICAB

THE LEADER IN WILL-CALL STORAGE

• Secure storage for will-call • Proven ROI based on labor cost savings • Improves customer service through a decrease in wait time • Sends the patient a text message when RXs are ready with AutoNotify

BEFORE

AFTER

• Integrates with Central fill • Maintains drug pedigree, lot, and expiration date when integrated with IntelliVault

See our full suite of products online Contact us: www.gslcorp.com |360.896.5354

WE HAVE SOME

HUG E NEWS!

GREAT PRODUCTS NOW FROM THE HCL FAMILY!

LABELI N G TAPES! T N I L LOW M O O R N A E L C S E P I W

GOHCL.COM â&#x20AC;¢ 1.800.848.1633

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Health Care Logistics – Your Small Friend, Indeed Discover an unmatched inventory of unique and hard-to-find solutions for nearly every facet of the healthcare industry.

Founder & CEO: Gary Sharpe Founded: 1978 Employees: 325 Toll-Free Phone:

(800) 848-1633 (800) 447-2923 Address: P.O. Box 25, Circleville, OH 43113 Website: www.goHCL.com Fax:

Company Background

What began 40 years ago as a garage-based business at the home of founder Gary Sharpe now encompasses five facilities in central Ohio and reaches customers around the globe. Health Care Logistics is a privately owned company specializing in manufacturing, packaging, and distributing unique and hard-to-find products for nearly every facet of the health care industry. HCL also offers complimentary search and development services for non-inventory items customers want but can’t find. Meeting the needs of its customers is the driving force behind the success of Health Care Logistics.

Process Overview

HCL’s inventory includes more than 10,000 different products such as boxes, bins, security seals, compounding and dispensing products, infection prevention solutions, and unit dose supplies.

In addition to stock items, HCL offers manufacturing divisions for cabinets, plastics, and metals to create specialty solutions with short lead times. An in-house print division is also available to custom print labels, magnets, banners, and clings and to laser mark products with names, departments, and bar codes to help professionals improve performance, reliability, and accountability.

HCL will manufacture or modify existing products to meet your needs.

We work with you to make products work for you.

HCL Tech

n Stat Stock – Your Med Replenishment Process Simplified Manual drug replenishment routines are loaded with hassles that hinder your workday and put patient safety at risk. Makeover your method with Stat Stock™, the automated medication replenishment process exclusively from Health Care Logistics.

Stat Stock is a fast, user-friendly way for pharmacies to check the status of medication and supplies for greater accuracy and improved patient safety.

The system uses RFID tags to manage your drug and supply inventory, allowing you to instantly identify and locate expired or recalled medication anywhere in your facility, then replenish or remove accordingly. Automated reports make it easy to monitor inventory and track trends. Watch how it’s changing drug replenishment in facilities just like yours.

Manage your inventory and improve safety quickly, easily, and affordably with the Stat Stock suite of applications. n Stat Temp – Easier, More Efficient Remote Temperature Monitoring Healthcare facilities and temperature monitoring go hand in hand, that’s no secret. But did you know you can automatically monitor temperatures from anywhere? At any time? From any device? Stat Temp, a new remote temperature monitoring system from Health Care Logistics, helps ensure temperature accuracy anywhere in your facility. Monitor temperatures within your set parameters and, in return, receive realtime alerts if results are trending outside of this range.

Stat Temp is equipped with a user-determined chain of command that alerts the appropriate personnel when a temperature breach occurs. You can easily customize the system to fit your monitoring, reporting, and alert preferences.

Health Care Logistics is ready to help fit Stat Temp into your standards of operations and procedures. Enjoy these features with your installation: • Mounts anywhere; monitors transmit information wirelessly and information is collected and recorded 24/7.

• Access readings anytime, anywhere via any internet-connected device. Stat Temp is a web-based, software-free system that won’t compromise valuable space on your computer. Likewise, multiple facilities can operate under one account.

• Eliminates the need to manually record each unit by multiple staff members. This solution is perfect for facilities not staffed 24 hours a day.

• Receive real-time alerts of abnormal temperature ranges and save thousands of dollars in drug waste.

• Easily access your temperature history – a requirement for any compliance agency.

• Accurately track who has resolved any issues and the action taken in response to any out-of-range temperature occurrences.

• Customize all monitoring and alert preferences to your requirements.

• Enjoy Health Care Logistics’ friendly and reliable customer service assistance.

Manage temperatures, prevent drug waste, and provide peace of mind with the Stat Temp remote monitoring system from Health Care Logistics.

Contact us to get started or to schedule your live, on-site demonstration.

Ordering Information

Call: (800) 848-1633 | Web: www.goHCL.com | Fax: (800) 447-2923 Email: hcl@gohcl.com | Electronically: GHX and EDI

n Chat Online

HCL’s Live Customer Service Staff is on Duty 8:00 am - 8:00 pm, EST After Business Hours Call Our Emergency Phone: (740) 207-4293 SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 55

USP compliance is critical care can’t pause for renovations.

Compounding can pull you in different directions, but you shouldn’t have to choose between regulatory compliance and patient care.

Letco’s team of experts can help you navigate the uncertainty surrounding USP and FDA guidance for hospital compounding. Our programs and products have been designed to help you use compounding to provide the best possible patient care without stretching your budget.

We’re Letco. Let us help.

Call or visit us online today

800-239-5288

letcomed.com

COMPOUNDING INGREDIENTS | ADVISORY SERVICES | SUPPLIES | SPECIALTY PRODUCTS | EQUIPMENT

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Letco Helps Compounding Pharmacies Stay Compliant and Profitable While Navigating USP and FDA Changes Market dynamics and regulatory pressure are squeezing compounding pharmacy profitability like never before. Given all of the challenges, Letco Medical understands the need to approach the market in a new and different way, to truly partner with compounding pharmacies and help them maximize profitability.

President & CEO: Doug Bowman Founded: 1993

Employees: 100+ Toll-Free Phone:

(800) 239-5288

Address: 460 E. Swedesford Road, Suite 2040

Wayne, PA 19087 Website: www.letcomed.com

Company Background Since its inception in 1993, Letco Medical has earned and built a reputation as one of the most innovative companies in the compounding industry. An employee owned company headquartered in Wayne, PA, is the supply partner of choice for profit-conscious compounding pharmacies everywhere. Letco Med has invested heavily in building a company that can serve the needs of compounding pharmacies today, tomorrow, and into the future, with a full-line of products and complementary programs and services. With a dedicated focus on the U.S. compounding market, Letco Med provides a wide and comprehensive portfolio of safe and consistent top-quality chemicals, compounding supplies, and equipment at highly competitive prices.

Proprietary Programs & Services Letco Med enables pharmacies across the U.S. to take full advantage of compounding as a profit center. Letco Med provides a wide array of value-added solutions: n Pharmacy Professional Services Providing support to you at no additional charge; we have you covered including pharmacy consultation, formulas, formulation support, USP <800>, and a variety of other technical support offerings. n Education Value Program Save up to 60% on continuing education training that leverages Letco’s Platinum Sponsorship with the American College of Apothecaries to provide the best industry rates. n Quality Savings Program Save up to 20% on laboratory service costs utilizing our proprietary Quality Savings Program in partnership with ARL Bio Pharma, the nation’s leading analytical laboratory. n NEW! Regulatory Solutions Program A partnership designed to provide you with expert regulatory consulting and deliverables.

Product Overview Letco Med’s product line includes chemicals covering a broad range of therapeutic categories, as well as supplies, equipment, capsules, and pre-made topical bases. In addition, an extensive range of dosage forms and delivery systems are available, including topicals, injectables, liquids, transdermals, inhalation, oral solids, and controlled-release.

n Financial Services Program Finance 100% of the cost of the equipment with incredibly flexible payment programs that suit your business.

Letco Med is focused on unwavering quality, exemplified by the company’s industry-leading quality assurance programs, stringent quality control procedures and an unblemished record with the FDA. • We are an FDA registered cGMP facility with VAWD accreditation.

• We operate in compliance with all regulatory requirements.

• We are committed to an ethical standard that begins and ends with quality.

• It is the solutions we provide and our operations that push us toward perfection.

• Our commitment to every customer is to provide the highest level of service.

At Letco, we take pride in delivering the products, services, and support needed to meet today’s challenges. We are equally committed to facing the future as your trusted partner. With complete dedication and focus on our customers, Letco is the ideal supply partner to help you realize significant profit opportunities for your compounding practice.

n ValueVue A quick-turn proprietary process that allows compounding pharmacies to assess purchasing effectiveness and save up to 30% on compounding purchases.

We’re Letco. Let Us Help.

For further information visit, www.letcomed.com.

Ordering Information

To order call (800) 239-5288 or visit www.letcomed.com.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 57

PYROSATE

®

RAPID ENDOTOXIN DETECTION KIT nsed

e DA Lic OW F

N

®

cens i L FDA

New Sensitivities Of 0.03, 0.125 and 0.25 EU/mL Final Product Release Easy-To-Use Method Rapid Test Results

OCIATES OF E CO D, IN C.

ASSOCIATES OF CAPE CO D, IN C.

ists in Endotoxin lucan Detection

Specialists in Endotoxin and Glucan Detection

OCIATES OF E CO D, IN C.

Bacterial Endotoxin Testing USP Chapter <85> Compliant Associates of Cape Cod, Incorporated

ASSOCIATES OF CAPE CO D, IN C.

124 Bernard E. Saint Jean Dr., East Falmouth, MA 02536 USA 888.395.2221 • INFO@ACCIUSA.COM • WWW.ACCIUSA.COM

ed

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Associates of Cape Cod — Delivering Rapid Endotoxin Testing Results for Compounding Pharmacies Pyrosate® has been developed as an easy-to-use Limulus Amebocyte Lysate (LAL) gel-clot test that enables rapid testing and does not require special laboratory supplies. The Pyrosate Kit provides rapid results and is especially convenient for research, testing water, and dialysate.

Toll-Free Phone: (888) 395-2221 Phone:

(508) 540-3444 Fax: (508) 540-8680 Address: Falmouth Technology Park 124 Bernard E. Saint Jean Drive East Falmouth, MA 02536 Website: www.acciusa.com

Company Background Associates of Cape Cod, Inc. (ACC), is one of the world’s largest manufacturers of products developed to detect and quantify gram-negative bacterial endotoxins and (1g3)-ß-D-glucans.

Our products are used worldwide by leading pharmaceutical and medical device companies to ensure the safety of their parenteral drugs, biological products, and medical devices.

Our goal is to provide the best products and services, as well as the best technical support and customer service in our industry, to enhance the productivity and efficiency of all our customers.

We are ISO 13485: 2016 NSAI certified, our laboratories are FDA inspected and DEA licensed. Our Beacon Diagnostics® laboratory is CLIA certified.

Product Overview Associates of Cape Cod, Inc., (ACC) is pleased to offer Pyrosate®, an FDA licensed version of our rapid endotoxin detection kit.

Pyrosate is well suited for performing endotoxin assays in full compliance with the Bacterial Endotoxins Test, USP chapter <85>. Pyrosate has been developed as an easy-to-use Limulus Amebocyte Lysate (LAL) gel-clot test that enables rapid testing and does not require special laboratory supplies. The easy-to-follow, step-by-step illustrated instructions allow the user to set up assays within minutes.

In addition to FDA licensure, the Pyrosate® Kit is now available in sensitivities of 0.03 EU/mL, 0.125 EU/mL and 0.25 EU/mL, in both 10-pack and 30-pack formats. With the introduction of this licensed version, in addition to research and water testing, Pyrosate is ideal for dialysis centers, compounding pharmacies, and pharmaceutical and medical device companies.

Performing the Test

The Pyrosate® Kit is a rapid gel-clot test that contains a 2λ* endotoxin tube (PPC) matched to the sample (SPL) tube for each sensitivity. This feature is unique to the Pyrosate assay. The endotoxin tube (PPC) assures that the sample does not interfere with the test, ruling out false negatives. Pyrosate is formulated to eliminate false positives due to (1 g 3)-ß-D-glucans. This endotoxin specific reagent does not require additional blocking buffers.

Reconstitution Pyrosate® is reconstituted directly with the sample by adding 0.5 mL to the sample tube (SPL). After approximately 60 seconds of gentle mixing, 0.25 mL is transferred to the endotoxin tube (PPC). The lot-specific incubation time at 37±1°C is given on the Certificate of Compliance.

Stability Pyrosate® is stable at room temperature and does not require refrigeration for shipping or storage.

Product Applications • Hemodialysis • Water and Water Systems • Filter Industry • Research • Final Product Release Product Benefits • Shorter Assay Time • Endotoxin Specific • No Dilutions Required • No Refrigeration Required • Matched Positive Product Control * λ (lambda) is the lowest concentration of endotoxin to cause a positive test result under standard conditions.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 59

T R A D E S H O W & M E E T I N G E v e n t Calendar

Event Calendar

Trade Shows, Meetings, & Expositions For listing and advertising details, please contact Sales@RXinsider.com or call 800.972.2083

RXinsider’s Virtual Pharmacy Trade Show 24 / 7 / 365 450+ Booths, 88 Aisles www.rxinsider.com

340B Coalition Summer Conference July 15-17, 2019 Washington, DC 340bsummerconference.org

Veterinary Pharmacy Conference June 6-8, 2019 Louisville, KY www.vetmeds.org/vpc

Cardinal Health RBC July 17-20, 2019 Gaylord Opryland Resort & Convention Center Nashville, TN Rbc.cardinalhealth.com

ASHP Summer Meeting June 8-12, 2019 Boston, MA www.ashp.org ECRM Health System/ Institutional Pharmacy EPPS June 24-26, 2019 Sheraton Grand Chicago Chicago, IL ecrm.marketgate.com/ sessions McKesson ideaShare June 26-30, 2019 Orange County Convention Center Orlando, FL www.mckessonideashare.com AACP Annual Meeting July 13-17, 2019 Chicago, IL www.aacp.org

2019 TPA Conference & Expo August 2-4, 2019 Irving Convention Center Irving, TX www.texaspharmacy.org NACDS Total Store Expo August 24-26, 2019 Boston, MA Tse.nacds.org Quality Compounding Summit September 5-7, 2019 Nashville, TN www.qcsummitrx.org NCPA Annual Conference October 26-29, 2019 San Diego, CA Convention.ncpanet.org

SUMMER 2019

I

All in One Convenient Location

More than 50,000 annual visitors turn to the Virtual Pharmacy Trade Show to research and connect with leading providers of products and services throughout every segment of pharmacy.

Virtual Pharmacy Trade Show For information on advertising opportunities within the trade show, contact our sales team.

RXinsider

800.972.2083

sales@RXinsider.com RXinsider.com 1300 Division Rd., West Warwick, RI 02893 continued on page 63

60

Virtual Trade Show

H E A LT H S Y S T E M • I N F U S I O N

© 2019 RXinsider LTD. All rights reserved.

We provide support in addressing your 340B operational and compliance challenges Prepare for a government or manufacturer audit

Stay compliant with changes to Medicare Part B reimbursements

Compare split-billing software vendors

Connect with 340B hospitals around the country

Member Benefits Advocacy

As your voice in Washington, we encourage you to join our advocacy efforts to protect 340B, which includes creating an Impact Profile document illustrating how your savings support your safety-net mission. Our staff is ready to help your hospital engage in advocacy through the development of op-eds and social media campaigns.

Webinars

You and your staff will be invited to 340B related webinars throughout the year on topics ranging from audit prep and findings to recertification. We host over a dozen webinars each year and encourage your team to join us.

Individual Membership

Through your hospitalâ&#x20AC;&#x2122;s membership, you are eligible to join this supplemental program which provides professional development and networking opportunities.

Real-Time 340B Information

Stay in-the-know and up to date through our email alerts, members-only bi-weekly Bulletin, and the 340B Informed blog.

Technical Assistance (TA) Calls

Take advantage of this invaluable resource by speaking with a member of our legal and/or pharmacy teams. Our staff is able to answer questions on topics ranging from audit prep and diversion to adding child sites and drafting policies and procedures.

National Conferences

340B Health, along with our 340B Coalition partners, provides you unparalleled access to information and networking opportunities at our summer and winter conferences. 340B Health and 340B Coalition members receive discounts to both events.

340B Health Website

The website has sample forms, letters and P&Ps, as well as policy guides and member best practices. Miss a webinar?

No problem, past webinars are housed on our website. Find our audit and compliance resource centers along with a calendar of upcoming events.

The Exchange

Access our secure online member discussion forum 24/7 for answers to your most pressing 340B related questions, hear ideas and best practices, and grow your network.

Roundtables

340B Health hosts interactive roundtables throughout the year. In 2018 alone, roundtables were conducted in nearly a dozen states. These half-day seminars provide vital 340B information, create a forum for idea generation, and are always free to attend.

Questions? Contact Shane Kelley at (202) 552-5864 or email shane.kelley@340bhealth.org.

DRIVE YOUR BUSINESS FORWARD Connecting products, services and pharmacy professionals to better align with market needs

UNCOVER NEW PRODUCTS, TECHNOLOGY AND SERVICES DRIVE EFFECTIVE INTERACTIONS BETWEEN QUALIFIED PARTNERS GAIN MARKET INSIGHT AND EDUCATION Contact Michael Castillo, SVP of Pharmacy & Medical Markets for more information 440-528-0441 | MCastillo@ECRM.MarketGate.com | ECRM.MarketGate.com

T R A D E S H O W & M E E T I N G E v e n t Calendar

Event Calendar

Trade Shows, Meetings, & Expositions For listing and advertising details, please contact Sales@RXinsider.com or call 800.972.2083

continued from page 60

2019 ASCP Annual Meeting & Exhibition November 7-10, 2019 Gaylord Texan Resort Grapevine, TX www.ascp.com/page/ events ECRM Pharmacy Technology, Services, Supplies, and Automation EPPS November 11-13, 2019 Hyatt Regency Intercontinental Houston Airport Houston, TX ecrm.marketgate.com/ sessions ASHP Midyear Clinical Meeting and Exhibition December 8-12, 2019 Las Vegas, NV www.ashp.org/Meetingsand-Events/ American College of Apothecaries Annual Conference & Expo 2020 February 19-22, 2020 The Don Cesar St. Pete Beach, FL acainfo.org/ace

2020 PDS Super Conference February 27-29, 2020 Orlando, FL www.pdsconference. com/2020-pds 2020 FAH Public Policy Conference and Business Exposition March 1-3, 2020 Marriott Wardman Park Hotel Washington, DC fah.org/conference/fahpublic-policy-conferenceand-business-exposition

Video Solutions Maximize Audience Engagement Through Video

Video is the most powerful digital marketing tool available.

Whether your audience is in the office (desktop), or on the go (mobile), video delivers engaging, persuasive, and credible marketing content. Integrate video into your marketing strategy to grow your businesses digital distribution and exposure. © 2019 RXinsider LTD. All rights reserved.

RXinsider.com

It’s Here

HIMSS20 Conference & Exhibition March 9-13, 2020 Orange County Convention Center Orlando, FL www.himssconference.org

20Ways Summer

APhA 2020 March 20-23, 2020 National Harbor, MD Aphameeting.pharmacist.com NHIA Annual Conference April 5-9, 2020 Gaylord Rockies Resort & Convention Center Aurora, CO www.nhia.org All shows are subject to change.

Download the 20Ways App at www.RXinsider.com / 20ways © 2019 RXinsider LTD. All rights reserved.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 63

Supporting Pharmacy Efficiency with a Growing Product Formulary

Liquid Unit Dose from American Health Packaging

American Health Packaging provides new unit dose products to support pharmacy efficiency and patient safety initiatives. Liquid Unit Dose cups, available through partner GPOs and wholesalers, facilitate dose-level scanning at bedside. Products come in multiple pack sizes to provide flexibility in managing local inventory.

Pull-tab labels promote ease of opening and product administration Thick gauge cups, excellent seal integrity aid in avoiding costly damage and clean up Differentiated labels provide visual guidance for distinguishing between look-alike, sound-alike products Cups and storage trays are designed to optimize limited shelf storage space

Unit Strength

Cup Delivery

Cup Strength

Pack Size

NDC

Fluoxetine Oral Solution, USP

20mg/5mL

5mL

20mg/5mL

40 cups

60687-0244-77

Fluoxetine Oral Solution, USP

20mg/5mL

5mL

20mg/5mL

50 cups

60687-0244-67

584557

Levetiracetam Oral Solution, USP

100mg/mL

5mL

500mg/5mL

40 cups

60687-0249-77

3775822

238550

Levetiracetam Oral Solution, USP

100mg/mL

5mL

500mg/5mL

50 cups

60687-0249-67

3777034

568063

Ondansetron Oral Solution, USP

4mg/5mL

5mL

4mg/5mL

30 cups

60687-0252-86

5508114

3751294

560649

Phenytoin Oral Suspension, USP

125mg/5mL

4mL

100mg/4mL

50 cups

60687-0275-66

10211558

5515705

3935129

575878

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

15mL

20mEq/15mL

30 cups

60687-0341-58

10212031

5520416

3909884

584904

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

15mL

20mEq/15mL

40 cups

60687-0341-64

10191061

5486220

3263035

321570

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

15mL

20mEq/15mL

50 cups

60687-0341-71

10211557

5515713

3935137

575894

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

15mL

20mEq/15mL

80 cups

60687-0341-07

10212749

5521521

10191066

5487574

3266467

10214626

5525027

3944592

594978

10182932

5427489

3772381

231142

10182920

5427497

3772373

231159

Theophylline Oral Solution, USP

McKesson Morris & Item # Dickson #

Product Description

5517206

3795689

584466

5465380

3917226

363275

10211783

5517214

3901766

10183100

5430343

10210354

5512413

10209414

ABC 8-digit #

Cardinal Item #

10211921 10188404

591016

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

30mL

40mEq/30mL

40 cups

60687-0341-14

465344

Potassium Chloride Oral Solution, USP 10%

20mEq/15mL

30mL

40mEq/30mL

50 cups

60687-0341-72

Ranitidine Syrup (Ranitidine Oral Solution, USP)

15mg/mL

10mL

150mg/10mL

40 cups

Ranitidine Syrup (Ranitidine Oral Solution, USP)

15mg/mL

10mL

150mg/10mL

50 cups

60687-0260-23 60687-0260-69

80mg/15mL

15mL

80mg/15mL

50 cups

60687-0258-71

T10302 19.4

Hitting the Mark American Health Packaging is a leading manufacturer of serialized, barcoded unit dose products for hospital, institutional, and long-term care pharmacy.

americanhealthpackaging.com

|

800.707.4621

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

AHP Offers an Evolving Unit Dose Portfolio to Support Efficient Bedside Scanning The market leader in manufactured barcoded unit-dose oral solids to the health care marketplace, American Health Packaging provides nearly 500 oral solids and liquids products meeting the diverse needs of inpatient pharmacy.

President & CEO: Bruce Bennett Toll-Free Phone:

(800) 707-4621 Address: Columbus, OH 43217 Website: www.americanhealthpackaging.com

Company Background American Health Packaging (AHP) is a manufacturer of serialized, barcoded unit-dose drug products for hospital, institutional, and long-term care pharmacies. A subsidiary of AmerisourceBergen, AHP offers a broad portfolio of unit-dose oral solids and liquids to meet the dynamic needs of care facilities. We are the market leader in providing barcoded unit-dose oral solids to the health care marketplace with nearly 500 products available through partner GPOs and wholesalers.

Product Overview Unit-dose oral medications are AHP’s core focus. Barcoded to the dose level, AHP products support bedside point-of-care initiatives for dose-level scanning at the patient bedside. Providing broad access and consistent supply to products across major therapeutic classes, our products meet a diverse range of customer needs.

AHP product stability testing provides for the longest possible shelf life while maintaining high quality. Product safety is addressed with AHP labeling utilizing a boldened product code within the NDC, large product names, highlighted strength for improved recognition, and extra emphasis on warnings and additional formulary information.

With more than 30 years of history, AHP is a leader in unitdose manufacturing compliance. Products adhere to Bar Code Medication Administration (BCMA) initiatives and the Drug Supply Chain Security Act (DSCSA) law. AHP was the first unitdose manufacturer to fully implement serialization through our manufacturing process to support “track-and-trace” initiatives.

American Health Packaging’s manufacturing facility is registered with the Food and Drug Administration (FDA) and fully adheres to current Good Manufacturing Practices (cGMP). Industry veterans with decades of collective experience lead our quality and manufacturing departments. In addition, AHP is licensed by the Drug Enforcement Administration (DEA) to package Schedule II-IV controlled substances.

Liquid Unit Dose Cups AHP introduced Liquid Unit Dose cups in 2017, following customer requests to provide unit-dose oral solutions and suspensions with similar safety and efficiency benefits to our oral solids. Our line now includes 17 products, available in multiple pack sizes, through partner GPOs and wholesalers.

Liquid Unit Dose contains a broad range of products to support flexibility for pharmacies in managing local inventory. Products provide many features supporting patient safety and pharmacy efficiency. Pull-tab labels promote ease-of-opening and product administration, while thick-gauge cups with excellent label seal integrity aid in avoiding costly damage and clean up.

Hitting the Mark for Continued BCMA Support Safety and efficiency. Two things that are at the forefront of any health system professional’s mind. While your facility is trying to build a consistent and safe supply of unit-dose medications, stop and consider AHP’s line of manufactured barcoded unit-dose drug products – featuring the industry’s largest portfolio of unit-dose oral solids with more on the way.

Effective execution of BCMA programs require medications that scan correctly and efficiently at the bedside. With our robust oral solids portfolio – and growing offering of Liquid Unit Dose cups – AHP unit dose supports patient safety and pharmacy efficiency through consistent supply and a broad range of products. AHP unit dose supports health systems that seek to not only free up internal resources but also commit greater focus to patient care.

Make the smart choice with AHP to simplify what is one of the most complex tasks related to supporting inpatient care – providing quality medications that support dose-level bedside scanning. This while promoting positive outcomes for patients.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 65

Temperature consistency on every level

NEW Double door models follettice.com/double

Protect your valuable temperature-critical items with Follett’s industry-exclusive plenum air delivery system, which distributes air evenly at every level to keep the entire cabinet in-temperature.

See our full line at folletthealthcare.com or call 800.523.9361 for more information.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Take the Worry Out of Medication Storage With Follett's Refrigerators and Freezers When it comes to product temperature accuracy, there is no room for error.

Follett high-performance refrigerators provide precise temperature control for your valuable medications.

President:

Korey Kohl Founded: 1948 Employees: 500+ Toll-Free Phone: (800) 523-9361 Phone: (610) 252-7301 Fax: (610) 250-0169 Address: 801 Church Lane Easton, PA 18040 Website: www.follettpharmacy.com

Company Background

Follett LLC is a leading manufacturer of innovative equipment for the healthcare market, including medical-grade refrigerators and freezers, ice and water dispensing equipment, and ice machines.

Our focus on 100% customer satisfaction results in equipment that provides outstanding innovation and design excellence to meet the specific needs of each healthcare facility.

Product Overview

Follett medical-grade pharmacy refrigerators and freezers maintain precise and consistent temperatures for your valuable medications and vaccines. Powerful forced air refrigeration enables quick recovery after door openings, ensuring medications are stored at specified temperatures and reducing the risk of lost product. n Follett upright refrigerators and freezers feature a powerful topmounted refrigeration module and innovative plenum air distribution systems for superior temperature consistency.

• Industry-exclusive ducted air distribution delivers cold air at six different levels for top-to-bottom temperature uniformity, allowing full utilization of the storage space.

• Modular refrigeration system with microprocessor controller provides a ±1⁰C temperature consistency throughout the storage cabinet, ensuring all product is stored within the proper range.

• Intuitive, full-color touchscreen user interface features enhanced data management, providing the ultimate in user convenience.

n Choice of storage options provide interior configuration flexibility.

• Industry-exclusive “floating” basket system on pharmacy models.

• Full extension, epoxy-coated “floating” baskets move with a gentle push or pull.

• Baskets and slide assemblies lift out without tools for full cleaning access.

• Heavy-duty, epoxy-coated shelves, adjustable in ½" (1 cm) increments are standard on laboratory models. n Follett’s innovative modular refrigeration system provides outstanding serviceability.

• Top-mounted modular design allows the refrigeration system to be removed as one unit without cutting refrigerant lines. If needed, a spare system can slide into place, virtually eliminating downtime. n High-performance countertop refrigerators and freezers offer superior temperature performance in space-saving configurations.

• 1 and 2 cu ft models fit on standard 24" deep counters.

• Forced-air cooling provides cabinet-wide temperature consistency and quick recovery after door openings.

• External digital temperature display offers user-selectable F or C with integral high/low alarming and display sleep mode.

• Keyless entry via keypad and electronic lock is available as an option. n Powerful undercounter refrigerators and freezers are designed for use below standard and lower ADA-compatible counters.

• Heavy-duty forced air cooling for quick recovery after door openings.

• External digital temperature display in user-selectable F or C with integral high/low alarming and display sleep mode.

• Keyless entry via keypad and electronic lock option.

Contact Information

For more information, contact Follett LLC at (800) 523-9361 or visit www.follettpharmacy.com.

Follett is a registered trademark of Follett LLC, registered in the U.S.

n Full stainless steel cabinets and high-quality components are designed with the user in mind.

• Heavy-duty, self-closing doors provide important energy savings and locks open at 90 degrees to allow easy product loading.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 67

CASE STUDY Environmental Monitoring Matters: Going Beyond the USP <797> Standard

Erin Patton Senior Product Specialist ~ Charles River St. Louis, Missouri

Erin received her Bachelor of Science degree in biology from Xavier University and her Master of Science degree in cell and molecular biology from the University of Illinois, Urbana-Champaign. Erin has over 15 years’ experience in molecular biology research, microbiology QC, and regulatory compliance. As a Senior Product Specialist for Charles River’s Microbial Solutions division, Erin provides innovative rapid micro solutions for endotoxin testing, microbial identification, and microbial detection (Celsis® rapid bioburden and sterility testing).

68

www.criver.com

PRIMARY INTENDED OUTCOME Compounded sterile products (CSPs) are individually made medications that are administered via injection, and include vaccines and epidural anesthesia.

Chapter <797> of the United States Pharmacopeia (USP) outlines the facility and operational requirements for compounding sterile drugs and specifically calls for the collection and monitoring of environmental data through air and surface sampling. These standards aim to ensure patient safety and reduce the real risks of contamination, infection, or incorrect dosing.

Charles River provides a range of environmental and product sterility testing that meets and exceeds compliance with USP regulations. Their laboratory services support drug manufacturing, monitoring, and testing, and can be tailored to a facility’s specific needs to ensure patient safety.

THE CHALLENGE Drug compounding creates relatively small batches of medications that are tailored to the needs of special populations, including patients with allergies or those who require nonstandard doses, such as children or the elderly. The compounding process is carried out under the oversight of state pharmacy boards, and enforcement of standards differs from state to state. Importantly, some compounded drugs are not regulated by the United States Food and Drug Administration for safety, effectiveness, or manufacturing quality. Serious adverse events have occurred, including a fungal meningitis outbreak in 2012, which was caused by a contaminated injectable drug. The facility that manufactured the drug was not in compliance with USP guidelines.

CASE STUDY

“

If you are not doing enough sampling, there is not enough granularity to tell the whole story of your facility.”

Erin Patton Senior Product Specialist ~ Charles River St. Louis, Missouri

“Sterility testing of finished drug products is important but is not sufficient to completely ensure patient safety”, says Erin Patton, Senior Product Specialist at Charles River. “Final product sterility testing uses such a small sample that, statistically, the product would have to be grossly contaminated to fail. Our model is process testing, which includes the facility, the ingredients, and the operators, even in products that pass sterility testing. This is a better way to ensure quality and safety of compounded drugs.”

USP <797> is currently in an extended revision process. The updated standard is expected to be published on June 1, 2019 and will become official on December 1, 2019.

THE DECISION Environmental monitoring involves collection of numerous facility surface and air samples and analysis of resulting sample data relating to enumeration and identification of flora captured during sampling. It measures the microbiological cleanliness of a drug-production process, documents the state of control of the facility, and, ideally, exposes any trends in loss of control that could lead to contamination. This level of data collection is a powerful tool that can provide early warning of serious issues, but only if used optimally. One of Patton’s concerns is the currently required frequency of monitoring.

“Right now, for surface sampling in hoods or compounding areas, the proposed USP <797> draft requirement is only one time per month,” Patton said. “This is just not enough. The key to sampling and identification is to look at the data to understand the story they tell. Monitoring once a month only provides a snapshot.”

Similarly, Patton believes the required level of microbial identification called for by the existing draft standard needs to be more specific. “If an investigation is required, the guidelines currently say you must identify the microbe to the genus level,” Patton said. “This is not good enough. We test to the species level. You can know the general group of bugs, but sometimes you find a genus that contains both routine microbes and problematic ones.” Without species-level testing, a facility may unnecessarily decide to destroy an entire lot of expensive drugs or – worse – take a risk with patient safety.

www.criver.com

69

CASE STUDY ESTABLISH ALERT LIMITS The existing version of USP <797> contains tables that provide what are called “action limits,” specifying the number of colony-forming units (CFUs) that indicate the acceptable cleanliness of a space. If a sample is found to exceed those limits, a facility is required to conduct an investigation.

“You don't have to wait until things get to that level,” Patton said. “You can take action sooner than that.” Many companies set their own “alert limits” that fall below action limits. “Say an action limit is 10 CFUs,” Patton said. “Many would establish an alert limit of 5 CFUs, which essentially gives the opportunity to catch a problem well before it starts.”

THE RESULTS Charles River offers a number of testing services that evaluate a facility’s entire environmental picture. “We always promote that it is better to have data from multiple perspectives – the room, the ingredients, the operator,” Patton said.

“If you are not doing enough sampling, there is not enough granularity to tell the whole story of your facility.”

The USP <797> requirements also apply to storage and testing of finished drug preparations. If a product fails a final sterility test, there is an obligation to test further and identify the contaminating organism. Additional testing can be timeconsuming and may pose a financial burden for compounders.

Charles River’s MALDI-TOF testing provides microbial identification results efficiently and affordably. “This is one of the biggest ways we support our customers,” Patton said. “We make this new technology affordable and accessible to compounders so that they may do more critical environmental monitoring work while keeping within the same budget.”

Rapid sterility testing is available through Charles River’s Celsis® line, which delivers bioburden testing results in 18 to 24 hours and sterility testing results in four to six days. These shorter turnaround times are beneficial in final product testing, but are also an advantage in process testing. “It can be frustrating to take the time to test raw materials before you even start compounding,” Patton said. “Our Celsis® instruments allow faster, confident testing along the way.”

THE CONCLUSION When environmental data are tracked and reviewed regularly, negative trends can be identified early and contamination can be caught and reversed before a problem occurs. Proposed revisions to the USP <797> standards place a greater emphasis on the requirement for conducting investigations and implementing corrective actions, but may still fall short of optimal procedures.

Going beyond minimum recommendations for in-process testing is the best way to protect patient safety from the start. “Compounders are so close to the patient.

I feel very passionately about improved testing beyond the standard,” Patton said.

“I believe it will make a difference to patients and can help a compounding facility stand out from the competition.”

70

www.criver.com

Compounding Solutions for Compounding Problems.

With compounding pharmacy regulations under scrutiny,

Offering unmatched regulatory expertise and a portfolio

compliance has never been more important. Maintain

of FDA-licensed products and GMP-compliant services,

control and consistency in your compounding procedures

Charles River is the trusted partner who can help you

with solutions from Charles River.

align your operations with current regulatory standards.

Endotoxin Testing | Microbial Identification for Environmental Monitoring Programs | Sterility Testing | Microbial Limits Testing

Learn more at www.criver.com/compounding 71

www.iso-med.com

CleanRoom/Medical Supplies CLEANROOM

MEDICAL SUPPLIES

ADHESIVE MATS

STERILE CHEMO GOWNS

ADHESIVE TAPES

STERILE SLEEVE SYSTEM

CLEANROOM APPAREL

STERILE CHEMO GLOVES

CLEANROOM LABELS

STERILE CHEMO PREP MATS

CLEANROOM PAPER

STERILE COMPOUNDING SUPPLIES

CLEANROOM SWABS

STERILE 70% ISOPROPYL ALCOHOL

DISINFECTANTS & CLEANERS

TESTING SUPPLIES

MOPPING SYSTEMS

WIPERS

Call for fast reordering:

800-797-1405

1220 Graphite Drive, Corona, CA 92881 USA | 800-797-1405 | sales@iso-med.com

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

ISO-MED, INC. – Your One-Stop Solution for USP Compliant Medical and Cleanroom Supplies Providing an unparalleled selection of specialized products, globally trusted quality and service, and delivery convenience for meeting USP <797> and USP <800> standards.

President:

Additional Product Lines

David Lowrie

Founded: 2010 Toll-Free Phone:

(800) 797-1405 Fax: (951) 547-1681 Address: 1220 Graphite Drive Corona, CA 92881 Website: www.iso-med.com

Company Background

Since 2011, ISO-MED, Inc., a medical supply distributor, has been supplying quality products for pharmacy cleanrooms and other medical industries in the United States. Providing high-grade supplies for cleanrooms, laboratories, homecare, and more, we are dedicated to achieving and maintaining compliant sterile compounding environments.

Product Overview

ISO-MED’s brand of products are manufactured at the highest-quality levels and meet or exceed USP <797> and USP <800> standards for labs, compounding pharmacies, homecare, and more. Providing an unrivaled level of customer service and delivery convenience, we offer highly cost-effective purchasing options for all our valued customers!

Whether solutions are needed for the pharmacy cleanroom environment, laboratory, or homecare, ISO-MED is known for developing and distributing superior products that meet or exceed USP <800> compliance. As a leading manufacturer in this industry, we are driven to help healthcare-oriented organizations save money.

USP <800> Compliant Cleanroom Products

Our USP <800> compliant, innovative cleanroom products include: • Adhesive Mats • Adhesive Tapes • Cleanroom Apparel (Both Sterile and Non-Sterile Disposable) for Compounding Hazardous Drugs

• Cleanroom Labels • Cleanroom Paper • Cleanroom Swaps • Disinfectants and Cleaners • Mopping Systems

USP <800> Medical Supplies

Our USP <800> compliant, innovative medical supplies include: • Sterile Chemo Gowns • Sterile Sleeve System • Sterile Chemo Gloves • Sterile Chemo Prep-Mats

• Sterile Compounding Supplies • Sterile 70% Isopropyl Alcohol • Testing Supplies • Wipers

• Akro-Mils Storage Bins • Bottles and Adapters • ChemoChek Refill Kits • Chemo Preparation, Administration, Safety Spill and Technique Testing Kits

• Chemo Spill Absorbent Pads and Prep Mats • Cleanroom Wipes • Disinfectants • Gamma Irradiatable Goggles • Healthcare Plastic Bags • Malt Extract Agar • Medi-Cup Blisters: Accommodates Virtually any Medication or Storage System

• Non-Sterile Disposable Apparel for Compounding Hazardous Drugs • Non-Sterile Chemo Gloves • Pharmacy Bins, Labels, and Supplies • Pill Crushers and Splitters • Proximal and Distal Luer Lock Connections • Respirators • SafeChemo Analysis HD’s • Safety, Sharps, and Biohazard Containers • Shoe Inn – Automatic Bootie • Skin and Wound Care • Sterile and Non-Sterile Gloves • Sterile Apparel for Beards, Heads, Faces, Sleeves, Feet, and Entire Body Wear

• Sterile Isopropyl Alcohol • Syringes • Tackey Mats • Tamper Evident Locks and Tape • Unit-Dose Packaging: Tamper-Evident, Bar Code Ready, Inhibits Ultraviolet, and Resists Moisture

• Wipe Sampling and Analysis Kits

Markets Served • Hospital • Compounding

• Infusion • Retail

Ordering Information

Contact us by phone at (800) 797-1405 or email sales@iso-med.com to gain access to our exclusive online ordering platform.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 73

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Q.I. Medical, Inc.™ Your Partner in USP <797> Pharmacy Compliance Providing quality assurance products to hospitals and pharmacies practicing sterile compounding, with a singular focus on pharmacy compliance. Our long-standing regional distribution partners are able to provide exceptional in-person service and training.

President & CEO: Brady K. Schwarz Founded: 1992 Toll-Free Phone:

(800) 837-8361 Phone: (530) 272-8700 Fax: (530) 272-8702 Address: 1415 Whispering Pines Lane, Suite 150 Grass Valley, CA 95945 Website: www.qimedical.com

Company Background Q.I. Medical, Inc. was founded in 1992 with a focus on providing the sterile compounding industry with testing kits and products to assure proper technique and quality is maintained in their facility.

We have a broad network of distribution partners throughout North America, Canada, and other international markets. These distribution partners provide in-person servicing and education to accounts to comply with USP guidelines.

Additional Product Lines Additional products are available for validation of hazardous drug handling, automated compounder manipulation validation, filter integrity testing, and vial adaptors.

Support equipment includes: • Incubators • Sterile Filters • Vial Blocks • UV Lights

Ordering Information

To learn more about how Q.I. Medical, Inc. can help your facility, please contact us at (800) 837-8361 or email info@qimedical.com.

Product Overview Our cost-effective, disposable products are available for various needs in the compounding pharmacy. Aseptic technique validation kits are available for low, medium, and high-risk settings. We also sell multiple ala carte sizes of vials, bags, tubes, and syringes of growth media for facilities looking to create a custom media fill test that mimics their day-to-day practice.

In regard to environmental monitoring/gloved fingertip sampling, our EnviroTest™ paddle is ideal for both. The rectangle shape and built in hinge allow for testing critical areas such as edges and corners of a hood and behind latch handles. Sterility testing products are available in both USP 71 approved methods of testing. For the full filtration method, the QT Micro™ and QT Junior™ systems work for both small and large volume solutions.

For the direct inoculation methods, our TuffTest 2™ product is ideal.

All Q.I. Medical growth media is challenged with a battery of USP specified organisms and lot specific Certificate of Analysis (CofA) are available for download.

All products are sold through regional stocking distributors in order to provide fast local service and support.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 75

Closed-System Transfer Devices (CSTDs) A comparison of CSTD manufacturers.

Is your pharmacy considering the implementation of CSTDs in 2019?

The following comparison matrix was developed as a complimentary service for

References https://www.businesswire.com/news/home/20180111005529/en/Baxter-Launches-ArisureClosed-System-Transfer-Device http://www.icumed.com/products/oncology/hazardous-drug-closed-systems-and-cstds/ chemolock.aspx http://www.equashield.com/wp-content/uploads/2015/12/021-Equashield-Closed-SystemTransfer-Device-CSTD.pdf https://corvidamedical.com/about-new-cstd-halo/product-components/closed-syringeadaptor/ https://www.bbraunusa.com/en/products/b/onguard-closed-systemtransferdevicecstd.html

anyone in the beginning stages of research.

http://yukonmedical.com/products/arisure-closed-system-transfer-device/

Due to <USP 800> becoming enforceable

https://www.cdc.gov/niosh/docket/review/docket288a/pdfs/ aperformancetestprotocolforclosedsystemtransferdevices.pdf

in December 2019, CSTDs will be required

https://www.ncbi.nlm.nih.gov/pubmed/?term=Comparison+of+closed+system+transfer +devices+for+turnaround+time+and+ease+of+use

for hazardous drug administration and

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938267/

recommended for hazardous drug preparation.

http://www.ajhp.org/content/70/7/619.long

Contributor Melanie Gaspar PharmD Candidate 2019 MCPHS University

76

DEVICE NAME

MANUF.

YEARS ON MARKET

ONB 510(K) CLEARANCE

DIFFERENTIATION

PROS

NEEDLE-FREE VS. NEEDLE-SAFE

CONNECTION MECHANISM

OnGuard®

B. Braun

12

Yes

Every component creates an audible "click" sound when attached correctly.

Can use with any standard Luerlock syringe.

Needle-safe (needle within system).

Click-to-lock

PhaSeal®

BD

20

Yes

First CSTD cleared under ONB product code.

First completely sealed drug delivery system.

Mechanically prohibits the escape of hazardous drug, vapor, or aerosols. Ensures leakproof drug transfer thanks to elastomeric, double membranes; has a sealed expansion chamber that captures and retains hazardous drugs.

Published worldwide. Meets both the NIOSH and ISOPP definitions of a CSTD. Leakproof and airtight. Can use with any standard Luer-lock syringe. Helps improve turnaround time of hazardous drug preparation and has integrated sets.

Needle-safe (needle within system and vial spike).

Push-turn-push

Texium®

BD

13

No

For Alaris™ pump customers, the Texium system components can be integrated into the administration sets to aid in workflow and prevent accidental disconnections to the infusion line.

Utilizes mechanical valve technology to protect healthcare workers and patients.

It features a needle-free Luer-lock connection on all vial adapters, the option for bonded syringes and the SmartSite™ needle-free connector for nursing. When paired with SmartSite™, they provide a leakfree, drip-free connection and disconnection.

Needle-free

Luer-lock

Corvida Medical

3.5

Yes

Only CSTD without an internal or external vent, valve, or filter, which maximizes drug extraction using six simple pieces. Designed especially to protect the healthcare worker.

Up to 14 connections.

Air-tight and leak-proof.

Single center puncture Vial Adapter.

Ergonomic design to reduce repetitive stress injuries. Secured connections.

Needle-safe

Push together, pull apart. Larger ergonomic touch points.

Equashield II®

Equashield

9

Yes

Fully encapsulated syringe barrel serving as a pressure equalization chamber, preventing plunger rod contamination and preventing accidental removal of plunger from the back of the syringe.

Needle-safe, easy to connect (push), fully encapsulated system to prevent spills; plastic spike for device to vial.

Needle-safe (dual syringe component that pierces vial with each connection).

Red to red alignment and click-to-lock in nursing.

ChemoClave®

ICU Medical

11

Yes

Needle-free and easy-to-use. Requires no assembly of components at the bedside and includes bonded and locking mechanisms that ensure compliance. For example the secondary administration sets incorporate the CSTD bonded to the set to create a non-removable connection to prevent accidental disconnect.

System offers vial spikes with the barrier containment and aircleansing/vented containment and bag spikes that allow pharmacy to safely prepare hazardous drugs without priming lines.

Needle-free

Luer-lock

ChemoLock®

ICU Medical

5

Yes

First needle-free CSTD to receive FDA clearance.

A system with a wider fluid path that requires less push-pull forces than needle CSTD systems.

Does not increase the risk of repetitive stress injuries.

Offers both barrier technology and air-cleansing technology. Has a single-motion click-to-lock design that requires no lining up and is easy-to-use.

Needle-free

Click-to-lock, that requires no lining up.

Yukon Medical

1

No

Features an intravenous dry spike that helps provide closed access to an IV bag for addition and removal of a drug or solution. No need to inject air into the vial.

Uses a physical barrier for containment. Low attachment force eases strain during vial insertion. High flow rate allows for easy drug extraction.

Needle-free

Luer-lock

Halo®

Arisure®

77

FOR PHARMACIES

Automated, affordable solutions for real-time temperature monitoring Manually monitoring temperature can be time consuming and expensive—not to mention prone to error.

Temperature Intelligence®

The EDGE family of wireless sensors and apps are designed specifically to help pharmacies:

• Remotely monitor medication storage 24/7 • Automate processes to improve accuracy • Get real-time notification of temperature excursions • Record and store data to meet pharmacy board requirements You’ll not only reduce operating costs, you’ll ensure the efficacy of the medications you dispense to patients.

Tap into the future of temperature monitoring at temptimecorp.com/edge A Zebra Technologies Company

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Temptime – Temperature Monitoring Solutions for Medication Shipments, Storage, and Pharmacy Facilities Providing the tools and knowledge to accurately monitor temperature sensitive medications, ensuring that they have not been exposed to temperature events that could impact their effectiveness in treating patients.

President & CEO: Renaat Van den Hooff Founded: 1987 Employees: 80 Phone:

(973) 630-6000 (973) 630-6100 Address: 116 The American Road Morris Plains, NJ 07950 Website: www.temptimecorp.com Fax:

Company Background

Founded in 1987, Temptime scientists developed the first miniaturized technology to monitor time-temperature exposure of vials containing the oral polio vaccine. Our commitment to public health is reflected in our dedication to being on the leading edge of understanding pharmacy needs, and bringing new and patient-centric temperature monitoring solutions both to the pharmacy operation and into the patient’s home.

Product Overview

Temptime has been improving global health with its range of temperature indicators and monitoring devices for over 30 years. By reducing the risk and costs associated with unpredictable temperature events in production, storage, and shipment – Temptime helps specialty pharmacies save money and increase patient confidence in medications delivered.

Our products include: • Low cost, chemically-based heat indicators and freeze indicators for application to temperature sensitive medication and biologicals.

• Heat and freeze shipment indicators for medications.

• Electronic EDGE® wireless temperature and humidity sensing systems with cloud-based data storage and sharing.

• View and share temperature data using the free EDGEVue® mobile app.

• Customize alarm limits, datalogging intervals, startup options, and more.

• Store unlimited data on EDGECloud® and generate reports through the EDGEVue® web application.

EDGE® PQ Performance Qualification Testing

As a specialty pharmacy, you already know the importance of performance qualification (PQ) testing. For one thing, it ensures that the critical and often lifesaving medications you send to patients have not been exposed to unsafe temperatures that could impact their effectiveness. It’s also required for certain pharmacy accreditations and participation in some pharmacy networks.

Temptime’s EDGE devices help specialty pharmacies simplify performance qualification (PQ) testing to optimize pack-outs and satisfy accreditation requirements. Since some pharmacy networks are making third-party validation testing a condition of participation – Temptime also offers Third-Party PQ Testing Services.

TransTracker® Shipment Indicators

TransTracker® visual temperature indicators monitor medication heat and freeze exposures during shipment and storage. Simple to read and understand, patients can easily see if medications have been exposed to extreme temperatures – cutting down on unnecessary reshipments due to suspected temperature damage. These cost-effective, single-use indicators also help with state regulation compliance.

EDGE® Wireless Sensing Systems

The EDGE family of wireless Bluetooth®-enabled sensors monitor and record temperature data 24/7.

EDGE W-200 wireless facility monitoring system monitors both temperature and humidity in medication storage areas, helping you comply with accreditation and regulatory requirements. Data can be viewed remotely using our web-based application EDGEConnect® and customizable alerts tell you instantly if any areas exceed your limits.

EDGE M-300 and EDGE S-400 programmable data loggers are ideal for monitoring temperatures during transport or storage with the ability to:

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 79

503

We’re like an elevator.

We eliminate steps for pharmacists.

Less steps means our product is easier and faster to use. Yet, provides safety and accuracy to make your processes more effective and efficient. Pentec’s 503B combines validated automation and process quality controls to make concentrated, single-dose products you can trust. We offer the peace of mind of a manufacturer with the efficiency of an outsourcing provider – enabling safe accurate medication, when it’s needed, where it’s needed, the way it’s needed. Less waste means greater value. To learn more please visit pentechealth.com.

www.pentechealth.com *

TM

*

*Must be further diluted.

2 0WAY S TO I M P R O V E PAT I E N T C A R E & P H A R M A C Y C O S T C O N TA I N M E N T

Snap-N-Go® and Dilute-N-Go® From Pentec Health Speed and Simplify In-House Compounding We deliver the efficiency and safety of single-dose medications with the automation of critical processes and the quality controls of pharmaceutical manufacturers. This means minimizing waste, maximizing time and inventory, and the ability to deliver precise medications on demand.

President & CEO:

Joe Cosgrove Founded: 1983 Employees: 600+ Toll-Free Phone: (800) 223-4376 Address: 9 Creek Parkway Boothwyn, PA 19061 Website: www.pentechealth.com

Company Background Pentec Health’s 503B sterile compounding division combines validated automation and process quality controls to make concentrated, single-dose products you can trust. We offer the peace of mind of a manufacturer with the efficiency of an outsourcing provider – enabling safe, accurate medication, when it’s needed, where it’s needed, the way it’s needed. Less waste means greater value. Our dedication to quality and patient safety spans over 35 years in the patient-specific space as a leading provider of renal nutrition for dialysis patients and intrathecal pump management for those with chronic pain or spasticity.

Our exceptional service in these industries naturally expanded into non-patient-specific compounding as the need for a trusted, innovative provider in this area became more apparent.

Product Overview Our Snap-N-Go® and Dilute-N-Go® products reduce the time it takes for pharmacists, technicians, and nurses to internally compound and administer drugs by reducing the majority of manual error-prone steps. Pentec Health’s sterile compounding solutions enable hospital pharmacies to combine the control of insourcing with the flexibility of outsourcing. Snap-N-Go and Dilute-N-Go make compounding safer, faster, and more precise while helping pharmacy and nursing staffs maintain control of patient administered medications.

Product Specifications Snap-N-Go and Dilute-N-Go products are concentrated, sterile solutions that come in single-dose vials or syringes, respectively.

When introduced into a diluent bag of choice, each vial or syringe delivers a precise dose or desired concentration that is not available commercially. In the forward positions, Snap-N-Go vials can be stored in automated dispensing machines (ADMs) for rapid retrieval, dose-tracking, and subsequent administration

to a patient by a nurse utilizing a standard vial-to-bag adaptor/ activation process. For added safety, each Snap-N-Go vial and Dilute-N-Go syringe is barcoded and includes GS1 barcode for track and trace capabilities and TALLman lettering to distinguish sound-alike, look-alike drugs from one another to prevent medication errors. Multiple safety warnings indicating the need for dilution are included on packaging and safety seals placed over each Dilute-N-Go syringe cap. Additionally, we proactively provide a Certificate of Analysis and Certificate of Conformity detailing each product’s purity, potency, sterility, and stability upon receipt of the product.

Testimonials “ Pentec offers the same benefits of buying from manufacturer, but in singledose solutions. It’s pretty powerful. I had never seen anything like that.” ­— Staff Pharmacist, Southeast U.S.

“ Pentec having the product in stock allows our pharmacy to go from the villain to the hero.”

— Pharmacy Director, Northwest U.S.

“ Pentec Health meets a lot of my needs, providing a reliable and safe product.”

— Pharmacy Director, Northeast U.S.

Awards & Recognition Snap-N-Go and Dilute-N-Go have received the following accolades: • Winner 2016: Marcum – Innovator of the Year • Finalist 2017: Health Trust Innovation Summit – Innovation of the Year • Finalist 2018: Process Excellence Network Awards – Best Project Contributing to Customer Excellence • Finalist 2018 and Nominee 2017: Premier GPO – Innovation of the Year GPO Affiliations We currently have GPO contracts with Intalere, ROi, and PDM Healthcare and are working with others to finalize contracts.

Ordering Information (866) 956-4376 | www.pentechealth.com SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 81

CASE STUDY

Case Study: Achieving Continuous Readiness for USP <797> and <800> for a Large Hospital System Regulatory bodies are paying increasing attention to hospital and health system pharmacies regarding sterile medication compounding. Enforcement of USP <797> and <800> revisions and regulations are slated to take effect on December 1, 2019, increasing pressure to be in compliance.

Topic Facility Requirements

Category 1 & Category 2 Compounded Sterile Products (CSPs)

Microbial Air and Surface Monitoring

Minimum Personnel Requirements

Proposed Changes To USP <797> Effective 12/1/19* Only Category 1 CSPs (with limited BUD) can be compounded if PEC is in an unclassified SCA/C-SCA. This includes RABs (i.e. CAI and CACI).

•

Replaces Low-, Medium- and High-Risk classifications

•

Category 1 – Compounded in a SCA

•

ü

BUD 12-hour room temperature/24-hours refrigerated

ü

Examples: LAFW, BSC including CAI or CACI located in a SCA or C-SCA

Category 2 – Must be compounded in a cleanroom suite ü

ISO classified area, not a SCA/C-SCA

ü

May assign full BUD

•

Viable Air Sampling: Every 6 months

•

Viable Surface Sampling: Monthly

•

Media Fill: Every 6 months

•

Gloved Fingertip Testing (GFT): Every 6 months ü

Must be completed in conjunction with media fill testing

ü

Observed hand hygiene/garbing competency assessment: Every 6 months

*Note: these are not final and may change before December 1

In preparation for the December 1 deadline, a hospital system chief pharmacy officer, who previously partnered with Comprehensive Pharmacy Services (CPS), brought CPS in to do an initial assessment and evaluate USP <797> and <800> compliance across ten pharmacies in hospitals and infusion centers across a large hospital system.

82

CASE STUDY

PHASE 1: Assessment CPS assigned a sterile compounding expert to spend one day at each of the ten sites reviewing USP <797> and <800> standards in the following areas: •

Physical plant and equipment

•

Work practices

•

Competencies and training

•

Environmental monitoring

•

Quality assurance activities and documentation

Because CPS sterile compounding experts are pharmacists who have worked in hospital and health system pharmacies, they take a holistic approach to the issues that directors of pharmacies and their staff face. The director of pharmacy can assign a staff pharmacist or lead technician to liaison with the CPS sterile compounding expert.

“Because we’ve done so many of these assessments in so many hospitals and large health systems, we’ve become very proficient and can get information very quickly.

In addition, we take a non-invasive and collaborative approach to conducting assessments that minimally interrupts the work flow, while being educational to staff,” said Chris Beebe, Division Vice President, Medication Safety for CPS. Following the assessments, each site received a full report and action plan that identified areas of non-compliance or partial compliance along with strategies to correct those areas.

PHASE 2: Continuous Readiness Implementation The action plans identified multiple opportunities for improvement and standardization across the ten sites. The chief pharmacy officer recognized the need for a single point of contact to coordinate implementing the recommended changes and standardization across the hospitals and infusion centers and selected the CPS expert to function as that single point of contact.

The implementation phase is currently an ongoing effort encompassing three years in order to ensure compliance to meet the December 1 deadline and beyond. During the implementation phase, the CPS sterile compounding expert is on-site three days every month to: •

Track progress on the action plan at each location

•

Work with corporate pharmacy leadership to implement standardization throughout the hospital system

•

Interface with architects and engineers tasked with building new pharmacies and/ or making changes to existing pharmacies to ensure that the construction of physical space is in compliance with USP standards

To standardize processes, the CPS expert works with system departments: •

Environmental services and housekeeping leadership to implement a standardized IV room cleaning program across the enterprise

•

Infection prevention department to standardize environmental monitoring program

•

Regulatory affairs department to assist with survey preparedness related to USP

•

Education department to standardize pharmacy competency training

83

CASE STUDY The CPS sterile compounding expert also leads the system hazardous drug task force to implement strategies related to USP <800> compliance covering assessment of risk, preparation and administration of hazardous drugs, and education of all staff involved in the process.

The CPS expert is on tap for support if the system has an accreditation survey issue related to USP during the continuous readiness engagement. By participating in the continuous readiness program, the system also has access to the CPS sterile compounding toolkit which typically is only available to CPS managed sites.

“Our toolkit includes a standardized assessment of risk for hazardous drugs on a hospital’s formulary,” said Beebe. “It’s an important tool for hospitals and was developed to be a comprehensive yet straightforward method to assess, document, and communicate the containment strategies a hospital will employ for these drugs.”

CONCLUSION Following the initial sterile compounding assessments and ongoing continuous readiness process including implementation of the action plans, subsequent regulatory surveys at system sites resulted in no USP-related findings.

Subsequent Regulatory Surveys Revealed No USP-Related Findings As the USP enforcement date approaches, hospitals and health systems must prepare to ensure that they are as compliant as possible. CPS brings a breadth of experience in hospitals of all types and sizes. Because they understand what surveyors are looking for, they have the expertise to set client hospitals and health systems up with a continuous readiness program that ensures their success.

ABOUT COMPREHENSIVE PHARMACY SERVICES Founded nearly 50 years ago and employing over 2,500 pharmacy professionals, Comprehensive Pharmacy Services is the nation’s largest provider of pharmacy services to more than 800 hospitals and healthcare facilities nationwide. CPS helps their clients tackle complex problems such as hyperinflated drug costs, specialty pharmacy, ambulatory/ retail strategy, operational effectiveness, and staffing efficiency. In addition, they address 340B programs, a variety of compliance concerns, and much more. CPS helps pharmacy leaders drive cost, quality, and safety improvements across the continuum of care. For more information about CPS, visit cpspharm.com.

800.968.6962 | contactus@cpspharm.com | cpspharm.com 84

The Deadline Will Be Here Before You Know It!

Is your Compounding Pharmacy ready for USP <800> Compliance?

For hospitals and health systems handling hazardous drugs, it’s critical to adopt the new USP <800> standards early.

Comprehensive Pharmacy Services partners with pharmacy leaders to: •

Evaluate hazardous drugs safety practices with complete site assessment

•

Develop procedures for compliance

•

Manage compounding operations and workflow

•

Educate staff on safety and compliance related to hazardous drugs

The time is now. CPS is ready to help bring your pharmacy operations into regulatory compliance.

FIND OUT HOW CPS CAN HELP YOU WITH USP <800> COMPLIANCE: contactus@cpspharm.com | 800.968.6962

P H A R M A C Y Job Opportunities

Get all of your pharmacy staffing needs filled by the pharmacy experts.

RPh on the Go has more than 33 years of experience delivering premier temporary and permanent pharmacists to facilities throughout the country.

JOIN THE TEAM THAT IS THE MOST TRUSTED PARTNER

To More Than 800 Hospitals.

We place talented temporary and direct hire pharmacists across all pharmacy specialties. To start your search, contact us today.

800.553.7359 • www.rphonthego.com

We are considered one of the most trusted partners in the industry, to hundreds of hospital pharmacies and health systems across the country. We provide tier-one analytics, robust technology solutions and deep expertise to every client we serve. For our team, we deliver unparalleled best practices, competitive benefits and continuing education, giving us all the superpowers we need to help our clients succeed.

Join the CPS team and specialize in operations, clinical, regulatory, safety, purchasing, 340B, antimicrobial and more. Find available positions at jobs.cpspharm.com today.

Virtual Job EXPO 800.968.6962 contactus@cpspharm.com | cpspharm.com

With more than 350,000 annual visitors, the Virtual Pharmacy Job EXPO is the perfect resource for employers to post career opportunities, brand their organizations, and connect with pharmacy professionals. For details, contact our sales team at sales@RXinsider.com or 800.972.2083. © 2019 RXinsider LTD. All rights reserved.

01982_CPS_Rx_Insider_1/2_Page_Final.indd 1

86

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N

4/30/19 5:17 PM

RXinsider.com

P H A R M A C Y Job Opportunities

• • • • •

Get the Most Out of Your Case Study

Case Study Antibiotic Drug als Steps Antimicrobial/ Prescribing Impact Reve itals on Antibiotic Over-

C A S E S T U DY

11.4% Study of 180 U.S. Hosp use and Reduce Use by to Combat Antibiotic Over U.S. Hospitals Can Take

THE CHALLENGE:

Polk’s Drugs transitions to next generation of pharmacy management with the help of QS/1®

CA20-5 SE0%STUDY

s Control e of medicine, the Center The Centers for Disease transformed the practic ics warn that Though antibiotics have that 20-50% of all antibiot and Prevention (CDC) Prevention (CDC) warn or inappropriate. for Disease Control and ls are either unnecessary hospita care acute ic antibiot prescribed in U.S. the growing problem of 1 ics has contributed to public health.

The misuse of antibiot threats Polk’s seriousDrugs ALL inANTIBIOTICS is to a small chain of pharmacies OFbased become one of the most organisms resistance, which has antibiotic-resis Mississippi.

The tant Ocean Springs store, which CRIBED IN U.S. people are infected with opened PRES ly.2 According to More than two million annual deaths about a ls are year 23,000 ago, is unique in that it also includes approximately acute care a hospita threatens the ce each year, resulting in resistan robial gas station. ation (WHO), antimic either unnecessary of infections the World Health Organiz range g creasin treatment of an ever-in or inappropriate.

3 effective prevention and For manager Jesse Murphy, PharmD, choosing es, viruses and fungi. caused by bacteria, parasit the right technology was ement crucial to ensuring his a new Medication Manag Commission publishedpharmacy not only opened with, a strong start, In response, the Joint ls and nursing care centers ls, critical access hospita but continued reduce toneed growto and operate as efficiently (MM) standard for hospita sizing the e Januar y 1, 2017, empha as possible. g requirin and s, which became effectiv setting robials in all health care on based is use of inappropriate antimic that dship program antimicrobial stewar“Our Atoward greatest concerns as we look large the hospitals to have an healt future d with 4 areh infecte system re. literatu ic are looking for ways to improve our gains valua current scientif ph profi acy antibio tic-resistant new rule armtability, ble insights inv tor maintain s (CMS) proposedand implement y mayear, into technologyen re and Medicaid Service patient safety ,”sms each nagement ate int particip ell to The Centers for Medica ige use in order Murphy ic said. ncorgani with supplye softw ls to reduce antibiot hospita s are ted, require . IN 2016) designa chain t (June RESULTING ls must appoin and states that hospita id 5,6 Medica or re s. in Medica program ship QS/1 has XIMATELY 23,000 helped Murphy address many of those APPRO robial steward 2 antimic those for qualified leaders concerns. As the next Comm ALLY. ANNU S generation ission DEATH of pharmacy Joint in meeting the health systemsmanageme nt software, SharpRx®’ss To suppor t hospital and ehensive Pharmacy Service powerful yet proposed rule, Compr intuitive system made a lasting impression. n, standard and the CMS “When robial Stewardship Solutio they showed me their first of its kind Antimic Hospitals and robial SharpRx, I was new product, (CPS) launched the health care hospitals through its Antimic U.S. 180 of study impressed ive systems in and hoped to switch as soon as possible, 35 million pat based on an expans ” the United Carr ie Boeckelman ientswith “It m. he said.

States handle designed eachthe yeaidea , RPh, BCACP was obviously Stewardship Pilot Progra you r. Thethat sav more than ings associ Manager, Amb se larg / e operation let the ulatory Phar 15, 2016. https://ww software w.cdc.gov do theate work, d wit and that’s s are finding h effe Serv . Accessed Augustmacy ices ip Programs ctiveprobably ~ hav UW Stewardsh Healt e ph Antibiotic tha

Supplylog ix Pharma cy Inventory Managem e TWO nt THAN Solu E MOR tions LE MILLION PEOP

You have invested in the development of a case study, don’t fall short on promoting it. RXinsider can help write and promote your case study to targeted practice settings throughout the pharmacy market via print, video, ebook, and web. Contact an RXinsider representative to learn more about our Case Study Promotional Services.

PRIMARY INTEN

DED OUTCOME

1

Intuitive and Easy-to-Use “SharpRx’s greatest benefit is how intuitive the system is,” Murphy said. “Some of the traditional pharmacy systems that have been around for many years may be very powerful, but a lot of that power comes at a cost of complexity.”

a big armacy sup what impressed t the cost meimp most.” act on the ply-chain ma bottom line nagement Jesse Murphy, PharmD , as well as can Supplylogix on patient offers a sui care. te of softwa competitiv re products e adv antages. Pha that enable that would have hidden settings or would s rmbe tools to opt ph diffi cult aci arm es acies to gai can leverage imize to do with other systems n arethe ir inv Supplylogix's very intuitive entoryand repeasy supply-chain ablSharpRx. lenishment, to figureuns e return”s, and outale with manage pot monitor the ential losses ir product mo from vement.

“I think an THindividual could sit down with SharpRx E CH

h Pharmacy . Core Elements of Hospital https:// Control and Prevention Accessed April 4, 2017. .html Centers for Disease Atlanta, GA: CDC; 2013. implementation/core -elements the United States, 2013. getsmart/healthcare/ Resistance Threats in and Prevention. Antibiotic s/fs194/en /# ediacentre/factsheet 8.pdf Centers for Disease Control http://www.who.int/m istance/pd f/ar-threats-2013-50 dship_ Accessed April 4, 2017. www.cdc.g ov/drugres /6/New_A ntimicrobial_Stewar e. (Updated: Apr 2015.) mission.org/assets/1 ion. Antimicrobial Resistanc w.jointcom Organizat https://ww 2017.

Health World Accessed April 24, ial Stewardship Standard.

Stewards hip in U.S. 4 Approved: New Antimicrob s, and Promotes Antibiotic Hospital-A cquired Condition 6-Fact-sheets-items/2016-06-13.html Standard.pdf Discrimination, Reduces heets/201 Prohibits that ase/Fact-s 24, Rule April Proposed /MediaReleaseDatab 5 Medicare. Accessed CMS.gov. CMS Issues w.cms.gov/Newsroom antibiotic use or exit April 24, 2017. https://ww rule for hospitals: Reduce Hospitals. Accessed r-exit-med icare.html Quality: CMS’ proposed duce-antibiotic-use-o Infection Control & Clinical 6 -proposed -rule-for-hospitals-re Becker’s Hospital Review. ospitalreview.com/quality/cms 2017. http://www.beckersh

2

3

Melissa Ngo, Pha

rmD

SharpRx has a lot of the same power without , BCACP Manager, Amb the ulatory Pharmacy complexity. “It was obviously designed Services ~ UW Health Phar with the idea macy that you let the software do the work, and that’s probably what impressed me most,” he said.

“Things

Case Studies r_CaseStudy_F.indd

001058_CPS_RxInside

1

ALLEN

GEfill a prescription and, after a few minutes, easily.

UW Health , anthat That’s not something intewe gracan say with 4/21/17 10:51 AM ted hea Wiscon”sin-Ma lth system other systems. associ dis

on, serves ated with the 600,000 pat region of the University ients each of country. Wit year in the h six hospit processes upw Upper Mid als and 15 west ards of 44,000 dispensing prescription sites, UW He services is related to spe s per month alth . cia A lty pharmacy large portion and HIV car items, includ of their e, making the ing diabetes, ir inventory standard ret cos tra nsplant, ts exception ail pharmacy ally high com . pared to

RXinsider.com

www.suppl

ylogix.com

© 2019 RXinsider LTD. All rights reserved.

SUMMER 2019

I

H E A LT H S Y S T E M • I N F U S I O N 87

Your journey to better medicine begins here.

The world of healthcare is evolving.

With increasing regulatory pressure and the need to reduce costs while improving the patient experience, access to quality medicine is more important than ever.

Leiters is an FDA-registered and inspected 503B outsourcing provider of high-quality, cost effective solutions including: Hospital services including prefilled syringes, IV bags and vials ON-Q* Pain Relief System fill services Ophthalmology services including injections and solutions COMPOUNDING HEALTHâ&#x201E;˘

Learn how at leiters.com

50 CELEBRATING

YEARS OF INNOVATION

GUARDED

LUER CONNECTORS Our new Guarded Luer Connectors are offered in both Female to Female Luer Lock and Female to Male Luer Lock configurations. They are the latest in IMI’s Prep-Fill™ family of products which facilitates the transfer of fluids.

• • • •

Perfect for transferring (or mixing) between syringes or connecting various IV sets.

Large finger grips help protect against touch contamination.

Connector-specific coloring allows for quick identification.

Individually packaged to facilitate aseptic technique.

INNOVATION IN SECURE DRUG DELIVERY IMI Invented the tamper evident cap technology for protecting IV syringes.

More importantly, we continue to innovate with tamper evident products designed to address various drug devices and connector types.

MADE IN THE USA

1.800.344.2554 WWW.IMIWEB.COM

Start Benefiting from Ready-to-Use CSPs. Raise the bar with PharMEDium prefilled syringes. Our enhanced labeling helps to promote differentiation and clear readability of drug name, volume and concentration to help clinicians dispense and administer the right medication.

To augment patient safety and quality, batch-level release testing for sterility, endotoxins and potency is performed on 100% of PharMEDium Compounded Sterile Preparations (CSPs). No other compounder serves pharmacists, clinicians and patients like PharMEDium—the long-standing leader in outsourced CSPs.

Why prefilled, pre-labeled syringes?1 • Enhanced Safety • Optimal Productivity • Increased Satisfaction • Better Compliance • Less Waste • Best Use of Resources

No dilution, reconstitution, or complex calculations needed before administering.

To learn how PharMEDium CSPs can benefit you visit PharMEDium.com or call 1-800-523-7749. ©2019 PharMEDium Services, LLC. All rights reserved. P20086_Rev1 1. References available on PharMEDium website at: https://www.pharmedium.com/compounded-services/operating-room-anesthesia/ *List of available admixtures is subject to change. Please visit PharMEDium’s Customer Resource Center at pharmedium.com for a current list of available services and new product announcements.