See pg. 31 For Details 2010 Fall Quarterly Edition
Board of Directors
2010 - 2011 Officers
Area Representatives
President ..........................................................Mike Smets, P.D., Fort Smith President Elect ..........................................Gary Bass, Pharm.D., Little Rock Vice President ......................................Dennis Moore, Pharm.D., Batesville Past President ..............................................Jan Hastings, Pharm.D., Benton
Area 1 (Northwest) ............Michael Butler, Pharm.D., Hot Springs Village Area 2 (Northeast) ..........................Brandon Cooper, Pharm.D., Jonesboro Area 3 (Central) .............................Kenny Harrison, Pharm.D., Little Rock Area 4 (Southwest/Southeast) ......................Mike Stover, Pharm.D., Rison
Ex-Officio Members APA Executive Vice President ..............................................................................................................................................Mark Riley, Pharm.D., Little Rock Board of Health Member ................................................................................................................................................................John Page, P.D., Fayetteville Board of Pharmacy Representative ............................................................................................................................Charles Campbell, Pharm.D., Little Rock UAMS College of Pharmacy Representative (Dean) ....................................................................................Stephanie Gardner, Pharm.D., Ed.D., Little Rock Harding College of Pharmacy Representative (Dean) ......................................................................................Julie Hixson-Wallace, Pharm.D., Ed.D, Searcy UAMS College of Pharmacy Student Representative ........................................................................................................................Danial Price, Little Rock Harding College of Pharmacy Student Representative........................................................................................................................Celia Proctor, Little Rock
District 1 Eddie Glover, P.D. U.S. Compounding 2515 College Ave. Conway, AR 72034
District 3 Danny Ponder, P.D. Ponder Economy Drug, Inc. 400 S College St, Mountain Home, AR 72653
District 5 Lynn Crouse, Pharm.D. Eudora Drug Store 140 S. Main St. Eudora, AR 71640
District 7 John Vinson, Pharm.D. Area Health Education Center 612 South 12th Street Fort Smith, Arkansas 72901
District 2 Brent Panneck, Pharm.D. St. Francis Pharmacy 210 Cobean Blvd. #10 Lake City, AR 72437
District 4 Laura Beth Martin, Pharm.D. Family Pharmacy 810 S. Main St. Hope, AR 71801
District 6 Stephen Carroll, Pharm.D. Allcare Pharmacy 517 Main St. Arkadelphia, AR 71923
District 8 Christy Campbell, P.D. Lowery Drug Mart #2 123 Central Ave. Searcy, AR 72143
APA’s Academy of Consultant Pharmacists President ................................................Larry McGinnis, Pharm.D., Searcy President Elect ........................................Muncy Zuber, P.D., Heber Springs
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APA’s Academy of Compounding Pharmacists President....................................................Mark Shinabery, P.D., Maumelle President Elect ..................................................................To Be Announced
Arkansas State Board of Pharmacy
Arkansas Association of Health System Pharmacists
President..............................................................Benji Post, P.D., Pine Bluff Vice President ......................................................Marilyn Sitzes, P.D., Hope Secretary ........................................................Ronnie Norris, P.D., McGehee Member ..........................................................Steve Bryant, P.D., Batesville Member ..................................................Justin Boyd, Pharm.D., Fort Smith Member..................................................Lenora Newsome, P.D., Smackover Sr. Citizen Public Member ..................................Ross Holiman, Little Rock Public Member............................................................Larry Ross, Sherwood
President ....................................................Jason Derden, Pharm.D., Benton President Elect ..........................................Rayanne Story, Pharm.D., Searcy Past President ......................................Maggie Miller, Pharm.D., Batesville Executive Director ............................Susan Newton, Pharm.D., Russellville Treasurer ..............................................Sharon Vire, Pharm.D., Jacksonville Secretary ............................................Marsha Crader, Pharm.D., Jonesboro Member at Large ............................Jody Smotherman, Pharm.D., Batesville Member at Large ................................Jennifer Priest, Pharm.D., Little Rock Member at Large ........................Andrea Donaldson, Pharm.D., Little Rock
The Arkansas Pharmacist
Contents
Arkansas
Pharmacist The
Arkansas Pharmacists Association 417 South Victory Little Rock, AR 72201 501-372-5250 501-372-0546 Fax
The Arkansas Pharmacist (ISSN 0199-3763) is published quarterly by the Arkansas Pharmacists Association, Inc. It is distributed to members as a regular service paid for through allocation of membership dues ($5.00). Non-members subscription rate is $30.00 annually. Periodical rate postage paid at Little Rock, AR 72201. Current edition issue number 52. POSTMASTER: Send address changes to The Arkansas Pharmacist 417 South Victory Little Rock, AR 72201. EDITOR: Mark Riley, Pharm.D. Executive Vice President ART & DESIGN EDITOR: Helen Hooks Communications Specialist Opinions and statements made by contributors, cartoonists or columnists do not necessarily reflect the attitude of the Association, nor is it responsible for them. All advertisements placed in this publication are subject to the approval of the APA Executive Committee.
Features Pharmacy Month ........................................................................................9 APA Annual District Meeting Highlights ................................................15 Pharmacy in Arkansas ..............................................................................31 USPS Statement of Ownership ................................................................33
Departments From the President......................................................................................4 The Executive’s Perspective ......................................................................5 Safety Nets..................................................................................................6 In Memoriam ..............................................................................................8 Compounding Report ................................................................................8 Harding Report ........................................................................................10 Rx and the Law ........................................................................................12 Calendar of Events ..................................................................................13 AAHP Report ..........................................................................................14 Member Classified Advertising................................................................22 UAMS Report ..........................................................................................29 Medicaid Alert ..........................................................................................27 APA Board of Directors Minutes..............................................................28
Index to Advertisers The Law Offices of Darren O’Quinn ........................................................7 Logix, Inc...................................................................................................8 Pharmacists Mutual ................................................................................11 EPIC Rx ..................................................................................................13 Pace Alliance ..........................................................................................23 Bio-Tech Pharmacal ................................................................................25 Cardinal Health........................................................................................26 Arkansas Pharmacy Foundation Legacy ................................................32 Arkansas Pharmacy Support Group ........................................................33 Pharmacy Quality Commitment ..............................................................34
APA Staff Office E-mail Address apasupport@arpharmacists.org Mark S. Riley, Pharm.D. Executive Vice President mriley@arpharmacists.org
Scott Pace, Pharm.D. Associate Executive Vice President scott@arpharmacists.org
Helen Hooks Communications Specialist hhooks@arpharmacists.org
Barbara McMillan Director of Administrative Services & Meetings bmcmillan@arpharmacists.org
Debra Wolfe Director of Public Affairs dwolfe@arpharmacists.org
Celeste Reid Administrative Assistant creid@arpharmacists.org
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From the President Talking is Good and so is Listening
Mike Smets, P.D. Coleman Pharmacy Fort Smith, AR
Some people like to hear themselves talk and some would rather not bother with any conversation that is not absolutely necessary. Hopefully, most of us, especially in our professional settings, land somewhere in the middle.
I was talking to one of my patients recently and learned that he was having continuing trouble with a rash. Upon hearing the nature and location of the rash, and after learning that he had been using hydrocortisone cream on it with little success, I suggested he try an antifungal cream instead. These types of encounters occur multiple times a day in the pharmacy world and small problems, such as an annoying rash, can be quickly and easily addressed, but only with a little communication. It has been shown that a little conversation, such as a few simple questions or an explanation during a patient counseling session, can prevent a large percentage of medication and prescription errors. Sometimes we get busy and are tempted to cut these visits short, but we need to remember that they are not only a good idea, but that many of these patient encounters are required by law - OBRA 90.
The other day - a beautiful Saturday - I rode my bike to work, a short pleasant trip for me. On the way home, I saw an elderly patient of mine working in a garden in his front yard. He didn’t see me ride by and I was in a little bit of a hurry to get home so I rode on past - not really wanting to talk to any more patients after a busy morning at the drug store. After another half block I thought about it and turned around to stop and say hi. Thirty minutes later I had a smile on my face thinking of one of the most pleasant conversations I’ve had in years. Mr. Hughes is just a great old guy and he was really happy to talk to someone that pretty afternoon - we covered healthcare, politics and of course his and his wife’s health. You could say it brightened his day and it made mine also. In the course of this conversation I was also able to let my friend know that he could get his Tricare prescriptions from our local pharmacy and not just by mail order as he thought. In our travels around the state this September for District Meetings we have spent a lot of time talking to state legislators, as well as many pharmacists. There have been some good conversations and some great conversations. These conversations help strengthen relationships and build trust, which will be invaluable this upcoming legislative session. I have come to learn our APA staff already knows - that this is time well spent and it is an important part of the process. I have a new level of respect for our local legislators and I have a new understanding of the time they spend, the work they do, and the commitment it takes to be a public servant. I think that the least we can do is take a few minutes to talk the our legislators and thank them for all the hard work they do for our communities, and we should make sure we mention the issues and concerns that are important to us. The point of these stories is that doing a little talking, asking a few questions, and doing a little listening, is always a positive thing. We have a lot to say and a lot to contribute. Pharmacists are an important part of the healthcare team and need to get out from behind the counter and let people know what we do every chance we get.
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The Arkansas Pharmacist
The Executive’s Perspective Just a few thoughts……. 2010 District Meetings have come to a close. I always enjoy the process of traveling the state and meeting many of you face-to-face and hearing your ideas, hopes, and fears first hand. I always come away from the District Meetings with a better awareness of what issues are important to you. This gives me a greater resolve to serve this membership. I also want thank APA President Mike Smets for his dedication to the profession. President Smets is committed to leading this association to be more efficient in addressing the issues your board of directors have made a priority. He is also a great guy to be around and has been a good friend to me for more years than I like to admit. I do regret that I missed a few of this year’s District Meetings. I was serving on the Search Committee for the new Executive Vice President/CEO of the National Community Pharmacists Association, and your APA Board felt it was important that I represent our state in selecting a new national leader for the profession of pharmacy.
Mark Riley, Pharm.D. Executive Vice President
So, where are we? We are trying to balance the myriad of issues that are beating at our door while trying to plan for where we want to be as a profession. On the business side, the regulations that have come from the federal government and constant onslaught of egregious practices of the PBMs have left the community segment of pharmacy looking and feeling much different than it did even a decade ago. Despite the challenges, pharmacy has had significant wins at both the state and federal levels in recent years. At the state level, we have a good relationship with Arkansas Medicaid, but we still have challenges, such as restoring the four percent lost on brand name drugs last year and getting an increase in our cost of dispensing. We also continue to have a great working relationship with the Arkansas State Employee/Public School Teachers Program. Our PBM and mail order educational efforts have been successful in the private sector too. Several businesses based in Arkansas have changed their PBM and eliminated their mail order programs because of our efforts. We must also increase our focus on the professional side. Almost every evaluation of the national health scene concludes that there is a dramatic shortage of primary care providers. This problem will only get larger as health care reform places an emphasis on preventative care services. There are simply not enough primary care physicians to handle all of the needs. Pharmacists are poised educationally, professionally, and geographically to fill many of these voids in primary care services and we need to step up and fill these voids. And, as we stated throughout the District Meetings, collaborative practice agreements with local physicians have been made possible by Arkansas State Board of Pharmacy regulations for performing virtually any service that you and a physician agree upon. The UAMS College of Pharmacy is doing a great job in providing collaborative practice training throughout the state. My final thought is this: The APA staff is working hard to address the issues that affect you. Some of those issues are tough – but that goes with the territory. However, we can only do so much as an organization. You are the key in the process. While, many of you have engaged politically with your local political leaders, many of you are reluctant to do so. Pharmacists have the potential to be one of the strongest grassroots organizations in this state and country, but you have to be engaged and you must step up to ensure that your voice is heard. I don’t think we have come close to tapping the true grassroots potential of the profession. I ask you to make a commitment to contact your legislators once a quarter. Every time the seasons change, make a call or send an e-mail to your state and national legislators and remind them how many patients you touch every day. Remind them that you don’t just provide pills, you provide healthcare. I applaud those who are already engaged in the political process and encourage everyone else to get involved! We want to win for you and your patients. Please resolve to help us. The Arkansas Pharmacist
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Safety Nets
Safety Nets A community pharmacist from East Arkansas reports the following – potentially lifesaving - intervention. Thank you for your continued support of this column. Eddie Dunn and Jonathan Wolfe A pharmacy technician from East Arkansas received the original medication order illustrated in Figure One. The
Dr. Jon Wolfe
Dr. Eddie Dunn
Figure One
technician entered the prescription information into the computer as “methotrexate 2.5 mg tablets with directions to the patient of “take six tablets, by mouth, every bedtime”. Noticing that the methotrexate quantity was not included in the order, the technician asked the pharmacist what number of methotrexate tablets should be dispensed. While examining the prescription, the pharmacist began to question the prescribed daily dosing interval for methotrexate. The pharmacist had previously received methotrexate prescriptions indicated for rheumatoid arthritis or psoriasis, but the prescribed dosing interval for these prescriptions had always been once weekly - never daily. The pharmacist asked the patient why she had been prescribed methotrexate. The patient responded that she had been suffering from psoriasis for some time and her physician had decided to prescribe methotrexate “to try and give me some relief”. At this point, the pharmacist realized the prescriber may have inadvertently written a daily methotrexate dosing interval for psoriasis, instead of the recommended weekly dosing interval. When contacted for verification, the physician immediately stated he meant for the patient to take six methotrexate tablets once weekly, not every bedtime as written. The physician then expressed his gratitude to the pharmacist for alerting him to this potentially fatal methotrexate overdose. After this, the pharmacist entered the corrected dosing interval – once weekly - into the computer and appropriately counseled the patient. Methotrexate is an antineoplastic medication which is also indicated for treatment of psoriasis and rheumatoid arthritis. The recommended methotrexate dosing interval for psoriasis and rheumatoid arthritis is once weekly – never once daily. This type of methotrexate dosing is sometimes referred to as “low-dose or intermittent methotrexate therapy”. The medical literature contains reports of deaths following overdoses of methotrexate. Many of these deaths resulted from methotrexate being inadvertently administered daily instead of weekly. In one reported case, a patient died after taking 15 mg of methotrexate (six 2.5mg tablets – as in this case) daily for just six days.
All pharmacists must use extreme caution when presented with prescriptions for methotrexate
The Institute for Safe Medication Practices (ISMP) has included methotrexate in its list of “high alert medications”, a list of medications having an increased risk of causing significant patient harm – including death - when used in error. Overdoses of methotrexate may result in severe mucositis, skin lesions, acute renal failure, pancytopenia and pulmonary toxicity. Deaths from methotrexate overdose are particularly unpleasant, involving terrible suffering on the part of patients. All pharmacists must use extreme caution when presented with prescriptions for methotrexate. Any prescription containing a dosing interval other than once weekly must be questioned and verified for accuracy by the prescriber. While all pharmacists understand that daily oral methotrexate administration could result in patient harm, distractions in the pharmacy, inadequate 6
The Arkansas Pharmacist
staffing and/or a heavy prescription volume could allow an error of this type to reach a patient. Pharmacy owners and managers must take steps to ensure that all pharmacy workplaces are as safe as possible for our patients. This case needs to serve as a prompt for all pharmacists and especially pharmacy managers. Do you have a policy to verify every prescription that appears to be for this medication? What is your practice if you see the abbreviation “MTX� in an order? What warnings does your current software provide about methotrexate? Are they sufficiently stringent or can they be made more robust? Does everyone in your pharmacy using this software know NEVER to override a warning when dealing with a high-risk medication such as methotrexate? Finally, are we making certain to check the finished prescription and to counsel the patient and/or caregiver? The pharmacist in this case is to be commended for preventing this potentially fatal medication error from reaching his patient. If this pharmacist had been working in a robotic fashion and had not questioned the order as written, the outcome could have been tragic. The authors of Safety Nets thank him for sharing this case with our readers. References: J Rheumatol 2005;32:2009 -11
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Compounding Report
In Memorium Dr. Phillip Futrell, Pocahontas Dr. Danny Eaker, North Little Rock Dr. Grace Leatherberry, Glenwood Dr. Jackson Haynes, Benton Dr. Robert “Bob” Low, Brinkley
Effective July 1, 2010, sales tax should be collected on all veterinary prescriptions. Pharmacy was kept out of the “loop” on this tax! The Department of Finance and administration, Veterinary Sales and User Tax Rule 2010-1 was approved by the state legislature. These rules were patterned after the sales tax rules established for optometrists, dentists, and chiropractors. Questions can be answered by the DFA by calling the Sales and User Tax Offices at 501-682-7104 or by the Board of Pharmacy at 501-682-0190. Obviously, this tax will affect compounders more than other pharmacy practices, but everyone should be affected by it. Enjoy the cooler weather and happy hunting! ~ Mark 8
The Arkansas Pharmacist
Pharmacy Month
• In the last quarter century, pharmacy has expanded its role within the health care delivery system from a profession focusing on preparation and dispensing of medications to patients to one in which pharmacists provide a range of patient-oriented services to maximize the medicine’s effectiveness. • Pharmacy is practiced in a wide range of settings: community pharmacies, hospitals, long term care facilities, the pharmaceutical industry, mail service, managed care, academia and government (Department of Defense, Department of Veterans Affairs, Indian Health Service, Public Health Service). Pharmacists practice in community pharmacy (chains and independents), in hospitals, and in consulting, government, academic, industry, and other settings. • Historically, educational requirements for pharmacists included the choice of two entry-level degrees: a five-year Bachelor of Science in pharmacy (BS Pharmacy) or a six-year Doctor of Pharmacy (PharmD). Today, schools of pharmacy offer only the PharmD degree. This extensive training makes the pharmacist the most knowledgeable health care professional when it comes to medicines and their use. • Medicines today have great power to heal and to improve the quality of life for millions of Americans. But medicines also may do serious harm if not taken correctly. The most expensive medication is the medication that doesn’t work. This is where the role of the pharmacist is most important. To make the most of your medications, you should choose your pharmacist as carefully as you choose a physician. It is best to use only one pharmacy so all medication records are at one location. This way there will be less risk of duplicating medicine or having one prescription interact harmfully with another. • Pharmacists who know their patients and have their medication profiles on file will be aware of possible harmful drug interactions or allergies to certain drugs. The pharmacist also will be able to discuss possible side effects; what foods, drinks, or activities that should be avoided while on a medication; what to do if you miss a dose; and a wide range of other helpful information. • The pharmacist is a key health care professional in helping people achieve the best results from their medications. Americans should choose a pharmacist they trust and build a partnership for good health.
The Arkansas Pharmacist
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Harding Report
In the words of an African proverb, famously quoted by a former first lady of Arkansas, “It takes a village.” While Mrs. Clinton may not have been speaking of the education of student pharmacists, she was making reference to the role an entire community plays in strengthening families. Those who work in schools and colleges of pharmacy across America are trying to accomplish a similar goal by working within the pharmacy “villages.” The shared task in pharmacy villages is strengthening pharmacy families to provide the support necessary to train student pharmacists. These new pharmacists will inherit and carry on our pharmacy families, and thus the profession of pharmacy, so we all have a vested interest in how they are trained. Certainly we all wish for them to become pharmacists who would make us continue to be proud of our profession. Experiential education has always been an important part of the education of pharmacists. However, it has become an increasingly large portion of the professional curriculum in schools and colleges of pharmacy across the country. Current Accreditation Council for Pharmacy Education (ACPE) standards require introductory pharmacy practice experiences (IPPEs) to account for at least 300 hours of the total curriculum and advanced pharmacy practice experiences (APPEs) to account for 25% of the total curriculum. Added together, the IPPEs and APPEs account for at least 1740 hours, or more than 33%, of the 4-year doctor of pharmacy curriculum. In order to meet these accreditation requirements for experiential education, schools and colleges of pharmacy face the challenging task of locating a sufficient number of well-qualified and motivated pharmacist preceptors in the pharmacy village as a whole. Each pharmacist brings strength and depth to the education experience and we can all think back to those who have inspired our lives by sharing their experiences with us. Imagine what could happen if that wisdom and knowledge was openly available to all! At Harding, it is our goal to be productive and helpful members of the pharmacy village, both in Arkansas and nationally. If there are ways you feel we could be better villagers, please do not hesitate to let us know. We encourage all of the pharmacy community to engage with the student pharmacists being trained today by serving as preceptors and mentors as they become full-fledged members of the pharmacy family. It takes the cooperation of all of us together to raise these new pharmacists in the way in which they should go and the way that will ensure our chosen profession continues to be as rewarding for them as it has been for all of us who have gone before them. Finally, Harding University College of Pharmacy has just seated its third class of student pharmacists, the class of 2014. There are 64 individuals in this class representing 19 states with 36% of the group coming from Arkansas. We received 398 applications for the class of 2014, a total increase of 10% over the past two years of our existence. The class had its White Coat Ceremony on August 20, 2010. We were thrilled to have Dr. Mark Riley, Executive Vice President of the Arkansas Pharmacists Association, as the keynote speaker. The ceremony was again generously sponsored by Walmart. The entering class is off to an exciting new year, joined by the members of the classes of 2012 and 2013 who returned to campus for the start of classes on August 23. We now have a total of 180 student pharmacists in our pharmacy village and hope you will enjoy coming to know them as they interact with you across the state!
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The Arkansas Pharmacist
The Arkansas Pharmacist
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Rx and the Law
Pharmacy Marketing Group, Inc.
AND THE LAW
By Don. R. McGuire Jr., R.Ph., J.D.
This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
THINK BEFORE YOU SPEAK Pat the pharmacist had been having a stressful afternoon in the pharmacy when Mrs. Green came in with 3 prescriptions from Dr. White in the next town over. Pat looked over the 3 prescriptions and saw that they were all controlled substances and all were in high dosages. “Mrs. Green, I can’t believe that you continue to see that doddering old fool, Dr. White! When are you going to start seeing a real doctor? If you keep going to Dr. White, he is going to kill you! Our store refuses to fill any prescriptions for any of his patients anymore.” Two weeks later, the county sheriff served Pat with a lawsuit. Dr. White sued Pat for slander since Pat’s statement was made verbally to Dr. White’s patient in front of other customers in the store. Defamation is the publication of anything injurious to the good name or reputation of another, or which tends to bring him into disrepute.1 Oral defamation is called slander, while printed defamation is called libel. The purpose of libel and slander laws is to protect innocent individuals from the harmful effects of false, disparaging remarks about their reputation or their professional abilities. The defamatory statement must also be published, that is, it must be made to someone other than the person who is allegedly defamed. It should be pointed out that the truth is a defense to slander and libel. In other words, if you speak or write truthfully about a person, it is not slanderous or libelous, even if it is damaging to their reputation. However, proving the truthfulness of a remark is not always easy. Objective evidence, such as a criminal conviction or a sanction by a licensing board, is a good way to prove the truthfulness of a remark. Look back at the statements made by Pat. How many of those statements are factual and objectively true? Maybe only the last one. But how is Pat going to prove it? In a law suit, Pat will have to list the names of the customers whose prescriptions were declined at the pharmacy. The store will have to list them as witnesses and then possibly call those persons as witnesses at a trial. Pat will have to articulate a reason why the prescriptions were not filled. Pat will also have to have an expert witness to state that this is the standard and practice of a pharmacist. It would aid in his Pat’s defense if other pharmacies 1. Barron’s Law Dictionary, Second Edition, Edited by Steven H. Gifis, Barron’s Educational Series, Inc., 1984.
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in the area were not filling Dr. White’s prescriptions for the same reason. Without objective evidence for the court to act upon, the question of truthfulness goes to the jury. If the jury decides that the statements were truthful, then Pat wins. If not, then the jury decides if they were defamatory. If they were, then the jury decides the amount of damages to award Dr. White. By the time that Pat gets this far into the litigation process, Pat will have invested a significant amount of time and money. Could Pat obtain insurance coverage to protect against these types of situations? Generally yes. Many commercial policies contain coverage for personal injury and one of the covered injuries under personal injury is typically slander or libel. Care must be taken, however, because certain exclusions will apply. One common exclusion is for personal injury arising from publication of statements that the insured knew were false when they were made. Personal injury arising from a criminal act committed by the insured is also excluded under many policies. Insurance coverage won’t protect someone who intentionally defames another. What is the best course of action for Pat? The best recommendation is to think before speaking. Know your audience. Know your content. Is it factual or inflammatory? “Mrs. Green, I’m not going to fill these prescriptions because, in my professional judgment, I believe that they may be detrimental to your health.” This statement is certainly less inflammatory and may not be actionable at all. But do not let fear prevent you from intervening. Pharmacists still need to ensure that patients are receiving safe, effective drug therapy. In this last example, Pat has still performed the valuable DUR and gate keeping functions without defaming Dr. White’s ability to practice medicine. © Don R. McGuire Jr., R.Ph., J.D., is General Counsel at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of
their employers and insurance companies, and act accordingly.
The Arkansas Pharmacist
Calendar of Events
2010 OCTOBER
2011 MARCH
October 23 - 27, 2010 NCPA Annual Convention Pennsylvania Convention Center Philadelphia, PA
March 1, 2011 APA Legislative Reception Trapnall Hall Little Rock, AR
DECEMBER
March 25-28, 2011 APhA Annual Meeting & Exposition Seattle, WA
December 5 - 9, 2010 2010 Midyear Meeting Anaheim Convention Center Anaheim, CA
JUNE
December 11 - 12, 2010 APA Board/Committee Meetings & Christmas Party Holiday Inn Airport Little Rock, AR
The Arkansas Pharmacist
June 8-11, 2011 APA Annual Convention Peabody Hotel Little Rock, AR
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AAHP Report
Rayanne Story, President I am excited to serve as the new president of the Arkansas Association of Health-System Pharmacists for the upcoming year. The leadership team has been busy working on the affiliation agreement with the American Society of Health-System Pharmacists and finding new ways to better serve the health-system pharmacists of Arkansas. To help keep you informed, we are updating our website, www.aahponline.org, and have added a Facebook page. Pharmacy Practice Model Initiative: Redefining. Reconstructing. Reinventing The PPMI Summit is an invitational consensus conference that is part of the ASHP and ASHP Foundation's Pharmacy Practice Model Initiative. The conference, to be held in Dallas on November 7 - 9, 2010, will bring together thought leaders throughout hospital and health-system pharmacy to reach consensus on optimal practice models that are based on the effective use of pharmacists as direct patient care providers. See the ASHP website for key information, invited attendees, agenda, and virtual participation. Shannon Hays, clinical coordinator at White County Medical Center in Searcy will represent Arkansas. Congratulations Dr. Hays! Technician Scholarship The Arkansas Association of Health-System Pharmacists (AAHP) is currently accepting applications for 2010 scholarships. The mission of AAHP is to represent our members by providing leadership and support in the promotion of pharmaceutical care. AAHP will award one scholarship in the 2010 year. The value of the scholarship equals the cost of registration for one PTCB national certification exam. Qualifications are as listed and the application is on the AAHP website. 1. Must be a registered pharmacy technician in the state of Arkansas 2. Must have worked as a pharmacy technician for a minimum of one year 3. Must be a current member of AAHP 4. Never been a recipient of an AAHP scholarship ASHP Midyear Clinical Meeting 2010 The meeting will take place December 5-9, 2010 in Anaheim, California. More than 20,000 pharmacy professionals from 86 countries attend this meeting to update their knowledge, network with colleagues, enhance their skills, and learn about the latest products and innovations. AAHP on Facebook! Please “like� the Arkansas Association of Health-System Pharmacists on Facebook to stay up to date with healthsystem pharmacy in Arkansas. We will keep you posted on continuing education opportunities and upcoming conferences. ASHP recognizes outstanding SSHP chapters Both UAMS and Harding University College of Pharmacy SSHP chapters were recognized for the 2010 year as outstanding chapters. Great job!!! Congratulations to the Harding College of Pharmacy SSHP for being chosen the as the September spotlight society! You can find a summary of their accomplishments on the ASHP website. Diana Park, vice-president of the HUCOP SSHP chapter was chosen to be one of two ASHP 2010 summer interns in Bethesda, Maryland. AAHP is proud of all of the accomplishments of the Arkansas pharmacy students. Arkansas Association of Health-System Pharmacists 14
The Arkansas Pharmacist
District Meetings
Thanks to :
Pine Bluff
for sponsoring the 2010 District Meetings.
The APA held 13 meetings all around Arkansas during September. This year’s meetings featured a “Pharmacy Open Door Forum” that sparked terrific discussion at all of the meetings. APA would like to thank all of the attendees who made this year’s meetings such a success. A special “thank you” to the Arkansas State Board of Pharmacy, the UAMS College of Pharmacy, and the Harding College of Pharmacy for being an important part of these meetings.
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Camden
Monticello
Russellville Hot Springs
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Camden
Monticello
Russellville
Hot Springs
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Little Rock
Jonesboro Forrest City
Texarkana
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Little Rock
Jonesboro
Forrest City
Texarkana
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Fort Smith
Bentonville Flippin
Batesville
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Fort Smith
Bentonville
Flippin
Batesville
Member Classified Advertising Opening for Full-time Pharmacist A leading community pharmacy in NW Arkansas focused on personalized service to individual patients and assisted living environments, is seeking a career-oriented individual, who must enjoy working with people. The opportunity includes medical/dental insurance, paid vacations & holidays, and a SIMPLE IRA retirement program. Interested pharmacists may submit their resumes to dbastian@cox-internet.com. For Lease Old Super D Express Space in Midtown Memphis 1800 Union Ave. 1500 sq ft $1950/month 15 parking spots. Great opportunity for new pharmacist, veteran, or expansion space. Tenant concessions available. 30 year history of retail, compounding pharmacy at this location. 1982-1996 Prescription House 1996-2010 Super D Express 2010- ? Your Business Here Contact Jamie.shoemaker@kroger.com. For Sale Four sections of metal wall shelving 8 ft. height, 4 ft. width Call Will 870-836-8176 Arkansas Pharmacists, CPTS Needed The Arkansas-1 Disaster Medical Assistance Team (DMAT) is actively recruiting pharmacists and certified pharmacy technicians to join the National Disaster Medical System. By doing so, you could be able to deploy and help during the next national disaster. AR-1 is one of more than 60 nationwide federal teams of medical professionals. AR-1 has deployed to multiple hurricanes including the superdome during Katrina, and the Twin Towers after 9-11. Recently two AR-1 members deployed as part of the federal response to the Haiti earthquake. Members of AR-1 enjoy job protection under USERRA as a uniformed reservist and only deploy voluntarily for up to two weeks as a time. Pharmacists and CPTs who are interested are invited to visit http://ar-1dmat.com/ for more information. Interested parties should also contact the AR-1 planning section chief Rick Pavick at rick.pavick@vzw.blackberry.net. Pharmacist Needed We are looking for a full-time or part-time pharmacist for an independently owned pharmacy in Paris, AR. Please call Elizabeth at 479-963-1555. For Sale All items located in Rison, AR Lighted wall fixtures - 70 total feet 5 ft gondolas - 10 total lexmark T640 printer - 1 total credit card terminal - 1 total Contact: Roth E. Rabb, P.D. @ 870-718-9482 or after 6:00 p.m. 870-325-6836 Opening for Part-time Pharmacist North Metro Medical Center, a community hospital in Jacksonville, AR, is seeking a part-time pharmacist for day shift. Please contact Amy Arnone at 501-985-7249 or Lauren Byrns at 501-985-7282 for additional details. 22
Independent Pharmacies Wanted Independent pharmacist interested in purchasing independent pharmacies in Arkansas. Pharmacies will remain independent after purchase. Purchaser has solid independent pharmacy background. If interested in selling your pharmacy, please contact Vance at 870897-1204 or via e-mail at VanPark@aol.com. Volunteer Pharmacists Needed Shepherd’s Hope Neighborhood Health Clinic is a ministry of Fellowship Bible Church and Oak Forrest United Methodist Church serving uninsured and indigent patients in the South Midtown area of Little Rock. The Clinic is located at 2404 Tyler Street (behind Oak Forrest). The hours of operation are 6:00pm to 8:30pm every Tuesday and Thursday night. Current needs are pharmacists willing to volunteer every 4 weeks. If you are available to volunteer and help with this ministry, please contact Bren May at 501-993-0729. Thank you! IVANRX4U, Inc., Pharmacist Relief Services, Career Placements. Relief pharmacists needed - FT or PT. Based in Springfield, MO and now in Arkansas. Staffing in Missouri, Arkansas, Eastern Kansas and Oklahoma. We provide relief pharmacists for an occasional day off, vacations, emergencies -- ALL your staffing needs. Also seeking pharmacists for full or part-time situations. Please contact Tracy Byrd, Marketing and Recruiting Director, or Mike Geeslin, President for information regarding current openings throughout Arkansas - temporary as well as permanent placements. Let IvanRx4u help staff your pharmacy, call 417-888-5166. We welcome your email inquiries, please feel free to contact us at: Ivanrx4u@aol.com or Ivanrx4u-tracy@hotmail.com. Pharmacist in Charge Wanted Competitive salary with up to 3 weeks paid vacation and major medical coverage plus 401K plan. Great schedule - Monday thru Friday, hours 9:00 a.m. to 6:00 p.m. Contact Alan Tweddell at 870931-2881 or send resume to: Country Mart Pharmacy, 208 Lincoln Dr., Fredericktown, MO 63645 Positions to be filled in S.E. Missouri. Relief staffing available through Staff RPh, Inc. We provide quality pharmacists and technicians that you can trust for all your staffing needs. Our current service area includes AR, TX, OK and TN. For more information call Rick Van Zandt at 501847-5010 or email staffrph@comcast.net. Pharmacy for Sale In beautiful North Arkansas. Established in 1974. Family owned with exceptional reputation in dynamic community. Excellent schools, recreational & retirement center, golf courses, lakes, rivers, 2.5 hours from Little Rock, AR; Memphis, TN; and Springfield, MO. Pharmacy is ideally located: a) across from doctor’s complex and new treatment, diagnostic, and emergency facility, b) next door to ophthalmologist and optometrist. Contact Mike Sprague at 512-799-5265. Full or Part-time Position Full or part-time position for residency trained pharmacist with BCPS or comparable experience. Contact Ramona McLean, Washington Regional Medical Center, 479-463-1102.
The Arkansas Pharmacist
UAMS Report College of Pharmacy Dean Stephanie Gardner, Pharm.D., Ed.D. Part of my duties as Dean of the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy includes traveling to various meetings and conferences around the country. While visiting with colleagues from colleges of pharmacy all over, I hear a great deal of positive feedback on the strides we’re making at UAMS, and it affords me the chance to gauge the reputation we’re building nationally within the profession. The comments cover certain programs and trends in Arkansas as well as the high quality of our faculty, but there is one common theme that most piques the interest of colleagues in those circles: “How do you get so many students to commit to student organizations?” And, better yet, “How do you get them to commit so much time and effort to those organizations?” I’m very proud to report that that those are some of the questions I receive the most from some of the country’s largest and most respected colleges of pharmacy. To me, that speaks volumes about the quality of educational and professional experience we’re providing at UAMS. Student organizations provide our future pharmacists the opportunity to learn about the history of the profession and to provide a compass to better navigate the issues and ethics that shape pharmacy as a whole. It’s not enough that students sign up for these organizations, but we stress active participation that helps them acquire a clearer vision and understanding of their roles as future members of the pharmacy profession. More than 90 percent of our students belong to at least one of 11 student organizations we offer within the UAMS College of Pharmacy: • • • • • • • • • • •
APhA-ASP (American Pharmacists Association – Academy of Student Pharmacists) CPFI (Christian Pharmacists Fellowship International) Kappa Epsilon Kappa Psi NCPA (National Community Pharmacists Association) Phi Delta Chi Phi Lambda Sigma Rho Chi SNPhA (Student National Pharmaceutical Association) SSHP (Student Society of Health-Systems Pharmacists) SSNP (Student Society of Nuclear Pharmacists)
Our APhA-ASP boasts over 400 members, and serves in many capacities as our student government. At the 2010 Annual Meeting and Expedition in Washington, D.C., the UAMS chapter was highly visible because of the following: • • • •
Chapter Advisor of the Year – Eddie Dunn, Pharm.D. National Heartburn Awareness Challenge award Student Leadership Award – fourth-year student Collin Ward Secretary of the ASP House of Delegates - fourth-year student Clint Boone
In July, our SNPhA chapter received the Chapter Excellence Award, the highest honor given annually, at the organization’s National Conference in Seattle. Our Kappa Epsilon chapter was also recently honored as Chapter of the Year at their 24
The Arkansas Pharmacist
National Meeting in Indianapolis. Finally, our chapter of the National Community Pharmacists Association (NCPA) competes in that organization’s annual Pruitt-Schutte Student Business Plan Competition. This year the UAMS team’s business plan was selected as a Top 10 Finalist. The list of accomplishments is ongoing, but to me, the hallmark of these student organizations is the work they do in the community, including the countless health screenings and political advocacy and public service missions they complete each year. To give an example of the commitment our students show, it struck me to hear that while most college students use spring break for rest or travel, we had several who spent theirs painting the interior of the Adult Services Center at the Easter Seals of Arkansas. They also raised and donated $6,000 for Easter Seals. And so to answer the frequently asked question about how we accomplish this tremendous student participation, the answer can be boiled down to two things: First, none of this could be done without exceptionally strong faculty advisers, many of whom spend countless hours working with the students on these projects and shaping them into the quality pharmacists they will become. The second is the type of students we’re recruiting to UAMS. While it is not a requirement to participate in a student organization, we are lucky to have dedicated students who not only actively seek to take advantage of the opportunities being provided, but often take them a step further. Incoming students see how high the bar is set by those preceding them, and they continually strive to exceed those expectations. To me, that’s a legacy I’m extremely proud to share with members of the Arkansas Pharmacists Association.
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Medicaid Alert Dear Pharmacy Providers, Arkansas Medicaid Pharmacy program would like to provide our pharmacy providers with additional information regarding our current and future edits. Current Edits: Proton Pump Inhibitors (PPI) edits were implemented on August 17, 2010. The complete criteria can be found on our website at: https://www.medicaid.state.ar.us/InternetSolution/Provider/pharm/scripinfo.aspx. Arkansas Medicaid allows for flexible dosing of H2 Blockers as an alternative to PPI therapy. Ranitidine 150 mg and many ranitidine 75 mg tablets are covered without a prior authorization as well as the liquid formulation for children ≤6 years of age or recipients who are NPO. Arkansas Medicaid covers many manufacturers of ranitidine 150 mg tablets but the ranitidine 75 mg tablets are listed as an OTC product with fewer covered manufacturers. Also keep in mind when ordering, because it is OTC, the ranitidine 75 mg tablets may have a different name such as Acid Reducer or Acid Control. The following is a list of covered manufacturers and labeler codes for the ranitidine 75 mg tablets: Bergen Brunswig (24385), Perrigo (00113), and Major (00904). The following H2 Blockers have POS criteria and may require a prior authorization: Famotidine oral susp, Famotidine RPD tablet, Nizatadine oral solution, Ranitidine efferdose tablet, Ranitidine granules, and Ranitidine syrup. For recipients who need a prior authorization for an H2 Blocker, the prescriber may call the Pharmacy Help Desk. The numbers for the Pharmacy Help Desk are Toll Free 1-800-707-3854 or Local 501-374-6609 x500. Arkansas Medicaid has also received many questions about the PPI criteria. If a recipient does not meet the point of sale (POS) criteria and receives a rejection at the pharmacy, it does not mean that they will be denied a prior authorization for a PPI. The intent of the approval criteria was not to require a recipient to have an endoscopy or to have the endoscopy repeated every two years. Arkansas Medicaid does not have the capacity to read everything at POS, especially with the complexity of some circumstances surrounding PPI usage. The endoscopy procedure in history is used as a marker with the assumption that a recipient has been worked up and the prescriber has found something to substantiate continuing the PPI therapy. If the prescription rejects at the pharmacy, the prescriber may call the PDL PA Call Center to explain the medical necessity to continue the PPI therapy beyond the three (3) months of drug therapy per 365 days that the recipient has already received. The numbers for the Evidence-based Prescription Drug Program PA Call Center are Toll Free 1-866-250-2518 or Local 501-526-4200. Future Edits: Beginning Tuesday, December 7, 2010, the Medicaid Pharmacy Program will implement an “accumulation quantity limit” on all solid oral dosage forms of benzodiazepine agents as approved by the AR Medicaid Drug Utilization (DUR) Review Board. The provider memo containing the details of the edit was mailed on August 26, 2010 and can be found online at: https://www.medicaid.state.ar.us/Download/provider/amprcd/Memos/ProvMem-00710.doc. In addition to the memo, both prescribing providers and pharmacy providers were mailed letters to identify their patients who would exceed the quantity limit on the benzodiazepine agents. Please review your patient lists prior to the implementation date and take proactive steps to prevent any delay in patient care. Thank you, Arkansas Medicaid Pharmacy Program The Arkansas Pharmacist
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APA Board of Directors Minutes Minutes Arkansas Pharmacists Association Board of Directors June 23, 2010 Marriott Hotel Fort Smith, Arkansas Members Dr. Jan Hastings – presiding Dr. Mike Smets Dr. Paul Holifield Dr. Kenny Harrison Dr. John Vinson Dr. Jim Griggs Ms. Collin Ward Dr. Julie Hixson-Wallace Dr. Dennis Moore Dr. Eddie Glover
Dr. Gary Bass Dr. Brent Panneck Dr. Michael Butler Dr. Gary Butler Dr. Mark Riley Dr. Lynn Crouse Dr. Buzz Garner Dr. Christy Campbell Dr. Laura Beth Martin Dr. John Page
Guests and Staff Dr. Cindy Stowe Harold Simpson – legal counsel Barbara McMillan Dr. Scott Pace Andrew Mize Dr. Richard Hanry - treasurer Dr. Steve Bryant
CONSENT ITEMS President Jan Hastings called the meeting to order at 9:15 a.m. President Hastings asked the Board to review the conflict of interest and antitrust statements. President Hastings requested Dr. Laura Beth Martin to lead the invocation. President Hastings asked the APA Board to review the minutes from the March 2010 meeting. A motion was made and seconded to approve the minutes as amended. The motion passed. DISCUSSION ITEMS Meeting Updates Barbara McMillan gave a brief update on this week’s convention. She encouraged board members to seek out first time attendees and thank them for attending the meeting. Ms. McMillan also reported that the 2010 APA Board retreat will be August 12th-14th at the Hilton Resort in Rockwell, TX, just outside of Dallas. Harding College of Pharmacy Report Dr. Julie Hixson-Wallace reported that Harding’s Pharmacy Camp is now underway with 23 students from 7 states. The College has hired four new faculty members. The student NCPA chapter will be organized and kicking off this fall. Consultant Pharmacy Academy The academy is working hard to ensure that younger pharmacists enter consultant practice. Dr. Griggs feels that consultants have done a good job at being able to receive payment for their services, and he said that the academy will continue to make sure that consultant services are paid properly.
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The Arkansas Pharmacist
Compounding Academy Report Dr. Gary Butler reported that Compounders on Capitol Hill meeting just concluded in D.C. IACP has named a new Executive Vice President, David Miller. One of the big topics that was discussed at the IACP meeting is whether or not it is legal to compound from bulk for animals. Board of Health Report Dr. John Page reported that the new flu vaccine for this season will include H1N1, which means there will only be one vaccine this year. Dr. Page also reported that the Board of Health is investigating K2, a marijuana-like drug that is being sold over the counter. They are investigating ways to stem the usage in Arkansas. UAMS College of Pharmacy Report Dr. Cindy Stowe passed out copies of the new Salary Survey for the 2010 graduating class. The average salary was $113,977, a 4.7% increase from 2009. The average student had school loans of $74,633. Dr. Stowe reported that there were 274 applicants and 120 were accepted. Average GPA was 3.64 and the average PCAT was 75. UAMS Pharmacy Camp was held last week. The Northwest Campus expansion continues and the ACPE site visit is schedule for March 2011. Arkansas State Board of Pharmacy Report Dr. Steve Bryant reported that the State Board of Pharmacy is currently focused on narcotic diversion cases, which have grown in recent years. The board will be discussing this and other issues during their meeting on Friday from 9-10. Dr. Bryant also stated that the State Board of Pharmacy is looking at PBM audits as a potential threat to public health. Federal Legislation Update Dr. Scott Pace gave an update on healthcare reform and two other pieces of legislation that are pending in Washington. These include an exemption for small pharmacies from competitive bidding and a bill that would allow pharmacies to be take back locations for expired or unused narcotics. State Pharmacy Legislation Dr. Mark Riley laid out several options for state legislative initiatives that APA may pursue in the 2011 Legislative Session, including: • PBM Transparency • Auditing Reform • Other PBM reform • Practice Changes Senator Malone Update Dr. Riley reported that Percy Malone is doing well after his automobile accident. He was beaten pretty badly by the accident, including multiple breaks in his left leg and trauma to his entire body. He has moved to a rehabilitation facility and is recovering.
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Dental Clinic Update The 4th Annual Mission of Mercy Dental Clinic took place in May 21st and 22nd in Monticello. Over 1200 patients were treated and over 700 prescriptions were dispensed. Board Retreat Dr. Riley talked about moving the Board forward through investing in a strategic planning process. Miscellaneous President Hastings presented plaques to Board members who are leaving the Board. Dr. Buzz Garner was recognized for his service as Area 1 Rep. Dr. Dennis Moore was recognized as Area 2 Representative. Dr. Gary Butler was recognized as the Compounding Pharmacy Academy President. Dr. Jim Griggs was recognized as president of the Consultant Academy. Ms. Colin Ward for her service as the UAMS ASP representative. Dr. Paul Holifield delivered remarks to the Board thanking them for allowing him to serve on the Board and as a past-APA President. ACTION ITEMS Financial Report Dr. Richard Hanry reported on the financials of the APA. He reported that the APA is working within the budget and all the financials are looking on target. Dr. Hanry submits the financials for approval. There is a motion and a second. The motion carried. A motion was made and seconded to place an ad in a magazine promoting the profession of pharmacy to high school aged students. The motion passed. Dr. Riley presented to President Hastings a framed photo of the journal recognizing her for her service as APA President this year. Adjournment A motion was made and seconded to adjourn the meeting at 11:55am. The motion passed.
APA Foundation Board June 23, 2010 Dr. Jan Hastings convened the Foundation Board at 12:00 p.m. on June 23, 2010. The Board made a motion to accept the actions of the Foundation Board. The motion was passed. A motion was made to adjourn the meeting at 12:15 p.m., motion passed.
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The Arkansas Pharmacist
On June 7, 1990, the Arkansas Pharmacists Association Board of Directors commissioned an oil painting to be created by artist Judith Boody of Little Rock. The painting was planed to express both the nostalgic reminiscence of pharmacy and a feeling of the present, combined with a unique feeling of Arkansas Pharmacy. Only 1,000 limited edition lithographs (paper size: 22” x 28” - image size: 18 1/4” x 23”) will be available. All are hand-numbered and signed by the artist. Please use the form below or order on the web at www.arpharmacists.org when ordering. Quantity ___________
Name Address City
Price plus Shipping/Handling $35.00 + $4.00
State
Net Price $39.00
Total ____________
Zip
Make checks payable to: Arkansas Pharmacists Association Mail to: Arkansas Pharmacists Association 417 South Victory Little Rock, AR 72201 The Arkansas Pharmacist
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Contents
Statement of Ownership, Management, and Circulation (All Periodicals Publications Except Requester Publications) 1. Publication Title
The Arkansas Pharmacist 4. Issue Frequency
Quarterly
2. Publication Number
9
4 4
_
13. Publication Title
14. Issue Date for Circulation Data Below
The Arkansas Pharmacist
2010 Summer
3. Filing Date
7 2 0
5. Number of Issues Published Annually
4
7. Complete Mailing Address of Known Office of Publication (Not printer) (Street, city, county, state, and ZIP+4速)
Arkansas Pharmacists Association 417 South Victory, Little Rock, AR 72201
9/29/10
15. Extent and Nature of Circulation Average No. Copies Each Issue During Preceding 12 Months
6. Annual Subscription Price
$5.00
No. Copies of Single Issue Published Nearest to Filing Date
2500
2525
Mailed Outside-County Paid Subscriptions Stated on PS Form 3541(Include paid distribution above nomi(1) nal rate, advertiser's proof copies, and exchange copies)
1669
1664
Mailed In-County Paid Subscriptions Stated on PS (2) Form 3541 (Include paid distribution above nominal rate, advertiser's proof copies, and exchange copies)
663
643
Paid Distribution Outside the Mails Including Sales (3) Through Dealers and Carriers, Street Vendors, Counter Sales, and Other Paid Distribution Outside USPS速
0
0
(4) Paid Distribution by Other Classes of Mail Through the USPS (e.g. First-Class Mail速)
0
0
a. Total Number of Copies (Net press run)
Contact Person
Helen Hooks
Telephone (Include area code)
501-372-5250
8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not printer) b. Paid Circulation (By Mail and Outside the Mail)
Same 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor (Do not leave blank) Publisher (Name and complete mailing address)
Arkansas Pharmacists Association 417 South Victory, Little Rock, AR 72201 Editor (Name and complete mailing address)
Mark S. Riley 417 South Victory, Little Rock, AR 72201
2332
2307
(1)
Free or Nominal Rate Outside-County Copies included on PS Form 3541
98
98
(2)
Free or Nominal Rate In-County Copies Included on PS Form 3541
12
12
0
0
27
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c. Total Paid Distribution (Sum of 15b (1), (2), (3), and (4))
Managing Editor (Name and complete mailing address)
Helen Hooks 417 South Victory, Little Rock, AR 72201 10. Owner (Do not leave blank. If the publication is owned by a corporation, give the name and address of the corporation immediately followed by the names and addresses of all stockholders owning or holding 1 percent or more of the total amount of stock. If not owned by a corporation, give the names and addresses of the individual owners. If owned by a partnership or other unincorporated firm, give its name and address as well as those of each individual owner. If the publication is published by a nonprofit organization, give its name and address.) Full Name
Arkansas Pharmacists Association
Complete Mailing Address
417 South Victory, Little Rock, AR 72201
d. Free or Nominal Rate Distribution (By Mail and Outside the Mail)
(3) Free or Nominal Rate Copies Mailed at Other Classes Through the USPS (e.g. First-Class Mail) (4) Free or Nominal Rate Distribution Outside the Mail (Carriers or other means)
e. Total Free or Nominal Rate Distribution (Sum of 15d (1), (2), (3) and (4)) f.
Total Distribution (Sum of 15c and 15e)
g. Copies not Distributed (See Instructions to Publishers #4 (page #3)) 11. Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities. If none, check box Full Name
h. Total (Sum of 15f and g)
x
None Complete Mailing Address
i.
Percent Paid (15c divided by 15f times 100)
137
163
2469
2470
31
55
2500
2525
94%
93%
16. Publication of Statement of Ownership
x
If the publication is a general publication, publication of this statement is required. Will be printed
Fall
Publication not required.
in the ________________________ issue of this publication.
17. Signature and Title of Editor, Publisher, Business Manager, or Owner
Date
9/29/10 12. Tax Status (For completion by nonprofit organizations authorized to mail at nonprofit rates) (Check one) The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes:
x
I certify that all information furnished on this form is true and complete. I understand that anyone who furnishes false or misleading information on this form or who omits material or information requested on the form may be subject to criminal sanctions (including fines and imprisonment) and/or civil sanctions (including civil penalties).
Has Not Changed During Preceding 12 Months Has Changed During Preceding 12 Months (Publisher must submit explanation of change with this statement)
PS Form 3526, September 2007 (Page 1 of 3 (Instructions Page 3)) PSN 7530-01-000-9931 PRIVACY NOTICE: See our privacy policy on www.usps.com
PS Form 3526, September 2007 (Page 2 of 3)
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