ARRx - The Arkansas Pharmacist Summer 2014 by Arkansas Pharmacists Association

Summer 2014 Award Winning Quarterly Publication of the Arkansas Pharmacists Association

APAâ&#x20AC;&#x2122;s New President Brandon Cooper Preaches Survival

State Board's Kirtley Reflects on Three Years as Executive Director

APA Staff Mark S. Riley, Pharm.D. Executive Vice President and CEO Mark@arrx.org Scott Pace, Pharm.D., J.D. Chief Operating Officer Scott@arrx.org Eileen E. Denne, APR Senior Director of Communications Eileen@arrx.org

4 Inside APA: Convention Recap and

Marketing Ideas: Do I Really Need a Website?

5 From the President: A David and

Pharmacist Immunization Program Increases Immunizations Exponentially

Goliath Story

6 APA 2014 Calendar of Events and

District Meeting Schedule

7 COVER: APA’s New President Brandon

Cooper Preaches Survival

12 Member Spotlight: Ward Lee, Clarksville

Family Pharmacy

14 New Drugs Column: Noteworthy

Quarter at the FDA

18 RX and the Law: Why is That

Pharmacist Asking So Many Questions?

Board of Pharmacy and AAHP Board Lists

Member Classifieds

UAMS and Harding Colleges of Pharmacy Report: 2014 Salary Survey Presents Positive Job Market Picture

AAHP Report: The Time is Now

APA Compounding Academy Report: FDA Responds to IACP Pharmacists’ Outsourcing Letter

19 Safety Nets: Rondec 20 Legislator Profile: Senator Jim Hendren

and Representative Harold Copenhaver

22 FEATURE: Prescription Drug Monitoring

Program Proves Value in Year One

AFMC Quality Notes: A New Era for Quality Improvement Organizations

15 FEATURE: State Board’s Kirtley Reflects

on Three Years as Executive Director

2014 APA Award Winners

APA Thanks its 2014 Exhibitors

APA Annual Convention CPE Attracts Lively Crowd

DIRECTORY OF ADVERTISERS 2 6 6 10 11 13

Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Celeste Reid Director of Administrative Services Celeste@arrx.org

CONTENTS Moving Forward

Eric Crumbaugh, Pharm.D. Director of Clinical Programs Eric@arrx.org

13 EPIC Pharmacies, Inc. Pharmacists Mutual Life Insurance 17 Bell & Company First Financial Bank 24 Pace Alliance Law Offices of Darren O’Quinn, PLLC 33 AAHP Fall Seminar Arkansas Pharmacy Support Group 33 Advertise in AR•Rx UAMS Alumni Association Retail Designs AR•Rx | THE ARKANSAS PHARMACIST

33 APA Pharmacy in Arkansas Print 36 Pharmacy Quality Commitment 43 APF Brick Walkway of Honor Back cover: APA Honors Pharmacy Partners of Arkansas: Larry and Angela Burns - Palace Drug

Debra Wolfe Director of Government Affairs Debra@arrx.org Office E-mail Address Support@arrx.org Publisher: Mark Riley Editor: Eileen Denne Design: Gwen Canfield - Creative Instinct Cover Photo: Molly Goodhart - Goodhart Photography Arkansas Pharmacists Association 417 South Victory Street Little Rock, AR 72201-2923 Phone 501-372-5250 Fax 501-372-0546 AR•Rx 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 68. © 2014 Arkansas Pharmacists Association.

POSTMASTER: Send address changes to AR•Rx The Arkansas Pharmacist 417 South Victory Little Rock, AR 72201 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. Visit us on the web at www.arrx.org.

APA Board of Directors

INSIDE APA

2014-2015 Officers

INSIDE APA

President - Brandon Cooper, Pharm.D., Jonesboro President-Elect - John Vinson, Pharm.D., Fort Smith Vice President - Eddie Glover, P.D., Conway Past President - Dana Woods, P.D., Mountain View

Convention Recap and Moving Forward

Area Representatives Area I (Northwest) Michael Butler, Pharm.D., Hot Springs Village Area II (Northeast) Brent Panneck, Pharm.D., Lake City Area III (Central) Vacant Area IV (Southwest/Southeast) Lynn Crouse, Pharm.D., Eudora

District Presidents District 1 - Clint Boone, Pharm.D., Little Rock District 2 - Kristy Reed, Pharm.D., Jonesboro District 3 - Chris Allbritton, Pharm.D., Springdale District 4 - Lise Liles, Pharm.D., Texarkana District 5 - Dean Watts, P.D., DeWitt District 6 - Stephen Carroll, Pharm.D., MBA, Arkadelphia District 7 - C.A. Kuykendall, P.D., Ozark District 8 - Darla York, P.D., Salem

Academy of Consultant Pharmacists Rachel Hardke, Pharm.D., Carlisle

Academy of Compounding Pharmacists Lee Shinabery, Pharm.D., Jonesboro

Arkansas Association of Health-System Pharmacists Marsha Crader, Pharm.D., Jonesboro

Ex-Officio APA Executive Vice President & CEO: Mark Riley, Pharm.D., Little Rock Board of Health Member: John Page, P.D., Fayetteville AR State Board of Pharmacy Representative: John Kirtley, 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., Searcy Legal Counsel: Harold Simpson, J.D., Little Rock Treasurer: Richard Hanry, P.D., El Dorado UAMS COP Student: Brett Bailey, Beebe Harding COP Student: Meredith Mitchell, Joplin, MO

Mark Riley, Pharm.D. Executive Vice President & CEO

et me start with a big “THANK YOU” to all of those who attended the 132nd Annual Convention of the Arkansas Pharmacists Association in Fayetteville June 12 – 14. From breakfast to Continuing Pharmacy Education (CPE) to the evening social events, everyone seemed to have a great time and the comments I have received have been extremely positive. I also want to thank all of my staff (Scott, Eileen, Debra, Eric, Celeste, and Susannah) for their tireless efforts in both planning and implementation of the event. Susannah was a “rookie” as far as planning a pharmacy convention but she sure didn’t perform like one. For the most part, the convention went smoothly and as expected (of course, no one can anticipate elevators becoming dysfunctional but, with the attendees help, we worked around that). The CPE programming was intended to help pharmacists begin to participate in delivering patient care services that are/will be needed in the new healthcare delivery models that we see developing. I believe the goal was accomplished through programs that were spot on in their content. I appreciate the full house attendance for the Arkansas Pharmacists Political Action Committee (AP-PAC) Breakfast, and especially appreciate Congressman Tim Griffin’s early drive “up the hill” to be our keynote speaker. There was great attendance at the Opening Reception in the Exhibitor Hall on Thursday night as well as the Friday night functions that honored our wholesale partners, Amerisource Bergen, Cardinal Health, McKesson,

Morris & Dickson, and Smith Drug. Attendees had the option of attending the Art of Wine (a wine tasting event at the Walton Arts Center) or dining at the world famous AQ Chicken. I want to thank outgoing President Dana Woods for his great work in leading the APA this past year. Dana has been a pleasure to work with and truly has the interests of our members at heart. New President Brandon Cooper brings a lot of experience and energy and is our youngest president in 30 years. Brandon has been involved in promoting pharmacy and growing in leadership since shortly after he graduated from UAMS College of Pharmacy. (Hmm, reminds me of someone else I know…) I know Brandon will provide great leadership for our association. Finally, it’s back to work in endeavoring to ensure pharmacists' place in the ever-changing landscape we refer to as healthcare reform. The system is begging for improved health outcomes and payers are demanding cost effectiveness. I believe pharmacists can be an important part of the answer with medication-related management of disease. As I said Saturday morning at the breakfast, be ready when opportunity comes. Oh, I know there are many “burning platform” issues to deal with and we are doing that every day, but, ultimately, the big picture issue now is how we transition into a more fully integrated system that serves the patients' needs and improves their health. I am confident that you will do your part. §

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FROM THE PRESIDENT

A David and Goliath Story Brandon Cooper, Pharm.D. President

et me start by saying what a privilege it will be to serve as your APA President during the upcoming year. I consider it a great honor to follow in the footsteps of the leaders of this great Association of pharmacists dating all the way back to 1882. Over the past decade since I first became involved with the Board of Directors, I have relied upon the friendships, expertise, and mentorship that I’ve received from all the Past Presidents and members who have shown me the importance of being an active and involved member of our chosen profession. For those who were unable to attend our Annual Convention in Fayetteville, consider what you missed. Not only did you miss out on a wealth of knowledge and information from the CPE programs and exhibits, but also the fellowship and camaraderie gained by communicating with your peers about the issues facing our practice setting is hard to replace. It is my hope over the next year that you’ll make it a point to become more involved in APA and maybe I’ll see you next year in Little Rock for our 133rd Annual Convention! Pharmacy practice in Arkansas, and for that matter across the country, has certainly faced its fair share of challenges and issues that arise each and every year. It seems that as we extinguish one fire, two more flames rekindle elsewhere. This is certainly true during a pivotal election season and impending legislative session that we are facing in the near future. That is why this year I’ve chosen to focus on SURVIVAL as our theme for the upcoming year. If we want to survive as a profession, survive as a viable Association, and survive on a personal or business level then we have to learn to effectively fight back against all the factors that come at us from every angle, whether known or unknown. I’m reminded of the Biblical story of David and Goliath, probably one of the most recognizable stories of courage through battle in the history of mankind. Sometimes as pharmacists we can relate to David, preparing himself for battle with only a sling shot, staff, and a shepherd’s pouch of ammunition facing the “giants” of health care wearing bronze suits and helmets and flanked by their heavily armored lobbyists holding javelins, spears, and swords.

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During a recent trip to the NCPA Legislative Conference in Washington, D.C., Representative Doug Collins from Georgia gave a rousing talk about one of the bills he was proposing to help with generic drug pricing transparency. During his speech he pointed out an often-overlooked fact regarding the ancient story of David and Goliath, the fact that David took with him five smooth stones. Most of us remember the one stone that David faithfully hurled towards Goliath to bring down the mighty giant, but what we don’t think about are the four other stones that he was still ready to use just in case that first one didn’t do the trick. David did not choose to take a fancy sword or shield with him, instead he chose what he was familiar with, something that he was comfortable using. He had faith and all the ammunition that he felt he would need, which included a back-up plan. You might be asking yourself, “What are the five smooth stones that APA is prepared to use to fight our legislative and professional battles this year?” Well, that is where you come into the picture. Each and every one of us has a grassroots effort that is waiting to be activated. The policy makers, movers and shakers, and the electorate that can help us achieve our goals walk through our doors each and every day. We must voice our concerns about our issues to those that can help make a difference. We also have another great opportunity as we look to add more pharmacists and “friends of pharmacy” to the state legislature and executive branch. We can show our continued support to them monetarily and by active involvement in their campaigns. This will only help us as we look to enforce many of the laws we’ve passed in recent years, like PBM transparency and MAC pricing. Finally, the other “stones” in our arsenal remain to be seen. It is my hope that as members, you will become more involved in the process by letting us know what ideas you have for protecting and strengthening our Association and profession. Feel free to contact me or a member of the staff should you want to become more active by joining a committee or sharing your ideas in another way. I look forward to hearing from you and I thank you again for the opportunity to work with you and for you during my term as President. §

2014 Calendar of Events and District Meetings AUGUST

Tuesday, September 23 District 5 Harding University Cone Chapel Searcy, AR

August 7-8 APA Board Retreat Crowne Plaza Hotel Little Rock, AR

SEPTEMBER Thursday, September 4 District 1 Embassy Suites Hotel Little Rock, AR Monday, September 8 District 6 Embassy Suites Hot Springs, AR

Tuesday, September 30 District 8 Grand Prairie Center Stuttgart, AR

OCTOBER

Tuesday, September 9 District 4 Camden Country Club Camden, AR Prescription Drug Take Back Summit September 9-11 State House Convention Center Little Rock, AR

October 2-3 Arkansas Association of Health-System Pharmacists Annual Fall Seminar Clarion Medical Center Hotel Little Rock, AR October 18-22 National Community Pharmacists Association Annual Convention Austin, TX

Thursday, September 11 District 5 Monticello Country Club Monticello, AR

October 23 APA Golden CPE Hosto Center Little Rock, AR

Monday, September 15 District 6 Lake Point Conference Center Russellville, AR

NOVEMBER

Tuesday, September 16 District 7 Holiday Inn City Center Fort Smith, AR Wednesday, September 17 District 3 Embassy Suites Rogers, AR Thursday, September 18 District 3 Big Creek Golf & Country Club Mountain Home, AR

Thursday, September 25 District 2 Jonesboro Country Club Jonesboro, AR

ARâ&#x20AC;˘Rx

November 5-7 American Society of Consultant Pharmacists Annual Meeting & Exhibition Gaylord Palms Resort & Convention Center Orlando, FL

DECEMBER

December 6-7 APA Committee Forum and Board Meeting Location TBD December 7-11 American Society of Health-System Pharmacists 2014 Midyear Meeting Anaheim, California

THE ARKANSAS PHARMACIST

APA’s New President Brandon Cooper Preaches Survival By Eileen E. Denne, APR

PA’s 2014-2015 president, Brandon Cooper, Pharm.D., is a man of faith like many of his fellow pharmacists. And he has a fervent mission in the coming year: to help pharmacists survive as a profession, as individuals and as members of their state association. He finds it difficult to narrow the important issues down to a single one.

Cooper did a three-month rotation in Dillingham, Alaska, and a month at the APhA headquarters in Washington, D.C.

“I went to the [Congressional] committee hearings and could actually see the process. I was able to see how pharmacy needed to advocate on behalf of the profession. “It wouldn’t do justice to our members to focus on one I attended some of the first hearings on Medicare Part D thing when we have so many things coming at us,” Cooper and the Health Insurance Portability and Accountability said. “This is a crucial time in our Act (HIPAA) rules. That introduced me profession, especially in independent to just how much we have to fight This is a crucial time in our community pharmacies. We just have against because of all the different to survive. Our livelihood is being interest groups and lobbyists that profession, especially in threatened by things out of our try to do so much that is not in independent community control.” the pharmacists’ best interest. [I pharmacies. We just have understood] how important it is to to survive. Our livelihood is have pharmacists working behind SPIN Coordinator for APHA-ASP the scenes on our behalf.” being threatened by things Although at age 36 he is the youngest president APA has welcomed in 30 out of our control. Independent Pharmacy Career years (since 1984 when current APA Following graduation from UAMS, Executive Vice President and CEO Cooper’s first job was at the first Mark Riley served as president,) Walgreens that opened in Jonesboro. After six months, he Cooper has been involved in serving his profession for a began working for Chad Register who had a pharmacy in number of years. While at the University of Arkansas for Kennett, Missouri, then did relief work for Fred’s Pharmacy Medical Sciences (UAMS) College of Pharmacy between in Northeast Arkansas for almost a year. Then, Cooper 1998 and 2002, Cooper had a strong interest in the said, “I found my way back home.” political process and he joined the American Pharmacists Association Academy of Student Pharmacists (APhA-ASP) While in high school, Cooper worked for Soo’s Drugstore. and became the Student Political Information Network As he tells the story, before his senior year in high school (SPIN) Coordinator. He was involved in the National he had his wisdom teeth removed and while at Soo’s Community Pharmacists Association (NCPA) student with his mother, the clerk asked if he had thought about chapter, the Christian Pharmacist Fellowship International working at the store during the summer or part-time as (CPFI) and served as treasurer of Kappa Psi, the a senior in high school. He couldn’t say anything at the pharmaceutical fraternity. During his senior year at UAMS, A A RR •• RR xx | | T HT EH EA RAKRAK N A SNAS SA SP HP A H RAM RA M CAICS ITS T

APA's NEW PRESIDENT BRANDON COOPER

Cooper with pharmacist-in-charge and owner Krystal Soo of Soo’s Drugstore and Compounding Center in Jonesboro.

Past President Dana Woods, P.D., turns the 2014-2015 gavel over to Cooper.

time, so he nodded. He went home and thought about it and decided he already knew most of the people who worked there. He thought it would give him an idea of whether [pharmacy] was what he wanted to do. So when Krystal Soo called about an open pharmacist position at Soo’s many years later, Cooper couldn’t pass up the chance and went to work with Krystal and Mike at the old store where he worked in high school. He has been there ever since.

Others have mentored Cooper as he has taken on more responsibility on behalf of APA. He served as District 2 President, then Area II Representative, then Vice President and President[HIPAA hearings] introElect. He always had an interest in the political process and being involved in duced me to just how much groups in pharmacy school helped him we have to fight against realize how important it was.

because of all the different interest groups and lobbyists that try to do so much that is not in the pharmacists’ best interest. [I understood] how important it is to have pharmacists working behind the scenes on our behalf.

Cooper’s success with patients may be a throwback to his deliveries for Soo as a teenager. “One of my favorite things was stopping to visit with all the little old ladies. They wanted someone to talk to and always asked if I wanted something to eat or drink. I would plan my route and knew my way around Jonesboro. I’d know where I needed to go and how I could end up getting [lots of] snacks. When I got back [to the store], they’d say ‘that was quick!’ so I would plan to visit that much longer with the little old ladies the next time.”

Pharmacy Mentors

According to Cooper, he learned a lot from original Soo’s Drugstore owner and pharmacist Albert Soo (father of Mike and grandfather of UAMS COP class of 2017 candidate Tyler Soo) who gave him his first job. Cooper also grew up next to pharmacist Mike Miller (currently pharmacist at Walgreens in Jonesboro). Some of Cooper’s favorite times working at Soo’s was when Mike worked on Tuesday and Friday nights. He also learned some good lessons from Bill Thompson and David Eddington. 8

“I remember [former APA Executive Vice President] Richard Beck and other pharmacists saying how important it was to get involved. Stephanie Goodart O’Neal was instrumental in getting me involved because I used to write articles in the [Jonesboro Sun] newspaper. She realized I was becoming vocal and she, Tony Bari and Mark Riley thought I should get involved. Since I started, Mark has been a pretty good nudger to get me more involved. Krystal has been my boss for 10 years and allowed me the opportunity to pursue these endeavors with the association.” Jonesboro has seen a number of past APA presidents, including Bob Evans and Roger Harmon. This year, in addition to Cooper as APA president, two Jonesboro residents are serving as Academy presidents: Lee Shinabery, Pharm.D., Shinabery Community Pharmacy, Academy of Compounding Pharmacists, and Marsha Crader, Pharm.D., St. Bernards Medical Center, Arkansas Association of Health-System Pharmacists.

Advocacy Role for Arkansas Pharmacists

Cooper wants APA members to understand that “we’re their advocates because we know they have busy work AR•Rx

THE ARKANSAS PHARMACIST

APA's NEW PRESIDENT BRANDON COOPER

hours and personal lives. Maybe they can rest a little easier because of the staff solving problems behind the scenes.” Cooper said APA has done many things to make it easier to implement new areas into pharmacists’ practice like immunizations or Medication Therapy Management (MTM) models. When asked about priorities during his presidency, Cooper narrowed them down to one word: survival. Until pharmacists are recognized as providers, he said, it will be hard to maintain this current status of just being paid for product. “We’re medication experts but not able to be recognized and paid to provide that expertise.” He also said survival on a personal level is challenging when economic times are tough and there are new regulations on controlled medications that are forcing people to go to great lengths to feed their addictions. In other parts of the country, Cooper said, pharmacists’ lives are on the line when drug seekers take drastic measures. He also cited survival of the profession and survival of the association. “Now that we’ve had so many new practitioners joining the profession due to increased class sizes and another pharmacy school, we have to find ways to make [new graduates] realize how important the association will be if they want to continue in their chosen profession. They have to realize that they need to get involved.” The association has not yet determined its 2015 legislative priorities, but Cooper thinks there will be bills proposed that APA will need to fight against. He also cited the need to strengthen and enforce the Pharmacy Benefit Manager (PBM) auditing and Maximum Allowable Costs (MAC) bills. “There are always those unknown things that we’re going to have to fight against,” Cooper said. “[Issues] may come out of the August Board meeting when we do strategic planning. We need to hear from the membership about what they think we need. It’s good timing because we’ll have another pharmacist in the legislature (Justin Boyd, Pharm.D., will become state representative for District 77 in January 2015). It means a lot having someone in our profession actually there to communicate one-on-one with legislators – having a colleague there. ”

Cooper wants APA members to understand that "we’re their advocates because we know they have busy work and personal lives. Maybe they can rest a little easier because of the staff solving problems behind the scenes." much impact if every person who worked as a pharmacist picked up the phone and took advantage of it.”

Future of Pharmacy

Although APA is thought of as mainly being a group for independents, Cooper said it is so much more than that. Hospital pharmacists and consultants also have their issues impacting the profession including [drug] shortages and rising costs. APA is working to bring the groups together. “We all need provider status and have to help each other,” Cooper said. “Independents can help with hospital folks and vice versa. [Each sector] impacts the profession as a whole. It would be nice to have more chain pharmacy members too.” Cooper has a special affinity for mentoring pharmacy students. He has served as a preceptor since he started working at Soo’s Drugstore and Compounding Center, taking students from UAMS, St. Louis and Harding Colleges of Pharmacy. He enjoys seeing different students and gets just as much out of his preceptor role learning from them and things they pick up while on rotation.

Cooper thinks pharmacists should be involved in the legislative process by supporting the people running that are in the pharmacy profession. Every legislator has to have a prescription filled, he said. “APA has a unique situation on so many issues just by using the relationships we already have with the legislators. I’d like to see us do more things as we did on the pseudoephedrine bill when legislators were bombarded with phone calls from pharmacists. We could have so

AR•Rx | THE ARKANSAS PHARMACIST

Cooper immunizing a patient at Soo’s Drug and Compounding Center.

Cooper with his father Eddie on the golf course.

“Tyler Soo (UAMS Class of 2017) wants to have a place to go when he graduates so if we don’t do something now to make sure the stores are still here, what’s he going to come back and do?” Cooper asked. His advice to new graduates: “Don’t just settle for what’s out there. Look for new ways to help the profession in your own way.” Just as Cooper himself has been doing for 10 years. §

I’d like to see us do more things as we did on the pseudoephedrine bill when legislators were bombarded with phone calls from pharmacists. We could have so much impact if every person who worked as a pharmacist picked up the phone and took advantage of it.

AR•Rx

THE ARKANSAS PHARMACIST

APA's NEW PRESIDENT BRANDON COOPER

BRANDON COOPER IN BRIEF: BIRTHDATE & HOMETOWN: March 13, 1978 in Jonesboro PARENTS: Father works in auto parts industry and mother taught 4th grade for almost 30 years. Cooper is the only child and only grandchild on both sides. SCHOOL: Completed pre-pharmacy curriculum at Arkansas State University and received his doctoral degree in pharmacy from UAMS in 2002. COMMUNITY ACTIVITIES: Cooper completed Leadership Jonesboro in 2005 and continues to be a Leadership Link member for the Jonesboro Regional Chamber of Commerce. He serves on the Institutional Animal Care and Use

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Committee at Arkansas State University and is a member of the Jonesboro Young Professionals Network. He is also an active member of Nettleton Church of Christ. AWARDS: He received APA’s Distinguished Young Pharmacist Award in 2007; the Diabetes HealthCheck Program Award of Excellence in 2005; the Lester Hosto Memorial Scholarship in 1999; Rho Chi Honor Society from 2000-2002; and Phi Lambda Sigma Pharmacy Leadership Society from 1999-2002. FOR FUN: Golf, travel and going to St. Louis Cardinals, Razorbacks and Memphis Grizzlies games.

Member Spotlight

Ward Lee, P.D.

—

CLARKSVILLE FAMILY PHARMACY, CLARKSVILLE

Pharmacy Practice: Independent Retail (previous experience in chain and institutional pharmacy).

Recent Reads: Heaven Is For Real, Sycamore Row, Drug Topics.

Graduation: 1992 Northeast Louisiana University.

Fun Activities: Camping, landscaping, attending my son's football games and singing in a gospel quartet.

Years in Business: 3 years at this location. Favorite Part of the Job: Patient contact and forming personal relationships with patients. Least Favorite: Dealing with PBMs. Oddest Request: A patient requested that I go out into the store and get her auburn hair color and a gallon of milk and give it to her through a bank-style drive-thru window when she had no Rx's. (This happened when I was working for a chain pharmacy.)

Ideal Dinner Guest: Anyone who will allow me to eat my meal at the temperature that it is supposed to be and not ask me any pharmacy-related questions when I am trying to eat. If not a pharmacist, then... a musician or carpenter. §

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Noteworthy Quarter at the FDA

he second quarter of 2014 was a busy one at the Food and Drug Administration (FDA). Headlining the news, the FDA lifted sales restrictions on generic versions of Plan B One-Step® after a year-long legal struggle with women’s health groups. Continuing in the headlines was the Zohydro®ER debate. Lawmakers have attempted to force withdrawal of the FDA’s approval or at a minimum severely restrict use of Zohydro®ER, but those efforts have been countered by a federal judge who recently blocked Massachusetts’ attempt to ban the drug. The FDA continues to defend their approval of Zohydro®ER amid the ongoing opioid abuse debate. Seemingly unnoticed during this debate is the approval of Xartemix™XR, an oxycodone/ acetaminophen combination that curiously features an extendedrelease formulation that is indicated for acute pain. Fourteen new drug approvals were granted over the past quarter, five of which received expedited review, breakthrough therapy designation, or orphan drug status. Of local interest, Sylvant™ (siltuximab) is an orphan drug that underwent priority review and is the first-ever drug to treat Castleman’s Disease, a rare blood disorder similar to lymphoma. Researchers at UAMS headed the clinical trial that led to the approval of Sylvant™. Zykadia™ (ceritinib) also received priority review and was granted breakthrough therapy designation for the treatment of late-stage metastatic non-small cell lung cancer. A third oncology drug, Cyramza™ (ramucirumab,) was approved with orphan drug status for advanced stomach cancer and malignancies at the gastroesophageal junction. Also of significance are two infectious disease drugs. Dalvance™ (dalbavancin) was approved to treat acute bacterial skin-related infections, including MRSA. Dalvance™ is the first drug to receive FDA designation as a Qualified Infectious Disease Product, which also qualifies it for 5-years of additional marketing exclusivity. Impavido® (miltefosine) was awarded a Tropical Disease Priority Review and is the first parasite-inhibiting drug to treat leishmaniasis. Several other firsts should be noted. The first sublinguallyadministered allergen extracts (Grastek®, Oralair®, and Ragwitek™) were approved to treat grass and pollen-induced allergic rhinitis. Alprolix™ (Coagulation factor IX, Fc fusion protein) is an orphan drug that is the first recombinant DNA-derived hemophilia B therapy with prolonged circulation in the body and is indicated for the 14

control and prevention of bleeding episodes. And finally, cobas® HPV Test is the first human papilloma virus DNA test that can be used alone to detect high-risk HPV and is recommended for firstline screening. Several drugs with chronic care implications were also approved. Entyvio® (vedolizumab) is a humanized monoclonal antibody used to treat adults with ulcerative colitis or Crohn’s disease. Otezla® (apremilast) is for adult psoriatic arthritis and as a safety measure requires a pregnancy exposure registry. Tanzeum™ (albiglutide) is a GLP-1 receptor agonist similar to Byetta® for use in adults with type 2 diabetes; this drug carries a boxed warning due to the occurrence of thyroid gland tumors in animals. Zontivity™ (vorapaxar) is a first-in-class antiplatelet used to reduce the risk of MI, stroke, cardiovascular death, and need for revascularization procedures in patients with a previous MI or peripheral artery disease. Zontivity™ has a boxed warning against bleeding risk and is contraindicated for use in patients with a history of stroke, TIA, or intracranial hemorrhage. Rounding out the list is Neuraceq™ (florbetaben F18 injection) used in brain PET imaging to estimate β-amyloid plaque density in patients being evaluated for Alzheimer’s disease or other causes of cognitive decline. Several significant new dosage forms were also approved. Evzio™ (naloxone) is an auto-injector formulation that can be used by family members or caregivers to treat a known or suspected opioid overdose. Other new formulations so far this year include: Aveed™ (testosterone; less frequent dosing,) Epanova™ and Omtryg™ (omega-3 fatty acid formulations,) Hemangeol™ (propranolol; oral solution,) Incruse™ Ellipta® (umeclidinium; COPD,) Purixan™ (mercaptopurine; oral suspension,) Qudexy™XR (topiramate; extended-release) and Tivorbex™ (indomethacin; low-dose). § _____________________________________________________________________ Contributing Author: Samantha Morrison, Pharm.D. Candidate, Harding University College of Pharmacy _____________________________________________________________________ Rodney Richmond, RPh, is Associate Professor, Pharmacy Practice, at Harding University College of Pharmacy in Searcy.

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State Board’s Kirtley Reflects on Three Years as Executive Director By Eileen E. Denne, APR

John Clay Kirtley, Pharm.D., Arkansas State Board of Pharmacy, updates APA on the past three years in his role as Executive Director.

rkansas State Board of Pharmacy’s John Clay Kirtley, Pharm.D., assumed his role as Executive Director three years ago following Charlie Campbell’s retirement. Arkansas licenses 5,300 pharmacists and almost 8,000 technicians. AR•Rx, The Arkansas Pharmacist, spoke to Kirtley about his transition from Assistant Director and his biggest challenges.

problems. I hired someone who was capable of anything that needed to be done.

As Executive Director, there are just more meetings, committees and everything else you get called to as agency director. A major responsibility for the Executive or his designee is serving as a member of the State and Public School Life and Health Insurance Board in the Employee Benefits Q. What looks different from the Division (EBD). Three years ago, I When we moved to our Executive Director’s chair now that was elected Vice Chair and last year, new offices on 4th and you’ve been in it for three years? I was elected as the board’s Chair. My One of the biggest things is the office Main Streets it opened up a term is up in June 2015. I get hate mail itself. When we moved to our new lot more possibilities for us for being on the EBD Board which is offices on 4th and Main Streets it to use our space in various odd because it is predominantly from opened up a lot more possibilities for us upset school employees accusing the ways. The State Board is to use our space in various ways. The board of having no concern for public now a lot more involved State Board is now a lot more involved school employees or their insurance. in delivery of Continuing in delivery of Continuing Pharmacy Both my parents and my grandmother Education (CPE). We are working with Pharmacy Education (CPE). are retired school teachers. When we the Drug Enforcement Agency (DEA) make a major design plan change, I and State Drug Director, Fran Flener, to know all too well how it affects state employees as well as deliver a new CPE mix to pharmacists in local communities. public school employees and their families. We’ve held five mini drug summits around the state in northwest, northeast and south Arkansas in the last 1-1/2 I enjoy it but it does take a tremendous amount of time. We years where we bring in pharmacists and law enforcement are making some good changes to right the ship and to officers for educational sessions. make [the insurance plan] a strong plan going forward and affordable for its members to the best of our abilities as a Many of my duties as Assistant Director have carried on Board. I am glad to be a pharmacist on the Board which is in my director role but Assistant Director Brenda McCrady a unique perspective when discussing healthcare coverage has also taken on a great deal of the work that I was doing. and benefits. One thing that is consistently held up as an She is in charge of investigations and complaints as well example of how things are going right is the employee as administrative review of applications with issues or benefit drug plan. It has been very well-managed.

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Door to the new State Board of Pharmacy offices on the 6th Floor of their building on the corner of 4th and Main Streets in Little Rock.

Q. What have you learned?

One thing I have learned is to delegate. It is impossible to do everything that people think only you can do. It has helped to empower our employees so they have better job confidence, skills and relationships. It helps to show that we’re all capable people when people call in with issues. If I didn’t have a good staff here there is no way I could go to outside meetings or EBD or conduct education outreach including the Prescription Drug Take Back program.

Q. What has been most surprising?

After 6 1/2 years working at the State Board as Assistant Director, a lot of pharmacists didn’t realize I worked here. A lot of people think the Board is only there to get them and lots are pleasantly surprised. They are hoping to get guidance and we’re able to give it to them. The fear of the State Board and our positions are at times healthy and at other times unwarranted. There is also misinformation about Board decisions. People pass along gossip rather than looking at facts. Pharmacists will get a monetary penalty and we’ll hear that licenses were revoked.

One of biggest challenges has been compounding. Arkansas has long been a leader in compounding; other states have looked at what we do. Although Arkansas was well-prepared, some of the questions from the federal government were on things that no state board of pharmacy was really tracking.

Q. What have your biggest challenges been?

One of biggest challenges has been compounding. Arkansas has long been a leader in compounding; other

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states have looked at what we do. When the fungal meningitis crisis hit in 2012 with New England Compounding Company at fault and people dying, very quickly we had requests for all kinds of information. Although Arkansas was well-prepared, some of the questions from the federal government were on things that no state board of pharmacy was really tracking. It was difficult trying to explain specific differences in professional jargon and different definitions of compounding. Brenda and I attended Food and Drug Administration (FDA) meetings as well as National Association of Boards of Pharmacy (NABP) meetings. The compounding issues are ongoing and continue to be convoluted.

Q, How about your role with NABP?

NABP does a great job of trying to get state board execs together so we can really talk about some targeted issues we are dealing with. We’ve presented the Arkansas approach to various issues and shared them with other state boards. Since 2006, I have served as president of a regional group of state board execs representing 13 southeast states called MALTAGON. The meetings are a great time for networking, brainstorming and talking about strategy for new problems that arise. NABP also appointed me to serve on the Accreditation Council Pharmacy Education (ACPE) Board starting July 1.

Q. Has the Arkansas Prescription Drug Abuse Summit called attention to the issue of prescription drug abuse?

I believe that the 2012 and 2013 Summits showed us how to change the focus for the next meeting on Sept. 9-10, 2014. It will have a health care track and breakouts to talk about specific health care issues. In 2012, we had had 500 participants. The second year, we had around 600, not counting speakers or students. I do not see problems

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STATE BOARD'S KIRTLEY REFLECTS

with prescription drug abuse going away any time soon. We have to continue to let the public know that prescription drugs are every bit as dangerous as street drugs.

Q. What is pharmacists’ role in prescription drug take back?

When counseling patients, let them know the risks to the legitimate user and implement the approach of monitor, secure and dispose. Be sure they know what drugs they are taking and be sure others aren’t taking from them. Patients need to have security on those drugs and to protect their own property so others don’t get it. Be sure patients know how to dispose of unused medications. One major accomplishment has been having a permanent drug drop-off box in every Arkansas county. The state board has partnered with the Benton Police Department, Arkansas State Drug Director and DEA for www.ARTakeBack.org. On that website you can put in your zip code and find out where to drop off drugs at either permanent locations or temporary events near you.

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Q. Is there anything else you’d like to share?

We try to share information with everyone. Don’t just think about calling, call us. We are here to answer questions. If you think you have an issue or problem, we’ll try to help with whatever the issue is — drug addiction, diversion, or problems with consumer complaints. Our role is to protect the public’s health and welfare — not only enforcing against pharmacists but helping pharmacists understand the rules and how to work with them. §

PHARMACY RESIDENCES

Why Is That Pharmacist Asking So Many Questions? This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and the Arkansas Pharmacists Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

ne of the duties required of pharmacists under O OBRA ’90 is that a Drug Utilization Review (DUR) be performed. In the years since, the profession has

developed specialized areas of DUR, such as medication reconciliation in the hospital setting. In the end, a healthcare professional should make sure that the patient is on the correct drugs for their condition(s,) that they are taking them at the correct dosages, and that all the medications work together. The professional best suited to provide this service, whatever you call it, is a pharmacist. What does the pharmacist need in order to provide this service effectively? Up-to-date patient information and an up-to-date medication list are key. Reasonable efforts to obtain this information should be made by the pharmacist or his or her staff. Patients are sometimes reluctant to provide this information. It may be a privacy concern, embarrassment, or it may be that they don’t understand why it is needed by the pharmacist. Patient education may be helpful in the latter case. In the hospital setting, an accurate list upon admission may be difficult to obtain initially, but with the help of the physician’s office, and many times the patient’s community pharmacist, the blanks can easily be completed. Medication reconciliation is also important at discharge. Discontinued or changed dosages are communicated to the patient. The patient should give this new information to their community pharmacist and pharmacists should be looking for it if they are aware of any hospital admissions or procedures. Continued focus on continuum of care will allow all pharmacists to better serve their patients through increased access to current information. In the end, the pharmacist must proceed with the information at hand. The patient should understand that the quality of the DUR depends on the information that the pharmacist has to use. We cannot force patients to provide the necessary information. However, the pharmacist should document their attempt to gather it if they cannot obtain it. Once the review is finished, the key to a successful DUR encounter is to take action with any findings that are out

of the ordinary. This may mean having a discussion with the patient about their condition and/or their therapy. Many times these conversations can clear up any misinterpretations or other mistakes. A well-informed patient can be a good ally to make sure that their therapy is appropriate. But at other times, a call to the prescriber about one or more drugs that are causing concern, or have the potential to cause a problem, is required. Again, documentation is key. Make good notes about the conversations or phone calls. Record the date, time, participants, and the content of the discussions. If changes to therapy need to be made, make sure that the changes are well-documented also. Don’t assume that someone else has discussed your concerns with the patient or has interacted with the prescriber. Many times the pharmacist is the last line of protection for the patient. This doesn’t excuse those professionals who have acted before you, but in most situations, there is no one to take action after you. There are also situations where prescribers will not change the ordered therapy. The pharmacist must then act to protect the patient within their professional boundaries. A previous article in this series discussed refusing to fill prescriptions. The patients’ health and well-being depend on all healthcare professionals doing their respective jobs to the best of their abilities. For pharmacists, one aspect of this means doing your best to gather patient information, performing a thorough DUR, and carrying through with any needed recommendations. Your patients may not realize that this is going on behind the scenes, so educate them about what you are doing to protect them. They should value your service even more. §

_________________________________________________________ © Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.

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PHARMACY RESIDENCES

UN N I V EE RR SS II TT YY O F A R K A N U N SS A A SS FF O ORR M MEEDDIICCAALL SSCCI IEENNCCEESS CCOOL LLLEEGGEE OOFF PPHHAARRMMAACCYY

Rondec Welcome to another issue of Safety Nets. This column illustrates the potential hazards associated with illegible prescriber handwriting. A community pharmacist from Central Arkansas reports the following potentially lifesaving intervention. Thank you for your continued support of this column, and to the pharmacist who shared this interesting case with our readers.

he electronic prescription illustrated in Figure 1 was transmitted from the prescriber’s office to a pharmacy in southeast Arkansas. The prescription, for a 25-year-old patient, was initially reviewed by a pharmacy technician. After examining the prescription, the technician was confused about the quantity of medication to be dispensed. The prescriber was contacted by telephone and said he wanted the patient to receive 120 mL, not “1” as indicated on the prescription. After this, the technician filled the prescription and Figure One placed it in line for pharmacist verification. The pharmacist verified the prescription had been correctly filled and labeled as Rondec DM® Syrup (chlorpheniramine, dextromethorphan, phenylephrine,) quantity 120 mL, with directions to the patient of “take 1 mL by mouth every six hours around the clock”. After this, the prescription was placed in the “will call” bin for patient pickup. Later that afternoon, the patient arrived at the pharmacy to pick up the prescription. After paying for the medication, the patient was directed to the counseling area of the pharmacy. During the counseling session, the pharmacist asked the patient if the prescriber had verbally instructed them to administer 1 mL of Rondec DM® Syrup per dose. The patient said they had not been provided with any instructions on how to take the medication. At this point, the pharmacist told the patient he wanted to verify this extremely small medication dose with the prescriber. The pharmacist telephoned the prescriber’s office for the second time regarding this electronically transmitted prescription. After expressing his concerns about the 1 mL dose to a nurse, the pharmacist was told the patient was to administer one teaspoonful of Rondec DM® Syrup every six hours as needed not 1 mL every six hours around the clock as designated in the sig field of the order. The nurse went on to explain that she could not locate the prescribed sig (i.e. one teaspoonful every six hours as needed) in the electronic prescription software. As a result, she selected the closest sig she could find (i.e. 1 mL every six hours around the clock). She then typed the prescribed sig (i.e. 1 tsp Q6H PRN) in the notes section located at the bottom of the order. After this, a corrected prescription label was generated and the patient appropriately counseled. The use of electronic medication orders is widespread in today’s health care system. E-prescriptions have been touted as having AR•Rx

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certain advantages over handwritten prescriptions including reducing the incidence of medication errors – especially those resulting from look-alike, sound-alike mix-ups. While electronic prescriptions may indeed reduce the likelihood of certain types of errors, their use does not guarantee an error-free order as this case clearly illustrates. In fact, the pharmacist in this case had to contact the prescriber not once – but twice – concerning this electronically transmitted order. In this case, the electronic prescription itself is the problem. The E-prescription actually contains two different sigs: “1 mL by mouth every 6 hours around the clock” and “1 teaspoonful every 6 hours as needed”. While checking the filled prescription for accuracy, the pharmacist verified the patient directions in the “sig field” without noticing the directions also listed in the “notes” section located at the bottom of the order. This prescription format laid a trap that could have snared any busy pharmacist or technician. In fact, if this electronic prescription had involved a medication with a narrow therapeutic index, the order could have been extremely hazardous. This prescription also reminds us that the use of “tsp," “tbsp” and old Apothecary symbols in prescriptions is contrary to United States Pharmacopeia policy. Only prescriptions written in the metric system are (since 1997) official in the United States. The introduction of information technology to prescription writing offers us all a reminder to cease using the obsolete and inherently hazardous Apothecary abbreviations. Fortunately for the patient in this case, the pharmacist performed required Board of Pharmacy patient counseling. If counseling had not occurred, the patient would have administered a subtherapeutic dose of Rondec DM® and their symptoms would not have been relieved. Electronic prescriptions are not guaranteed to be error-free. In fact, the legibility and neatness of electronic prescriptions may – in some cases – increase the risk of error compared to handwritten prescriptions which may be more carefully examined by the pharmacist. Pharmacists must remain careful to scrutinize all prescriptions – handwritten and electronic. § 19

Legislator Profile

Senator Jim Hendren

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(R- GRAVETTE)

District: 2 Represents: Northwest Benton and Washington Counties.

Most admired politician: Ronald Reagan.

Years in Office: 6 in Arkansas House; 1st term in Senate (1-1/2 years).

Advice for pharmacists about the political process and working with the AR Legislature: Don't hesitate to call. We value your opinions and the phone calls make a difference.

Occupation: Engineer; own plastic manufacturing company. Your pharmacist: Ron Teasley and Ken Austin (Both have been amazing to my family for years). Like most about office: Making a difference that matters. Last session I sponsored a bill to remove income tax from active duty military, saving every Arkansas military family an average of $1,600.

Your fantasy political gathering would include: Condaleeza Rice, George W. Bush, Bill Clinton. Toughest issue of the past Session: Private Option. What do you do for fun: Fly airplanes, spend time with grandkids. §

Like least about office: Seeing decisions based on politics instead of good policy. Upcoming election: In 2016.

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Legislator Profile

Representative Harold Copenhaver District: 58 Represents: The city of Jonesboro in Craighead County. Years in Office: 1-1/2 years. Occupation: Small business owner. Your pharmacist: Mike Soo, Parker Road Pharmacy. Like most about office: Being able to address the needs of my constituents, big or small. Serving as Representative has given me a stronger appreciation for people willing to inform their elected officials of issues they are facing in their day-to-day lives. People who are willing to communicate their needs to members of the State Legislature are responsible for continuously making our state move in the right direction. Like least about office: Over recent years political campaigns have become less about shaking hands and more about what is said in a 30-second commercial. Wholesale politics has created a gridlocked US Congress and, unfortunately, we are starting to see more of that in state-level politics. Upcoming election: In 2014. Most admired politician: There are many great leaders I have admiration for but Thomas Jefferson will always be at the top of my list. I am Democrat because I believe our nation’s strength comes from the land owner and laborer just as Jefferson adamantly professed during his political career.

—

(D- JONESBORO)

well-versed on issues facing pharmacists without being educated by the people impacted. It is critical that you inform your legislators about issues facing your profession so that they can fairly assess the legislation that they are voting for or against. Your fantasy political gathering would include: There have been numerous moments in our nation’s history that I would have preferred to be a fly on the wall. I've always been curious to know what it would have been like in the 1930's to hear Hattie Caraway and Huey Long stump for Senator Caraway's election. Senator Caraway will always have a significant place in our history and it's an honor to know she called Jonesboro, Arkansas, her home. Toughest issue of the past Session: I can say with confidence that my colleagues and I would all choose the Arkansas Private Option and Medicaid expansion. Obamacare would not have been passed if Arkansas legislators were voting in D.C. but it did and our state needed to create an efficient health insurance program. After many long, drawnout debates we were able to create a unique health care model that allowed those on Medicaid to purchase private insurance. Within the first quarter of the year, a hospital in my district saw a drastic reduction in uninsured ER visits and also saw a $9 million increase in revenue. What do you do for fun: I enjoy playing golf, taking my son hunting and cooking out on Sundays for our weekly family dinner. §

Advice for pharmacists about the political process and working with the AR Legislature: Stay in contact with your representative. Often times, your representative won't be AR•Rx

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Prescription Drug Monitoring Program Proves Value in Year One By Eileen E. Denne, APR

Prescription Drug Monitoring Program Administrator Denise Robertson, P.D., flanked by UAMS College of Pharmacy students Megan Phillips and Grant Florer, who helped register new users at APA’s 2014 Annual Convention in Fayetteville.

fter a busy year one for Arkansas’s Prescription Drug Monitoring Program (PMP,) Administrator Denise Robertson, P.D., said the database is being used daily by pharmacists to verify dispensing and duplication of prescription drugs. The PMP is also helping the Drug Enforcement Agency (DEA) and local law enforcement catch doctor shoppers and forged prescriptions.

2. When can those of us on border towns share data?

Our goals are being met, Robertson said in a recent interview. When the PMP became operational March 1, 2013, at the Arkansas Department of Health, the setup went smoothly because Arkansas was able to take advantage of lessons learned by other states. A common goal for all states with PMPs that don’t have mandatory registration is continuing to build the number of users, Robertson said. One of her main focuses is getting users signed up.

3. Can I let my techs access the PMP? The PMP may

There are currently 4,400 prescribers and pharmacists registered on the PMP which includes 12.6 million prescription records. Robertson would like to encourage more Advance Practice Registered Nurses (APN) and Physician Assistants (PA) to sign up as well. In addition to the APA, the PMP works with the Arkansas Medical Society, state Nursing, Medical, Pharmacy, and Dental Boards. Every practitioner received the brochures and information directly. The top three questions from pharmacists on the PMP platform are the following:

1. Can we share the data? Robertson said pharmacists

can share the data with any pharmacist or physician listed on the PMP report. The information cannot be faxed but if there is a pharmacist-patient relationship and physician relationship, pharmacists can share data and clarify the information with the other practitioners.

Robertson said there is a Memorandum of Use between states. Missouri still doesn’t have legislation passed to create a PMP. Other border states are in the process of changing legislation so they can share: Tennessee and Oklahoma hope to be able to share data by the end of 2014. Texas is also examining how to do it. propose a change in the law during the 2015 legislative session to allow delegates access which would include techs. That will allow more access and use and save time. Although data from the PMP has not yet been analyzed, Robertson reported that from March 1, 2013 to 2014, law enforcement made 125 queries related to the database. Of those, there have been 16 arrests for doctor shopping, two convictions and 21 queries which led to opening other cases. There are 20 cases still pending. Arkansas’s experience with the PMP matches other states although it has been easier to set up and maintain. The program is seeing some of the same parallels as well, including ups and downs on certain groups of drugs. Robertson says pharmacists can look forward to a new service this fall. The PMP will be sending an alert to certain pharmacies and prescribers saying there is evidence of activity on certain patients and to check patient records. If a pharmacist at a store isn’t signed up, the alert will go to the pharmacist-in-charge. If not signed up, the PMP will to mail them a letter saying “you have an alert on one of your patients.” From the beginning they will set parameters and do threshold reports. This will help the PMP target practitioners who need to be first to sign up. § AR•Rx

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MARKETING IDEAS

Do I Really Need a Website? Marketing Ideas from Pharm Fresh Media By Liz Tiefenthaler

es. You do. Today.

The decision of whether or not to have a website is no longer a why, it is a when. There was a time that you could squeak by without a website but that time has passed. For those of you who do not have a website but feel you are doing well, I would say that you are: *The only pharmacy for miles; *Your script count is steady but not growing; *And, you are leaving money on the table.

The obvious first answer is that is allows your patients to more easily refill their prescriptions and that can be done in a safe and secure way. Do not think that refilling prescriptions online is only for the young. A store I work with told me that the day his site went live, the first person to refill a prescription was a 92-year-old woman.

If people cannot find you, they cannot buy from you. Your website should give directions, hours, phone and other contact information. Here is what we know: almost This is not any more than you 80 percent of people will would expect from any other If people cannot find you, they cannot check you out online before business that you search. And buy from you. Your website should deciding to do business with speaking of search, be sure give directions, hours, phone and other you. That’s right. If they can’t that any company you work contact information. This is not any more find you online, they look with understands search. somewhere else. Knowing how to write for the than you would expect from any other internet is critical to having business that you search. Ask yourself when you last your pharmacy show up on wandered into a business that first page of a search. If prepared to spend money I am looking for a pharmacy without first checking them out online. Could you imagine that offers free delivery and prescription packaging and I staying at a hotel in an unknown city without first looking put those words into search and your website has those at their website? I would wager that most of you book words, then guess who I am going to call! your vacations, buy gifts, and get information daily on the internet. Why would you think that pharmacy is exempt As search moves from desktop to mobile, be sure that from this same kind of search? your website is mobile-friendly. Internet usage from mobile and tablet devices is roughly half of all internet traffic. My So, where do you start? You start with a company that daughter recently left the bank she had been with since she you trust. Here are some questions to ask before signing put baby sitting money in at age 12 because they didn’t up with a company to build your website. allow online mobile banking. Ask your web developer what it will take to optimize your website for mobile. 1. How do you build your website? Is it flexible so that I can add pages if my needs grow? My company builds about 20 pharmacy websites a year. 2. Will I own my website so that I can make my own We have a chart for organizing web pages and suggestions changes and updates? for content that I would be happy to share. Don’t delay; 3. How does hosting work? How do I get my URL? make your website your priority. § 4. What are my responsibilities? 5. How much will this cost? About Liz Tiefenthaler: Liz is the President of Pharm Fresh Media, a marketing An important thing to remember is if your website is not services company serving Independent pharmacy. She is a going to make you money, then it is not correctly designed. columnist for America's Pharmacist and Drugstore Canada How does a website make you money? as well as a frequent presenter for NCPA.

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Pharmacist Immunization Program Increases Immunizations Exponentially Throughout State By Eric Crumbaugh, Pharm.D.

APA’s Eric Crumbaugh gives KARN’s Andy Pearson his annual flu shot on the air. On air immunizations were part of the public relations efforts to create public awareness of the need for immunizations.

n February 2012, the APA started a partnership with the were a printed toolkit, immunization records, “We Arkansas Department of Health (ADH) to improve the Vaccinate” window cling, and vaccine-preventable disease number of immunizations given by Arkansas pharmacists. posters. These materials were distributed to over 600 The initial program was slated to take place over an Arkansas pharmacies. 18-month period: February 2012 through July 2013. After a successful The online toolkit contained sample Our baseline surveys found first year, the APA was awarded an protocols, insurance coverage and extension through June 2014. tips for getting billing processes set that 47.4% of all Arkansas up, immunization schedules, best pharmacies and about 30% The main goal of the program practices, Occupational Safety and of independents offered was to increase the number of Health Administration requirements, immunizations. flu, pneumococcal, and shingles frequently asked questions, and other vaccinations given by Arkansas useful resources for pharmacists. This pharmacists by 10%. The first step was section of the APA website became to perform an assessment of current the most visited page within a few By the end of the twoimmunization practices and identify months of being posted. year intervention period, barriers. Our baseline surveys found that 47.4% of all Arkansas pharmacies This program also offered technical 63.3% of AR pharmacies assistance to pharmacies by answering and about 30% of independents and almost 50% of vaccine-related questions via phone, offered immunizations. Lack of time in independents were offering text, and email as well as onsite the normal workflow of the pharmacy pharmacist-delivered pharmacy visits. For pharmacists who and to set up these services were the immunization services. The were unable to find a local physician most reported challenges to providing number of immunizations to sign their immunization protocol, a immunizations in these surveys. statewide protocol was established given by pharmacists also with an ADH physician. In addition to To accomplish the goal of a 10% drastically increased during supporting pharmacists’ immunization increase, the program provided printed the two-year period. practices, an aggressive public relations and online provider/patient materials campaign was conducted with monthly to pharmacies, identified insurance media interviews, letters to the editor, coverage of pharmacist-administered and magazine and newspaper columns educating the immunizations, and offered immunization trainings and public about immunizations and encouraging them to talk continuing education programs. The educational and with their pharmacist about their vaccination status. promotional materials provided throughout the program

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PHARMACIST IMMUNIZATION PROGRAM INCREASES

By the end of the two-year intervention period, 63.3% of AR pharmacies and almost 50% of independents were offering pharmacist-delivered immunization services. The number of immunizations given by pharmacists also drastically increased during the two-year period. The main program objective of a 10% increase in immunizations given each year was exceeded exponentially, especially zoster vaccination which increased by almost 300% during year 1 and 266% year 2. The program accomplishments were recognized nationally by the National Adult and Influenza Immunization Summit for two consecutive years with an honorable mention in “Immunization Excellence Award Overall Adult Immunization Activities Beyond Flu” and the national

winner of the “Immunization Excellence Award Adult Immunization Champion.” The results of this program are a testament to Arkansas pharmacists who, when challenged, will step up and get the job done. Even though the funding for the program has been exhausted, the APA is committed to maintaining the existing resources such as the online immunization toolkit, supporting members’ immunization practices, and continuing to offer training classes and education programs. Currently, additional funding opportunities for other clinical initiatives are being pursued to show how valuable pharmacists are as an integral part of the healthcare team. Pharmacists should continue recommending, offering and expanding immunization services to keep patients and their families protected from vaccine-preventable disease. §

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PHARMACIST IMMUNIZATION PROGRAM

ARKANSAS FOUNDATION FOR MEDICAL CARE (AFMC)

A New Era for Quality Improvement n recent years, the federal government has contemplated IQuality restructuring the longstanding, state-based, Medicare Improvement Organization (QIO) Program. The

purpose of the QIO Program, which has been in existence for over 30 years, is to improve the quality of care to Medicare beneficiaries by providing local, providerspecific technical assistance in improvement efforts; investigating and reviewing beneficiary complaints and appeals; and conducting care-related reviews to ensure Medicare payment was reasonable and appropriate.1 And in 2011, Congress added QIO Program reforms, as a $330 million funding offset, to the Trade Adjustment Assistance Extension Act (H.R. 2832). This Trade Bill gave the Department of Health & Human Services (DHHS) Secretary the authority to reorganize the next QIO Program contract in order to improve quality outcome metrics while also incurring cost savings to the Medicare program. In December 2013, the Centers for Medicare & Medicaid Services (CMS) released a Request for Proposal (RFP) for the QIO Program’s 11th Statement of Work (SOW) which is scheduled to begin on August 1, 2014.2 This 11th SOW included many changes to the program as it seeks to create regional Quality Innovation Networks (QINs).

QIO Program Reforms

The first major change written into the RFP includes expanding the geographic scope of the QIN-QIOs. Instead of having a QIO in every state, the 11th SOW QIN-QIOs will each cover a regional territory consisting of three to six states. The choice of which states are included in each region will be defined by each QIN-QIO as there is no requirement for regions to be contiguous. Another major reform to the QIO Program includes the separation of family/beneficiary protection and quality improvement functions. The purpose of this separation is to eliminate potential conflicts of interest that can arise when a single entity performs both activities. As a result, a separate RFP was released to establish five Beneficiary and Family Centered Care (BFCC) QIOs that will cover case review functions for the entire nation. The 11th SOW also lengthened the QIN-QIO contract from three years to five years so that contractors and providers would have more time to demonstrate improved outcomes.

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Last, but not least, the new RFP expanded the eligibility requirements for QIO work in order to increase competition and subsequently lower costs.

The Medicare 11th Statement of Work

Despite the many changes to the QIO Program, the quality improvement work outlined in the RFP remains centered on beneficiaries and their families. The overarching aims of the 11th SOW are to improve the health status of communities; to provide beneficiary-centered, reliable, accessible, and safe care; and to provide better care at lower costs. Within these aims, each QIN-QIO must perform certain tasks in order to achieve improved healthcare outcomes. These tasks are as follows: • Improve Cardiac Health and Reduce Cardiac Healthcare Disparities • Reduce Disparities in Diabetes Care • Improve Prevention Coordination through Meaningful Use of HIT and Collaboration with Regional Extension Centers • Reduce Healthcare-Associated Infections in Hospitals • Reduce Healthcare-Acquired Conditions in Nursing Homes • Coordination of Care • Quality Improvement Through Value-Based Payment, Quality Reporting, and the Physician Feedback Reporting Program The 11th SOW delineates a set of evaluation metrics each QIN-QIO must perform during the performance of the aforementioned tasks. Some of these metrics have been included in previous QIO SOWs such as reducing 30-day hospital readmission rates and reducing antipsychotic medication usage in nursing homes. Other metrics new to the QIO work include improving the number of beneficiaries who complete diabetes self-management education programs, reducing the number of 30-day hospital readmissions related to adverse drug events and improving the number of days beneficiaries spend in their home setting (community tenure).

Next Steps

As with any health care reform, the restructuring of the

QUALITY IMPROVEMENT

QIO Program has been considered controversial by some organizations while others view the changes as opportunities for innovation. Additionally, the changes underscore the continued need to form meaningful partnerships and collaborations with other health care organizations/stakeholders in order to successfully navigate the new health care landscape. Pharmacists and pharmacy organizations, being the medication experts, are well-positioned to be at the heart of these health care partnerships and quality improvement initiatives. The CMS is slated to announce the 11th SOW QIN-QIO awardees in July 2014. §

REFERENCES 1. Social Security Act. §1154 [42 U.S.C. 1320c–3] 2. DHHS CMS Request for Proposal Number HHSM-500-2014-RFPQIN-QIO (2013)

_________________________________________________________ Christi Quarles Smith, PharmD, is a pharmacy specialist at the Arkansas Foundation for Medical Care (AFMC,) and is the team lead for AFMC's reducing adverse drug events and care transitions projects. She is a graduate of the University of Arkansas for Medical Sciences (UAMS) and completed a Pharmacy Practice residency at UAMS. She can be reached at csmith@afmc.org.

AFMC is the state's health care Quality Improvement Organization and contracts with the Centers for Medicare & Medicaid Services to give technical assistance to health care providers. AFMC's mission is to promote excellence in health and health care through education and evaluation.

Arkansas State Board of Pharmacy President. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Larry Ross, B.A., M.S.Ed, Sherwood Vice President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lenora Newsome, P.D., Smackover Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stephanie O’Neal, P.D., Wynne Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Steve Bryant, P.D., Batesville Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Tom Warmack, P.D., Sheridan Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kevin Robertson, Pharm.D., BCPS, Little Rock Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Percy Malone, P.D., Arkadelphia Public Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Joyce Palla, Arkadelphia

AAHP Board Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Susan Newton, Pharm.D., Russellville President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Marsha Crader, Pharm.D., Jonesboro President-Elect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rob Christian, Pharm.D., Little Rock Past President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lanita S. White, Pharm.D., Little Rock Treasurer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sharon Vire, Pharm.D., Jacksonville Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Wendy Jordan, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Maggie Williams, Pharm.D., Batesville Member-at-Large. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Niki Carver, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .James Reed, Pharm.D., Conway Technician Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Janet Liles, CPhT, Searcy

Member Classifieds Part-time instructor for Pharmacy Technician program. Remington College – Little Rock Campus seeks a part-time instructor for our Pharmacy Technician diploma program. Associate's degree and diploma in pharmacy technology. At least 4 years of work experience. Resumes to rosalie.lampone@remingtoncollege.edu. (7/2/14) Seeking pharmacist for independent pharmacy in Little Rock. Need Full-time or Part-time pharmacist for independent pharmacy in Little Rock. The pharmacy is in the Hospital district. Compensation at $55 dollars an hour. The Pharmacist will

Member Classifieds are free to APA members and $40 per month for non-members. Contact eileen@arrx.org for more information.

have a licensed pharmacy tech to assist as well. Please call (817) 707-9575. (6/25/14) Independent West Little Rock pharmacy looking for a full time clerk with great customer service skills. Don's Pharmacy is open 8 a.m. - 6 p.m. during the week and 8 a.m. - 4 p.m. on Saturdays; it is closed on Sundays. Visit the website, dons@donsrx. com, for more information. Please fax a resume to 501-225-8683 or email dons@ donsrx.com. To be an employee at Don's, you must be caring, willing to work hard and available to work some weekends. This position includes operating a cash register, answering the phones, helping

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customers in the store, stocking inventory and numerous other duties. This job involves being on your feet most of the day. Random drug testing is a requirement. (6/23/14) Seeking part-time pharmacist in DeQueen. Harris Drug and Gifts, an independent pharmacy in SW AR is looking for a part-time licensed pharmacist. Store hours M-F 8 a.m.-5:30 p.m. and S 8 a.m.12 p.m. Please send resume to Harris Drug 205 DeQueen Ave. DeQueen, AR 71832 or send via email to harris.drug@yahoo. com. This position will be for 2-2 1/2 days a week. (5/27/14)

THE ARKANSAS PHARMACIST

MEMBER CLASSIFIEDS

Pharmacy for sale in Strong. Only pharmacy in small town and has been in business for 36 years. The building is 3000-square- feet. There is a clinic with a doctor in town. The closest competition is 30 miles away. Residents can take advantage of The El Dorado Promise which provides graduates of El Dorado High School with a scholarship covering tuition and mandatory fees that can be used at any accredited two- or four-year, public or private educational institution in the US. For more information, please call 870-951-0534 or e-mail newsomjf@sbcglobal.net. (5/22/14) Pharmacist needed in Sherwood. Pharmacist-In-Charge needed for Sherwood, Monday thru Friday, 9 a.m. to 6 p.m. Self-motivated, friendly, trustworthy need apply. Send resume to srice@ unitedpaincare.com. (5/22/14) Independent pharmacy in Van Buren is seeking friendly, personable, efficient pharmacist. Duties will include the normal staff pharmacist duties as well as helping with MTM consulting, immunizations, etc. Relief Pharmacist hours available as well, to cover vacations and Saturdays. Store hours are Monday-Friday 9 a.m.-6 p.m. and Saturday 9 a.m.-1 p.m. Send resume to kbarlow@pharmacyexpressvb.com or fax to (479) 474-3131. (5/22/14) Opportunity to open pharmacy in north central AR. Great opportunity to own your own business. Small town in north central Arkansas currently has no pharmacy. Large population draws from surrounding communities. Land owner will build and design to suit pharmacy. Option to have graduated rent until business established. Building site overlooks and is walking distance to Bull Shoals lake. If interested contact Jeff or Pat Dell at 870-436-5405 or ccr@southshore.com. (5/20/14) We are seeking a friendly, energetic, pharmacist for possible employment in a leadership position within our company. Candidate must possess excellent people skills. If interested, please call Robert Woolsey 479-667-7338. (5/15/14) Seeking pharmacy techs in Conway. US Compounding Pharmacy in Conway is seeking pharmacy technician applicants. Please send resume and request application from lwilson@uscompounding. com. (5/12/14) Chicot Memorial in Lake Village seeking pharmacist. Chicot Memorial Medical Center is seeking a dynamic, engaged Pharmacist to manage the Pharmacy Operations of our critical access hospital. We are a collaborative, patient centered, AR•Rx

learning organization focused on improving patient outcomes, patient satisfaction and patient education. Our Pharmacy Director will serve in a key position in helping us achieve our goals. We offer a very competitive compensation and benefits package. Please apply at www.chicotmemorial.com or call 870-265-9395 for more information. (5/2/14) Independent pharmacy in Ft. Smith seeks part-time pharmacist. Local independent pharmacy in Ft. Smith, AR seeking Licensed Pharmacist for one to two nights a week (6 -10 p.m). and every other weekend Sat. & Sun. (14-hr shift). Send resume to 700 Lexington Ave., Ft. Smith, AR 72901 or email anderson.1@live.com or call 479-7822881. (3/27/14) 10 Pharmacy Technician positions open in Little Rock. SCA Pharmaceuticals, one of the fastest growing pharmaceutical companies in the US, is recruiting ten pharmacy technicians to provide sterile compounding services for hospital clients in all fifty states. Sterile compounding experience is preferred but SCA has an excellent training program. SCA hires for attitude and trains for skill. Join a dynamic team of professionals dedicated to providing the highest quality products and outstanding service to our hospital pharmacy clients. SCA is a “people oriented” company where each individual is treated with respect, professionalism, and growth opportunities. Excellent salary, benefits, bonus, etc. SCA is an FDA registered Outsourcing Facility located in Little Rock. Contact: Phyllis Wike; pwike@scausa.net; (877) 5505059; (501) 312-3200, Fax (501) 312-2805. (3/24/14) Pharmacy for sale in Jonesboro. This is a great opportunity for someone to purchase their own profitable pharmacy. Average 1.5 million in annual sales, large front-end with gifts. Pharmacy located in a medical building with 25 physicians and 5 APN's. Business and building are for sale, but can be sold separately. There has been a pharmacy in this location for more than 24 years. For more information email, cmrx@ outlook.com. (3/24/14) PRN Pharmacist at North Metro Medical Center in Jacksonville, AR. Education: Bachelor's Degree in Pharmacy required; Pharm.D. preferred. Licensure/Certification: Current pharmacist's license issued by the Arkansas State Board of Pharmacy required. Experience: Two years acute care hospital experience preferred. Apply online www.northmetromed.com. (2/27/14) Pharmacy building for sale in HARRISON, AR. Formerly USA Drug/Consumer Pharmacy since 1971. 1960sq ft, all brick,

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built 1971, renovated 2011 at cost of over $200,000. Two drive-thrus, lot 175 x 190, perfect condition, directly across the street from Boone County Hospital. Close to multi doctors' offices. Call Dan Drewry 417-343-7838. (2/3/14) Northwest Arkansas Free Health Center in Fayetteville looking for pharmacy volunteers. We provide health and dental care to low income and uninsured individuals. Our pharmacy hours are Wednesday 1-3 and Thursday 6-8. Contact Monika Fischer-Massie at mfischerm@ nwafhc.org or call 479-444-7548. (12/12/12) Charitable Clinic Needs Service Minded Pharmacists- Want to be thanked dozens of times a day? Tired of dealing with insurance? Join our team at River City Charitable Clinic in North Little Rock. We are looking for volunteer pharmacist to take an active role in the healthcare of low income, uninsured, unassisted patients. Volunteer(s) are needed specifically for a new "refill clinic". You can pick your ideal clinic time on Monday, Wednesday, or Thursday. Staff it weekly or share with a friend. Interested pharmacists can contact Pam Rossi at PRRossi@uams.edu or call Anne Stafford, RN Medical Manager at 501-376-6694. (2012) Experienced Relief Pharmacist AvailableExperienced relief pharmacist (retail/ hospital/IV) available in Central Arkansas. Willing to travel reasonable distances. Fred Savage 501-350-1716; 501-803-4940; fred.savage@sbcglobal.net. (5/7/12) 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 Christine Bommarito, Marketing and Recruiting Director, for information regarding current openings throughout Arkansas, including 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: ivanrx4uchristine@ centurylink.net. (2011) STAFF RPH, Inc.- Pharmacist and Technician Relief Services. 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 501-847-5010 or email staffrph1@ att.net. (2011) 29

COLLEGES OF PHARMACY

UAMS AND HARDING UNIVERSITY

2014 Survey Presents Positive Job Market Picture Stephanie Gardner Pharm.D., Ed.D. Dean

e offer our sincere congratulations to all of the UAMS and Harding graduates and wish them the best in the coming weeks as they take the NAPLEX and start their new jobs or postgraduate work. As in previous years, we appreciate their willingness to complete a salary survey during the week of graduation. We also thank Dr. Schwanda Flowers for compiling the data for both schools and the information shows a good picture of the job market for our 2014 Arkansas graduates. Overall, the average salary was $119,255 (0.6% increase over last year). Of the 179 students who completed the survey prior to graduation, 82% had already accepted a position and the majority (64%) characterized the position opportunities as excellent or good. Some trends from previous years have remained relatively constant. Fifty percent of the students accepted a position at a

Julie Hixson-Wallace

place where they had served as Pharm.D., BCPS an intern or spent time during an Dean experiential rotation. The majority (68%) accepted positions in a community/retail setting and 19% plan to own a pharmacy in the future. The biggest change during the past year was a significant increase in the number of students pursuing residency or postgraduate education (14 in 2013, compared to 31 in 2014). The average amount of student debt is also on the rise ($113,284 in 2013, compared to $138,725). In summary, our graduates continue to have many opportunities for employment at the time of graduation. We share their excitement as they begin their professional careers! — Dean Stephanie Gardner and Dean Julie Hixson-Wallace

Arkansas Colleges of Pharmacy 2014 Salary Survey Results By Schwanda K. Flowers, Pharm.D. Associate Professor, UAMS College of Pharmacy

Summary • 179 AR Graduating pharmacy students completed the survey (UAMS (n=120); Harding (n=59) • 82% of respondents have accepted a position. • 64% of respondents believe the position opportunities available were excellent or good. • 68% of those who have accepted a position did so in a community/retail setting. • 31 students have accepted a residency/fellowship position. • 12.5% will receive a sign-on bonus and the average reported sign-on bonus is $18,571. • 37% of the students accepting positions will practice pharmacy in central Arkansas. Excluding residencies, graduate programs 26% of the students accepting positions will practice pharmacy in central Arkansas. • Overall, 33% of the students accepting positions will practice pharmacy or do a residency out-of state. Excluding residencies and graduate programs, 19% of the students accepting positions will practice pharmacy out-of state. • Top benefits include: paid vacation, health insurance, paid holidays and retirement. These were unchanged from 2013. 3% of graduates will have their APA membership dues paid by their employer.

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COLLEGES OF PHARMACY

• • •

Average salary for a graduating pharmacy student from an Arkansas College of Pharmacy (excluding residency) position is $119,255; an increase of $699 (0.6% increase) from 2013. Approximately 19% plan to own a pharmacy in the future. Approximately 87% have student loans, with an average amount of $138,725.

Table 1: Demographics (n=179)

Table 2: Position Information

(continued)

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COLLEGES OF PHARMACY

Table 3: Salary Information by Position Environment

Table 4: Salary Information by Location in State3

Table 5: Benefits

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ARKANSAS ASSOCIATION OF HEALTH-SYSTEM PHARMACISTS

The Time Is Now

o you know what time it is? It is time to be an advocate for your profession. As we have all heard, pharmacy is at a crossroads with the implementation of healthcare reform. The pharmacy profession is in a unique position to gain momentum with the expansion of our role in healthcare. Now I know what many of you are thinking. “I am only one person. What can I really do to help change the face of our profession?” I offer you the thought that making changes within the profession alone can be difficult, but each one of us playing our part can move mountains. Moving the profession forward cannot only take place at the national level, it must also take place at the state and local levels as well. As a volunteer of the Arkansas Association of HealthSystem Pharmacists (AAHP) over the past six years, I can appreciate how every Arkansas pharmacist is needed in their respective state organizations. I am proud of the work that AAHP has been able to accomplish in so many areas of our profession. As the new AAHP President, I sincerely ask that you become involved in your state organization. Each organization needs your help to continue to grow organizational outreach and ultimately the practice of pharmacy. We ask that you consider your strengths and professional passions to find where you might find a place of service.

Member,) and Rayanne Story (ASHP Delegate) were installed for their terms of office at the annual APA Convention in June.

Marsha Crader, Pharm.D. President

As the mother of two young children, I can appreciate the need for work/life balance. If volunteering is not something that you can do at this time, we want to thank you for your continued support through your membership and participation at Fall Seminar. We also ask that every pharmacist support H.R. 4190 by contacting your congressman. This congressional bill was introduced in March, and it has the potential for licensed pharmacists to receive reimbursement for their clinical services authorized under each state’s scope of practice laws. This opportunity would be open to pharmacists nationally in medically underserved areas, medically underserved populations, and health professional shortage areas as designated by Health Resources and Services Administration (HRSA). New 2014-2015 officers for AAHP: (L to R) Past President Lanita White, President-Elect Rob Christian, We are at the early stages in a multiTreasurer Sharon Vire, and ASHP Delegate year process, and I would be proud Rayanne Story. if Arkansas pharmacists become the leaders in efforts to approve this bill. It will take efforts at the grassroots level, adoption of practice models incorporating these changes, and media and legislative efforts to be successful.

AAHP has many opportunities where you can become involved to benefit the organization and ultimately the AAHP is proud that the American patients we serve. First, it takes Society of Health-System everyone doing their job well at their Pharmacists’ chief executive officer, Dr. Paul Abramowitz, will be with us respective institutions and providing input from their experiences. There at our annual Fall Seminar this year to are ongoing opportunities to work AAHP 2013-2014 President Lanita White passes the discuss transforming patient care. We invite you to join us in Little Rock at the with Fall Seminar, volunteer on a gavel to 2014-2015 President Marsha Crader. Clarion Hotel Medical Center October committee, or become a board member. All of these areas involve education, mentoring, 2-3, 2014. Our theme is “Be Extraordinary.” Speakers will and advocacy along with innovative approaches in be discussing hot topics such as H.R. 4190, changes in providing current and new services to our membership. practice, and various clinical topics. We continue to improve Technicians, students, residents, new practitioners, and this event each year, and if you have not been able to attend veteran practitioners all benefit from the volunteers that in the past, please consider joining us this year. We will be serve. AAHP would like to thank those that ran for board able to provide technicians, students, residents, and healthpositions during the recent election and to congratulate our system pharmacists with the education and networking newly elected board members. Rob Christian (Presidentopportunities to become extraordinary. Please visit Elect,) Sharon Vire (Treasurer,) Brandy Owen (At-Large Board www.arrx.org/fall-seminar for more information. § 34

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COMPOUNDING ACADEMY

FDA Responds to the IACP Pharmacists’ Outsourcing Letter

he International Academy of Compounding Pharmacists (IACP) has been closely monitoring the U.S. Food and Drug Administration's (FDA) communications and activities regarding the newly established Outsourcing Facilities (OF). We are concerned regarding several areas on which we believe the FDA has failed to provide guidance, causing considerable confusion for pharmacies. For example, the FDA sent letters to the states and hospitals requesting the hospitals only do business with the registered OFs. The FDA also asked States to implement a requirement that anyone who ships into their state must be registered as an OF. However, the FDA hasn't inspected any of these recently registered OFs; they have delayed the reporting requirements to OFs that register; and the FDA hasn't developed any of the lists that dictate what OF's can compound. In addition, the FDA hasn't clarified with any pharmacies wishing to register as OFs whether they have to comply with the Current Good Manufacturing Practices, or whether the FDA is drafting an alternative standard that will be enforced at these OFs. Thus, OFs are being asked to register, and they don't even know which standard of compliance they will be held. With so much uncertainty, IACP sent a letter to the FDA asking that they cease sending letters endorsing these facilities that haven't developed any of the guidelines they were authorized to develop under HR3204. In June, IACP received the FDA's response. Visit http://bit.ly/1f6ilBm to read IACP's letter to the FDA. Visit http://bit.ly/1kYqETT to read the FDA's subsequent response. All pharmacies and pharmacists are licensed and strictly regulated by State Boards of Pharmacy. Compounding is a core component of pharmacy and has always been subject to the oversight and monitoring of these agencies and the state legislatures who decide upon the way pharmacy compounding should be regulated within their borders. Additionally, the FDA has authority over some aspects of compounded prescriptions at the federal level under the direction of Congress. Standards set by the United States Pharmacopeia are integrated into the day-to-day practice of pharmacy compounding and are mandated by law in most states. Even greater oversight comes through accreditation from a variety of non-profit agencies that establish and survey on guidelines designed to improve quality in the compounding process.1 In a March 20, 2014, Inside Health Policy article, "Jurisdictional Issues Surface as States Mull Outsourcing-Facility Licensing." IACP's David G. Miller, RPh, CEO/EVP, said "Compounding pharmacies, like drug manufacturers, are involved with distributors, making states unsure about whether OFs can be AR•Rx

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Warren Lee, Pharm.D. regulated under the Prescription Past President Drug Marketing Act. The 1987 law requires a state license to engage in wholesale distribution in interstate commerce."

Miller pointed to bills being considered in Florida and California that would prohibit nonresident compounding pharmacies from shipping drugs into the state without a license or permit. These measures could also affect firms registered with the FDA as OFs. The Florida bill specifies that OFs must hold a state permit to distribute in the state. "Other states, " Miller said, don't know what to do. "Both flags are on the flagpole for OFs." he said, using an analogy made by lawmakers. "Until we get clarification, this is a gray area that will keep getting grayer."

The USFDA Tells Congress "No Office Use"

In addition to all the confusion surrounding OFs, pharmacies have been told that office use would continue to be governed under state laws. Specifically, there are more than six Statements on the record from both the House and the Senate stating that the FDA does not have jurisdiction to prohibit pharmacies for compounding for office use (or for the administration within a doctor's office or hospital) and that it's an issue that should be left to the states. The FDA recently sent the House Energy & Commerce (E&C) Committee responses to Questions for the Record (QFRs), stating that despite the Congressional intent, the FDA will use its "discretion" to prohibit all office use compounding by pharmacies under 503A. The FDA also has begun sending warning letters that express to pharmacies that solely based on the fact they are compounding for office use for doctor's office and /or hospitals, they are a manufacturer and, thus, in violation of the Food, Drug, and Cosmetic Act. This represents huge concern for pharmacies and Congress. To respond, it is IACP'S understanding that Congressman Morgan Griffith (RVA) intends to send a letter to the FDA that expresses concern and disappointment with the FDA's most recent actions on prohibiting office use.2 § 1 Non-profit agencies that establish and survey on guidelines designed to improve quality in the compounding process: Visit http://bit.ly/1jxeake for the FDA's letter to hospitals promoting OFs. Visit http://bit.ly1m2GVqBfor the FDA's letter to the States promoting OFs. 2 Visit http://bit.ly/1m2HiS4 for the FDA's most recent responses to the House E&C Committee regarding prohibiting office-use (the answer from the FDA is on page 10).

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APA Congratulates the 2014 Award Winners

PA with other sponsoring organizations presented eight 2014 awards to deserving individuals on Thursday, June 12, during its 132nd Annual Convention held at The Chancellor Hotel in Fayetteville on June 12 to 14. “We’re proud of our award winners and their extraordinary contributions to the pharmacy profession, to their towns,

businesses and to others through their work or public service. Arkansas pharmacists contribute their time and concern to their communities and professional associations whether they work in retail, community clinics or other practices,” said APA Executive Vice President and CEO Mark Riley.

Pharmacist of the Year Award

Excellence in Innovation Award

APA President Dana Woods presents the Pharmacist of the Year Award to Michelle Crouse, Pharm.D.

APA President Dana Woods congratulates Marcus Costner, Pharm.D., Excellence in Innovation Award winner.

Michelle Crouse, Pharm.D., co-owner of five pharmacies in southeast Arkansas, was presented with the 2014 Pharmacist of the Year Award. Crouse is described as an educator, mentor, small business owner and advocate for pharmacy in southeast Arkansas who goes above and beyond expectations to ensure that her patients receive the care they deserve.

Marcus Costner, Pharm.D., BCPS, Associate Director of Clinical Pharmacy and Residency Program Director for Veterans Healthcare System of the Ozarks (VHSO) in Fayetteville, was presented with the 2014 Excellence in Innovation Award.

With her husband Lynn Crouse, Pharm.D., she owns and operates five independent pharmacies: City Drug in Monticello, Eudora Drug Store in Eudora, Hunter’s Pharmacy in Lake Village, Portland Drug in Portland and Baker’s Pharmacy in Crossett. Crouse has served as a mentor to the pharmacists who work in the stores and advocates for pharmacists as an integral part of the healthcare team. She works tirelessly in the areas of disease prevention, wellness and nutrition in this rural southeastern part of the state. She works closely with local physicians to promote patient health and wellness and collaborates with other health care providers. Her knowledge of complementary and integrative medicine allows her to improve the overall health and therapeutic outcomes of her patients by educating them on nutritional and lifestyle modifications, helping to prevent disease. Crouse graduated from the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy with a doctor of pharmacy in 1996 and completed undergraduate work at Williams Baptist College in Walnut Ridge from 1988-1991. She completed a Fellowship in Anti-Aging and Regenerative Medicine in 2012. Crouse’s community activities include: spending time with family on the lake, coaching elementary basketball, attending children's activities and traveling every chance she gets. She and Lynn, who is Area 4 Representative on the APA Board of Directors, live in Lake Village with their three children, Samara, age 12; Miriam, age 10; and Josephine, age 7. They are members of Our Lady of the Lake Catholic Church in Lake Village. AR•Rx

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This award was established in cooperation with National Alliance of State Pharmacy Associations (NASPA) to annually recognize a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy. Costner joined VHSO in January 2012. He was selected in 2013 to serve as Associate Director of Clinical Pharmacy and supervises 10 clinical pharmacists. His leadership and management have led to cost savings of close to $ 4.3 million in fiscal years 2013 and 2014. Costner’s leadership for VHSO has included setting up a PG1 residency program and gaining approval for two new clinical pharmacy specialists to work under the Patient Aligned Care Team. He is working to add a clinical pharmacy specialist in Oncology. He works with Veterans Affairs’ leadership locally and regionally to educate them on new lipid guidelines, among other topics. He maintains a close relationship with the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy Northwest campus and provides rotations for up to 60 students each year. Before joining VHSO, Costner worked for Central Arkansas Veterans Healthcare Systems (CAVHS) between 2008 and 2011. He completed a residency there in 2008. He graduated with a doctor of pharmacy from the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy in 2007 and he earned a bachelor’s degree in Chemistry from Ouachita Baptist University in 2003. He is a member of the American College of Clinical Pharmacy (ACCP) and the Arkansas Association of Health-System Pharmacists (AAHP). Costner and his wife Brandie live in Fayetteville with their three children, Nathan, Lindsay and Daniel. 37

APA 2014 AWARD WINNERS

Distinguished Young Pharmacist of the Year

Bowl of Hygeia Award

Cardinal Health Generation Rx Award

Joe Baker, Pharmacists Mutual Companies, presents the Distinguished Young Pharmacist of the Year award to Stephen Carroll, Pharm.D., MBA.

APA President Dana Woods presents the Bowl of Hygeia Award to Eric Shoffner, P.D.

Cardinal Health’s Denise Grissom presents the Generation Rx award to Denise Robertson, RPh.

Stephen Carroll, Pharm.D., MBA, Chief Operating Officer at AllCare Pharmacy in Arkadelphia, was presented with the 2014 Distinguished Young Pharmacist Award. The APA Distinguished Young Pharmacist Award is given annually to an outstanding young pharmacist who has been out of pharmacy school less than 10 years and who has demonstrated leadership among his or her peers.

Eric Shoffner, P.D., pharmacist in northeast Arkansas, was presented with the 2014 Bowl of Hygeia Award. The Bowl of Hygeia Award is sponsored by the American Pharmacists Association Foundation and National Alliance of State Pharmacy Associations, with premier support from Boehringer-Ingelheim. This award was established to honor pharmacists who have contributed to the progress of their community. Recipients must have compiled an outstanding record of community service which reflects well on the profession.

Denise Robertson, P.D., Administrator for the Prescription Drug Monitoring Program (PMP) at the Arkansas Department of Health, was presented with the 2014 Cardinal Health Generation Rx Award. This award honors a pharmacist who has demonstrated outstanding commitment to raising awareness of the dangers of prescription drug abuse among the general public and among the pharmacy community.

Carroll has worked for AllCare Pharmacy since 2006 and currently serves as its Chief Operations Officer. He was nominated for his commitment to patient care and leadership in the company. According to President and CEO and former State Senator Percy Malone, AllCare customers know that Carroll has their best interests at heart and will provide the best service possible. He has done this by working closely with the computer software development team to improve the pharmacy dispensing system and pushing technology vendors to improve their products. Specifically, he manages relationships with longterm care facility administration to assist with patient care and business relationships and oversees personnel issues. Carroll has served as APA’s District 6 President and as a member of McKesson’s Long Term Care Advisory Board since 2010. He is a member of the National Community Pharmacists Association (NCPA) and serves as a Long Term Care Advisory Board member. He also served as a Long Term Care Steering Committee Member from 2012-2013. He graduated from the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy with a doctor of pharmacy in 2005 and he earned a master’s in business administration in 2006 from the University of Arkansas at Little Rock. Carroll and his wife Lauren, also a pharmacist for Allcare, live in Arkadelphia and are expecting twins in July. They are members of First United Methodist Church in Arkadelphia. 38

Shoffner is a pharmacist in Newport and is very involved at ground level in his home community. Shoffner has been a preceptor for 11 students and is said to challenge them daily with relevant projects in a real world pharmacy to aid in building their involvement and knowledge. His mentoring efforts have led to presentations to various civic groups and he sets an example for his students of lifelong mission of service to others. He is viewed in the community of Newport as influential on prescription drug abuse and what is does to his community. Shoffner graduated from the University of Arkansas for Medical Sciences (UAMS) with a degree of pharmacy in 1990. His community activities include: Jackson County Sheriff’s Office Prescription Drug Take Back Champion/Volunteer; AR Continuing Pharmacy Education speaker on drug abuse and the AR Prescription Drug Monitoring Program; member of the Jackson County Medical Society, National Association of Chain Drug Stores and National Community Pharmacists Association. He has served as preceptor and mentor to both UAMS and Harding University Colleges of Pharmacy and as an Adult Bible Class teacher. Shoffner and his wife Katrina live in Newport and have four children, Kris, age 25; Gary, age 21; Will, age 19, and Katlin, age 17. They are members of Holden Avenue church of Christ in Newport. AR•Rx

For the past year, Robertson has served as Administrator for the Prescription Drug Monitoring Program (PMP) at the Arkansas Department of Health. As the AR PMP administrator, she is responsible for the day-today administration, educational awareness and support of the program for the state. One of the main goals of the PMP is to help curtail misuse and abuse of prescription drugs including doctor shopping. The PMP is a tool to help pharmacists and prescribers to know their patients’ controlled substance history and make informed dispensing and prescribing decisions. Robertson’s previous years in retail pharmacy gave her firsthand knowledge of the extent of prescription drug abuse and the need for a state PMP. Being directly involved in pilot testing and implementation of new pharmacy software for two different companies also gave her a unique perspective on the needs of the Arkansas PMP. Robertson has 27 years of combined experience in retail, consulting and long-term care. In 2010, she was directly involved with the implementation of new pharmacy system software for USA Drug in Arkansas. In 2008 she was involved with the implementation and supervising of the Medication Therapy Management Program for Harvest Foods pharmacies. She is licensed in Arkansas and Louisiana and is licensed as a consultant pharmacist in Arkansas. Robertson is a 1985 graduate of Xavier University College of Pharmacy in Louisiana and was the recipient of the Merck & Co. Award.

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APA 2014 AWARD WINNERS

Charles M. West Scholarship Award

Arkansas Pharmacy Foundation Scholarship

APA President Dana Woods with Charles M. West Scholarship Award winner Brandon Achor.

APA President Dana Woods with Charles M. West Scholarship Award winner Melanie Smith.

APA President Dana Woods congratulates Abby Everett, recipient of the Arkansas Pharmacy Foundation scholarship award.

Brandon Achor, third year student at the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy, was named winner of the 2014 Charles M. West Leadership Award. The Charles M. West Leadership Award honors a student who has demonstrated exemplary leadership abilities and contributed to the profession of pharmacy.

Melanie Smith, third year student at the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy, was named winner of the 2014 Charles M. West Leadership Award. The Charles M. West Leadership Award honors a student who has demonstrated exemplary leadership abilities and contributed to the profession of pharmacy.

Abby Cooper Everett, third year student at the Harding University College of Pharmacy, was named winner of the 2014 Arkansas Pharmacy Foundation (APF) Scholarship Award. The Arkansas Pharmacy Foundation Award honors a student who has demonstrated exemplary leadership abilities and contributed to the profession of pharmacy.

Achor has served as President of the NCPA chapter at UAMS College of Pharmacy from 2013 to 2014 and Vice President from 2012 to 2013. He was Associated Student Government Class Representative in 2011 and was inducted into UAMS's Beta Iota Chapter of the Rho Chi National Honor Society. His volunteer activities at UAMS COP include: Big Buck Classic Health Screening volunteer (2014); Amboy Food Drive (2013); Arkansas Rice Depot (2013); Kroger Health Screenings (2011, 2012 and 2013); New Student Orientation Committee (2012 and 2013); and 12th Street Health Fair (2012). He has worked as a pharmacy technician and intern at Argenta Drug in North Little Rock for four years. Achor completed his pre-pharmacy course work at the University of Arkansas at Fayetteville in 2010 and graduated from Arkansas Baptist High School in 2007. He is a native of Maumelle, Arkansas.

Smith has served as American Pharmacists Association– Academy of Student Pharmacists (APhA-ASP) Vice President of Patient Care Projects, Phi Lambda Sigma Vice President and Phi Delta Chi Worthy Correspondent from 2013 to 2014. She also served as UAMS Student Ambassador (2013 – 2014); UAMS Scholastic Standing Committee (2012 to 2014); a member of the ACPE Self-Study Committee (2012 to 2014); 12th St Health & Wellness Center Student Board of Directors (2012 to 2014); Associated Student Government Representative (2012 – 2013); and Class of 2015 Treasurer (2011 to 2012). She has worked at Baker Drug in North Little Rock from February 2013 to present and at Washington Regional Medical Center from September 2009 to August 2012. Her UAMS COP volunteer activities have included: Health Screenings and other volunteer work (2011 – 2014); Editorial Advisory Board for APhA’s Pharmacy Today (2014 – 2015); APhA – ASP Vice President of Patient Care Projects (2013 – 2014); 12th Street Health & Wellness Center – Heart Failure Transitions Clinic (2014); 12th Street Health & Wellness Center Student Board of Directors Member (2011 – 2014); attended the 2013 NCPA Legislative Conference to lobby Congress in Washington, D.C.; P1 Project Fundraising Chairperson (2012); and P1 Amboy Food Drive Chairperson (2011). Smith is a 2006 Magna Cum Laude graduate of the University of Central Arkansas with a bachelor of science in nuclear medicine technology and a 2001 Honor Graduate of Clinton High School in Clinton. She is a native of Clinton, Arkansas.

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Everett ‘s student activities include membership in American Pharmacists Association Academy of Student Pharmacists (ASP) and National Community Pharmacists Association. She serves as NCPA Vice President of Governmental and Legislative Affairs and as Chapter President (2013-2014) of the Rho Chi Honor Society. Honors include receiving the 2013 NCPA Presidential Scholarship, Rho Chi Honor Society induction, and Alpha Chi honor society induction. She was on the 2011, 2012, and 2013 Dean’s List for Harding University College of Pharmacy. Everett worked at Mark’s Pharmacy in Melbourne as a pharmacy clerk from May 2009 to January 2010; and at Allied Health Services (long-term care pharmacy,) in Melbourne, as a pharmacy technician from July 2010 to August 2011 and as a pharmacy intern from May 2012 to present. She obtained her pre-pharmacy prerequisites form Harding University. Everett grew up in Melbourne and graduated from Melbourne High School in 2008. 2014 is the first year that the Arkansas Pharmacy Foundation has presented a scholarship to a deserving Harding University College of Pharmacy student.

Thank You to Our 2014 APA Annual Convention Exhibitors!

Eric Crumbaugh, Pharmacist Immunization Program.

Jeff Mercer, Dean Julie Hixson-Wallace and Tim Howard, Harding University College of Pharmacy.

Jimmy Dodd and Kelli Beavers, Merck.

Allan Rhodes, PharMEDium.

UAMS P3 Megan Phillips, Denise Robertson, and UAMS P3 Grant Florer, Prescription Drug Monitoring Program.

Kallie Epperson, Nephron.

Kevin Elder, Retail Designs, Inc.

Hugh Hyde, BCI Team.

Lisa Jones, Jannsen Pharmaceuticals.

Nathan Shanor and Eugene O’Donnell, iMedicare.

Glenn Willis, Pfizer.

Mark Hiester and Shelly Small, McKesson Corporation.

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Barbara White, Ken Campbell and Carter Corvin, HD Smith.

Jennifer Morrow, Frances Bauman and Michael Davis, Novo Nordisk Inc.

Joe Baker, Pharmacists Mutual Companies.

Jeremy Manchester and Vince Leonard, Liberty Software.

Henry Dannehl, Morris & Dickson.

Bo Garmon, First Financial Bank.

Kaleigh Manson, Lindsay Williams and Dave Finley LeadsOnline/LeadsOnLabs.

Brent Forshee, EPIC Pharmacies.

Buddy Teale and Adam Hollrah, Astra Zeneca Diabetes.

Faye Hipps, AR Foundation for Medical Care.

Leigh Austin and Will Arnold, UAMS COP.

Vic Fulford, Pharmacy Plus.

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Thank You to Our 2014 APA Annual Convention Exhibitors!

Kim Easton and Jamey Lumley, PBA.

Christopher Holl and Scott Potter, Chattem-Snofi.

James Donathan, DataRx.

Ray Carney and Denise Grissom, Cardinal Health.

Bri Morris, National Community Pharmacists Association.

Robert Kloeppel and Mike LeGay, Medicine Shoppe.

Dave Lanier and Jody Orth, Smart-Fill.

Creed Cultra, Scott Potter and Cindy Judy, Sanofi.

Jay Williams and Krystal Kuykendall, QS/1.

Kyle Potts, Randa Jankowski and Donny Ray, Amerisource Bergen.

Brittany Caple and Scott Long, Takeda.

Brandon Harris, Amy Avlos, Buddy Strozyck and Paul Cheatham, Smith Drug Company.

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APA Annual Convention CPE Attracts Lively Crowd

PA’s Themed Blocks of Continuing Pharmacy Education (CPE) provided during the recent Annual Convention in Fayetteville attracted more than 150 pharmacists. The five blocks covered team-based healthcare, medication therapy management, CMS’

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Star Rating system, clinical issues and protecting your pharmacy license. If you have suggested topics for next year’s Annual Convention, to be held June 11-13, 2015, at the Embassy Suites Hotel in Little Rock, please contact Scott Pace (scott@arrx.org). §

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