ARRX Third Quarter 2018

Third Quarter 2018 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

LEADING the Way STEPHEN CARROLL, Pharm.D. 2018-2019 PRESIDENT

POINT OF CARE TESTING IN ARKANSAS COMMUNITY PHARMACIES

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APA Staff Scott Pace, Pharm.D., J.D. Executive Vice President and CEO Scott@arrx.org

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John Vinson, Pharm.D. Chief Operating Officer John@arrx.org Jordan Foster Director of Communications Jordan@arrx.org Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Lauren Jimerson, Pharm.D. Executive Fellow Lauren@arrx.org Celeste Reid Director of Administrative Services Celeste@arrx.org Debra Wolfe Director of Government Affairs Debra@arrx.org Office E-mail Address Support@arrx.org Publisher: Scott Pace Editor: Jordan Foster Design: Gwen Canfield - Creative Instinct 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 84. © 2018 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.

CONTENTS 4 Inside APA: Pressure Forces Change

24 AAHP: Times Are Changing

5 From the President: Looking Ahead...

25 Legislator Profile:

6 Member Spotlight: Duane Jones, P.D.

26 2018-2019 New APA Board Members

7 Member Spotlight: Robert Acord, P.D.

26 APA Welcomes New Executive Fellow

9 FEATURE: Point of Care Testing in

27 2018 Calendar of Events

Barriers or Opportunities?

Arkansas Community Pharmacies

12 Rx and the Law: Animal Patients 13 Safety Nets: Staying Alert Saves Lives 15 New Drugs: Yin and Yang of the Drug

Approval Process

16 FEATURE: Leading the Way:

Stephen Carroll, Pharm.D. 2018-2019 APA President

20 Financial Forum: Getting (Mentally)

Ready to Retire

21 2018 UAMS and Harding Colleges of

Pharmacy Salary Survey

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Representative Greg Leding

28 2018 APA Annual Convention Wrapup ADVERTISERS 2 Pharmacists Mutual 8 Retail Designs, Incorporated 8 Arkansas Pharmacy Support Group 14 EPN 19 Law Offices of Darren O'Quinn 20 UAMS 23 EPIC Pharmacies 35 Pharmacy Quality Commitment Back Cover: McKesson / Cornerstone Pharmacy

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APA Board of Directors

INSIDE APA

2018 - 2019 Officers President – Stephen Carroll, Pharm.D., Benton

Pressure Forces Change

President-Elect – Dean Watts, P.D., DeWitt Vice President – Kristen Riddle, Pharm.D., Greenbrier Past President – Lynn Crouse, Pharm.D., Lake Village

Regional Representatives Region 1 Representatives Dylan Jones, Pharm.D., Fayetteville Spencer Mabry, Pharm.D., Berryville Lacey Parker, Pharm.D., Centerton Region 2 Representatives Greta Ishmael, Pharm.D., Cherokee Village Region 3 Representatives Brandon Achor, Pharm.D., Sherwood Clint Boone, Pharm.D., Little Rock Lanita White, Pharm.D., Little Rock Region 4 Representative Betsy Tuberville, Pharm.D., Camden Region 5 Representative James Bethea, Pharm.D., Stuttgart At Large Representatives Yanci Walker, Pharm.D., Russellville Stacy Boeckmann, Pharm.D., Wynne Academy of Compounding Pharmacists Larry McGinnis, Pharm.D., Searcy Arkansas Association of Health-System Pharmacists David Fortner, Pharm.D., Rogers Academy of Consulting Pharmacists Tyler Shinabery, Pharm.D., Sherwood

Ex-Officio APA Executive Vice President & CEO Scott Pace, Pharm.D., J.D., Little Rock AR State Board of Pharmacy Representative John Kirtley, Pharm.D., Little Rock UAMS College of Pharmacy Representative (Dean) Keith Olsen, Pharm.D., Little Rock Harding College of Pharmacy Representative (Dean) Jeff Mercer, Pharm.D., Searcy Legal Counsel Harold Simpson, J.D., Little Rock Treasurer Richard Hanry, P.D., El Dorado UAMS COP Student Cortni Hicks, Little Rock Harding COP Student 4 Jacilyn McNulty, Searcy AR-Rx_Summer 2018 - Jordan.indd 4

Scott Pace, Pharm.D., J.D. Executive Vice President & CEO

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he last two decades in pharmacy have been an unprecedented time of growth for jobs in our profession. Finding a job at the conclusion of pharmacy school was a given for a generation of our colleagues. That trend appears to be slowing down as supply of pharmacists has balanced out with demand.

have challenged the assumptions for projected number of pharmacists in traditional roles.

But regardless of the underlying causes of the marketplace changes, I believe that these challenges are a breeding ground for opportunity.

There is no doubt that the education and experience I think the marketthat pharmacists possess place changes have immense value in may encourage our healthcare system and create an opportunity a number of our for each of us to stretch colleagues to step what we want our careers out and take an to be.

The demand for pharmacists is measured by a group called the Pharmacy Manpower P ro j e c t (PMP) at p h a r m a c y m a n p o w e r. com. The PMP has been entrepreneurial producing the Pharmacist Demand Index for almost For example, the leap.

Pharmacist Demand 20 years, monitoring Index nationally shows trends on a state-bystate and national basis. the demand to be greater I have to admit that I have not always for pharmacists who are specialized in agreed with PMPs' data over the years. an area of practice and for pharmacists Their data has not always reflected the who have management background. boots on the ground reality and angst While these are not paths that everyone may choose to pursue, I do think these that are felt by some of our colleagues who are searching for a new professional numbers do not just show current demand, in my mind they are also an opportunity and are having difficulty finding it. However, I do think it serves indicator of future demand. as a useful guidepost for us to keep an eye on.

Lastly, I think the marketplace changes may encourage a number of our colleagues to step out and take an There are multiple factors that have entrepreneurial leap. Whether as an likely contributed to the changes in the owner, consultant, or other business pharmacist marketplace. The growth venture that allows you to use your in the number of colleges of pharmacy healthcare knowledge and patientand class sizes in the U.S. gets the most attention from current practitioners. But focused education, I encourage you to factors such as the Great Recession of not put limits around what you think you 2008 may have contributed a far greater can do or achieve. I am confident that role than initially thought, as pharmacists there is a place for all of us to play a vital who were on the cusp of retirement role in healthcare and some of those roles extended their stay in the job market may not have even been created yet. by as much as a decade longer than they may have planned. Technological Let’s all get out there and create what changes, slower than expected changes pharmacy in Arkansas will be for the next at the federal level to engage pharmacists two decades! § in Medicare, and other similar factors AR•Rx

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FROM THE PRESIDENT

THE WORLD TURNED UPSIDE DOWN

Looking Ahead...Barriers or Opportunities?

Stephen Carroll, Pharm.D. President

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herever you are in your career and whatever your pharmacy practice setting, you constantly work to climb the wall of obstacles and strive for success.

A barrier many pharmacies have faced recently is access to some medications, whether it be manufacturing shortages or limited distribution medications. Other barriers include limited pharmacy networks and self-insured plans that limit access for their members. Regulatory barriers affect almost every practice setting on a daily basis. Everyone from hospital pharmacists, retail pharmacists, consulting pharmacists, specialty pharmacists, clinical pharmacists, and compounding pharmacists experience some form of barrier. Reimbursements have affected retail pharmacists and specialty pharmacists. Hospital pharmacists have been affected by changes to insured patients and changes to the 340B program, as well as major drug shortages. Some pharmacists practicing in retail chains have experienced barriers with star ratings, increased demand on pharmacists' time, and even staffing cuts.

Arkansas pharmacists have been known to innovate in healthcare, whether it be increasing the use of automation to free up time to focus on new initiatives or evaluating alternative therapies as we heard from Lynn Crouse this past year in his practice. Amazon recently announced the acquisition of PillPack, a mail order pharmacy licensed in 49 states. Arkansas pharmacists must develop a plan to compete with the services they provide. We have all learned of the benefits of synchronizing a patient's medication in order to increase adherence. Multi-dose packaging is one service we can provide to improve our bottom line and retain patients. At

the annual convention, attendees heard from a wide variety of speakers who spoke about ways to innovate and diversify.

We learned about their success in the areas of patient care services. Many Arkansas pharmacists have seen great success with adherence programs, point of care testing, and immunizations. These are just a few items that pharmacists across Arkansas are doing today to climb the wall.

In specialty pharmacy, where I practice, the wall to climb is very complex. It starts with getting access to insurance networks. Many PBMs have several requirements for entry into the third party network, including being accredited by certain organizations. There are also limited distribution networks to navigate in order to get access to medications from certain manufacturers. As with all retail pharmacies, specialty pharmacy has seen a decline in reimbursements from third party payers. We continue to innovate to ensure that Arkansas patients receive the care they need and deserve when they have a complex disease state.

I see a great opportunity for Arkansas pharmacists in different practice settings (retail, hospital, compounding, specialty, and nuclear) to collaborate and ensure patients receive uninterrupted care for their disease states. We have seen success in our ability to collaborate and care for patients who are discharged from a hospital stay and need a seamless transition of care to a retail pharmacy. If you look around this great state of ours, you will find there are pharmacists with unique and innovative practices. I encourage you to work with other Arkansas pharmacies to take care of your patients and the citizens of Arkansas and surrounding states. ยง

2018 Regional Meetings APA Regional Meetings are a chance for Arkansas pharmacy leaders and Arkansas pharmacists to meet, discuss current issues, and visit informally in 11 cities throughout the state during the month of September. Meetings are approved by the Arkansas State Board of Pharmacy for 2.5 hours of Continuing Education credit. APA appreciates the many pharmacists who attend the Regional Meetings and encourage all interested pharmacists to participate.

To check dates or register for a Regional Meeting, check out www.arrx.org/regional-meetings.

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MEMBER SPOTLIGHT

Robert Acord, PD Director of Pharmacy Harps Food Stores

Pharmacy practice: I work in the home office of Harps Food Stores. Our headquarters are located in Springdale and I live in Tontitown which is less than 10 miles away.

Pharmacy school and graduation year: I graduated from

UAMS COP in 1987. I met my wife (Dena) during my last year at UAMS. It was her last year of Dental Hygiene too. We were married in October 1987 and we have three daughters: Baylee, Brinkley and Brighton......and a girl dog!

Years in business/years teaching: I've been in pharmacy

at some level or another for 31 years now. I started out as a pharmacy manager at Wal-Mart in 1987. I was promoted through several positions at Wal-Mart before leaving for Medicine Shoppe. After Medicine Shoppe, I was fortunate enough to become part of the Harps Pharmacy team. I have been at Harps Pharmacy a little over 10 years. At all of the previous positions I have had, teaching was always a component, whether it was teaching pharmacy students, new pharmacists, or technicians. It's been a great part of the jobs I have been fortunate to have.

Favorite part of the job and why: As the Director of

Pharmacy, I get to see a lot of different aspects of pharmacy.

Some of those aspects of pharmacy most people don't ever think about. Some of those aspects are fun and exciting (like teaching). To see someone grow professionally that you have worked with and invested time in is very rewarding. Also, it is very rewarding personally when you help a patient through a difficult situation healthwise.

Least favorite part of the job and why: My answer might

be the same answer that 90% of the pharmacists in Arkansas would respond - dealing with PBMs. The biggest reason is that they seem to be more of a roadblock than a solution to 6

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helping patients receive the health care they need.

What do you think will be the biggest challenges for pharmacists in the next 5 years? Pharmacist as providers could have a huge impact on our profession. It will depend on what the final definition of provider comes out to be. Another area to be watching closely is the continued mergers in the PBM world and the vertical integration of health care.

Recent reads: I am currently reading The Culture Code by

Daniel Coyle. This book has some unique insights and ideas that can have enormous impacts for today's organizations.

If you want to learn more about customers/groups of people and why some perform better than others, this book is a must read.

Favorite activities/hobbies: Golfing and seeing new movie

releases. I'm a huge fan of going to see movies at the theater.

Why should a pharmacist in Arkansas be a member of the Arkansas Pharmacists Association?

Harps is proud to say we have paid for our pharmacists to be APA members for many years. I encourage others to do the same. If there was ever a time when the pharmacists of Arkansas were shown the value of coming together and being united in direction and voice, it was this year.

Under the leadership and guidance of the APA, Arkansas has led the nation in bringing PBMs out of the dark, smoky environment they like to operate in. The APA has shed light on how deceptive and possibly illegal some of the actions of the PBMs are. The APA was instrumental in the fight for PBM legislation. This will benefit ALL pharmacists. ยง

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THE ARKANSAS PHARMACIST

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MEMBER SPOTLIGHT

Duane Jones, PD Pharmacy District Manager Harps Food Stores

Pharmacy practice: Community Pharmacy Owner and

community pharmacy clinical programs including Hospice Medical Board of Directors, Child Psychiatric Medical Board of Director, Home Infusion Pharmacy, Nursing Home Consulting, and manager/district manager for corporate pharmacies.

Pharmacy school and graduation year: University of

passed in his stool. And it was a bean.

Recent reads: In The Grip of Grace, Max Lucado Favorite activities/hobbies: Golf and running Ideal dinner guests: Very few people impress me so I would

Oklahoma 1977

say the 12 Disciples. What great stories they would have to tell!

Years in business/years teaching: 41

If not a pharmacist then…: I would want to be a physician.

Favorite part of the job and why: My favorite part of

Why should a pharmacist in Arkansas be a member of the Arkansas Pharmacists Association? The Arkansas

pharmacy is patient interaction and medication therapy management. I enjoy helping patients understand their disease state and become knowledgeable in selfmanagement of their outcomes.

Least favorite part of the job and why: I think least favorite part of the job for all pharmacists in community pharmacy is battling the PBM limitations they place on patient care and their practices of manipulating patients for their financial gain.

Pharmacist Association is one of the strongest and most effective pharmacist associations in the U.S. Our leaders are actively involved in advancing the pharmacist’s role in patient care. We are the only profession that gives away professional knowledge free of charge and the Arkansas Pharmacists Association is actively involved at the state and national level to position pharmacists to be instrumental in improving health care and being compensated as a provider of those services. §

What do you think will be the biggest challenges for pharmacists in the next 5 years? The biggest challenges will also be the biggest opportunities and that will be workflowing clinical services to manage medication therapy to improve patient outcomes. The opportunity is being compensated for that clinical intervention.

Oddest request from a patient/customer: There are so many! Probably oddest was the patient that brought his stool sample to the pharmacy to ask me to identify the tablet he

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Point of Care Testing in Arkansas Community Pharmacies

By Lauren Burgess, Pharm.D. Candidate and Megan Smith, Pharm.D., BCACP University of Arkansas for Medical Sciences

Brandon Achor of Lackie Drug Store in Lonoke administers a flu test.

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ccording to research by Deloitte, point-of-care testing will exceed immunizations as a driver of revenue for community pharmacy1. Point-of-care testing (POCT) is defined as medical diagnostic testing at or near the patient to bring convenient and immediate testing to the patient.

Tests that are commonly employed in community pharmacy settings are blood glucose, hemoglobin A1c, and lipid panel. However, there are also tests that aid in diagnosis of infectious diseases such as: human immunodeficiency virus, hepatitis C, influenza, and Streptococcus pyogenes (e.g. “strep throat�). The federal regulation Clinical Laboratory Improvement Amendments (CLIA) of 1988 requires facilities to obtain a Certificate of Waiver in order to perform waived tests. State-level scope of practice for pharmacists affects how these tests are performed and follow-up care is provided, if at all, leading to inconsistency nationwide2.

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Many pharmacies struggle with the expanding application of POCT for infectious disease for a variety of reasons, including provider pushback and lack of third party billing2. When it comes to cost, most pharmacies charge their patients a cash price since third party billing is difficult. POCT can be used for both acute and chronic diseases by offering avenues to manage and diagnose diseases, counsel patients, and provide medication therapy management. This is just one way pharmacists are expanding accessible, cost-effective, and high quality services.

In 2017, Arkansas formed a Community Pharmacy Enhanced Services Network (CPESN) to focus on integrating enhanced services, much like POCT, to optimize coordination of health services in our state and communities3. In July of 2017, the Arkansas CPESN network surveyed pharmacies in Arkansas

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POINT OF CARE TESTING IN ARKANSAS COMMUNITY PHARMACIES

on the types of services they offered. From this survey, four pharmacies in the state reported providing POCT for influenza and/or Strep. pyogenes. We found this interesting and decided to study the barriers and facilitators to implementing POCT in community pharmacy in order to help others wanting to offer these services. We decided to interview pharmacists who had provided at least one screening in the previous twelve months. Only one pharmacy of the four met this criterion. This article describes the pharmacist’s experience in providing POCT for influenza and Strep. pyogenes and patient satisfaction with services rendered between November 2017 and January 2018.

Cost

Providing influenza and Strep. pyogenes testing is financially viable for both the pharmacy and the patient. The pharmacy incurs a net profit of between $16 - $28 per test. The pharmacy charges each patient thirty dollars out of pocket per test, which is less than a typical outpatient copay. The pharmacist stated in the interview that this benefits the pharmacy and patients; therefore, they will continue to provide these enhanced services.

Patient Satisfaction

To assess patient satisfaction, patients who received a point-of-care test for influenza or Strep. pyogenes at the Implementing POCT pharmacy between November 2017 to January 2018 were Implementation was portrayed as a simple process requiring asked to complete a five question survey. A total of 20 little space. This particular pharmacy received supplies at a patients completed the survey. Three questions on the tradeshow, applied for a CLIA waiver, and survey performed unanimously among all within three to four weeks the pharmacy participants, those being questions assessing was ready to administer its first test. The satisfaction. All participants indicated they pharmacist had received no prior training The pharmacist were very satisfied (on a five point Likert outside of pharmacy school, and instead scale), indicated the service was worth their recognized the watched online videos for instruction time, and were extremely likely (on a four biggest challenge provided by the company used to purchase point Likert scale) to recommend the service was marketing or the supplies. Once a patient arrives in the to someone else. From these findings, we pharmacy and verbally requests a pointgetting the word out were able to conclude that influenza and of-care test, the pharmacist or technician Strep. pyogenes point-of-care testing as that this service is will process the sale and prepare the test. highly satisfactory. We evaluated the impact “just as good as a Testing is conducted in a private area, which of cost on whether the patient was satisfied doctor’s visit.” takes approximately ten minutes, where the with the service; all but one patient indicated pharmacist or technician administers the test that the cost was either less than expected and the patient fills out a general intake form. or about the same as they were expecting If the test is positive for influenza or Strep.

(Figure 1). pyogenes, the pharmacist will call the provider in the area for a verbal order for appropriate prescription treatment. The Lastly, we wanted to analyze the primary reason for receiving patients who are local to the pharmacy are typically from one a point-of-care test at the pharmacy (Figure 2). A doctor or of three clinics, which makes getting verbal orders simple for pharmacist had recommended only three patients for the the pharmacy. The staff at this pharmacy were all very receptive test. Over half of the participants stated one of their primary to implementation of this testing according to the pharmacist. reasons for receiving a point-of-care test was that it was Interestingly, the pharmacist indicated the majority of patients affordable, at a convenient location, and no appointment that request these services usually test negative but are looking was necessary. for reassurance or confirmation they are indeed not positive.

Challenges and Successes

The pharmacist recognized the biggest challenge was marketing or getting the word out that this service is “just as good as a doctor’s visit.” This pharmacy has tried to overcome this by mailing directly to the population within the pharmacy’s zip code as well as flyers sent to local schools and doctors’ offices highlighting “no wait flu testing.” The pharmacist recognized provider acceptance and ease of implementation contributed to the services’ success. Although this pharmacy was able to quickly establish a working relationship with a local provider, the pharmacist acknowledged this is not always true for all pharmacies. The pharmacist reported POCT in the local pharmacy saves patients' time as well, compared to an outpatient visit. The example given was a family of four could all get tested for influenza or Strep. pyogenes within about thirty minutes.

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Final Thoughts

This enhanced service being offered in Arkansas is well accepted by patients and a viable avenue to increase community pharmacy revenue. Additionally this allows pharmacists to showcase their knowledge and skills for services beyond dispensing. The convenience and affordability leads to a better experience of care for patients and reduces overall healthcare costs. §

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POINT OF CARE TESTING IN ARKANSAS COMMUNITY PHARMACIES

8% 5% 16% 17% 25% 29%

Literature cited: 1

Point-of-Care Testing, 2018, www.ncpanet.org/innovation-center/diversified-revenue opportunities/pointof-care-(poc)-testing.

2

Gilbreath, Marsha. Point-of-Care Testing Background Paper Prepared for 2015-2016 APhA Policy Committee. pp. 1–12, Point-of-Care Testing Background Paper Prepared for 2015-2016 APhA Policy Committee.

3

Foster, Jordan. “Community Pharmacy Enhanced Services Network.” Arkansas Pharmacists Association, www.arrx.org/cpesn.

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Animal Patients 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.

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he pharmacist at Anytown Pharmacy had prepared prescriptions for two pets and placed them in the refrigerator awaiting pickup. When Butch’s owner came in to pick up his prescription, the owner was given another dog’s prescription. Upon administration, the dog became lethargic and Butch’s owner took him to the vet. Unfortunately, Butch’s symptoms couldn’t be reversed and he died as a result of the incorrect drug’s effects. Butch’s owner subsequently made a claim for damages against the pharmacy.

What damages is Butch’s owner entitled to recover? In the majority of states, pets and other animals are considered personal property. As such, the owner is not entitled to recover damages for emotional pain and suffering or mental anguish, no matter how close the owner is to the pet or how much a part of their family they consider the pet to be. This can make these types of claims difficult to settle because the owner feels that the bond with their pet is not being considered. Under the law, they are correct. The bond with their pet is not compensable.

What is compensable is the market value of the animal and other costs resulting from the incident. These other costs could be the cost of treatment by a vet or in extreme cases, the cost of burial or cremation of the animal. The market value of an animal includes a number of factors, such as the original purchase price, the cost of replacement, and other elements that can enhance the animal’s value. For example, if the animal patient is a prize-winning race horse, the owner would be entitled to recover lost stud fees and other income derived from the horse’s performances. The cost to replace a winning race horse can also be substantial.

The potential vet bills for an injured pet could also be substantial. Because of the bond with their pet, the distraught owner might be willing to try any treatment, even those with only a small chance of success. It would not be unusual for vet bills to exceed the market value of an animal.

Because animals are considered property under the law, some states may have different procedures for these types of claims. States that have damage caps in medical negligence cases may not apply them here. These caps are generally applied to the injured patient’s damages for pain and suffering.

Because animal claims are property claims and there are no emotional damages, these caps do not apply. Also, because

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these claims are property claims, they may not be eligible for the Medical Review Panel process if that is in place in your state. In the Medical Review Panel process, the negligence claim is reviewed and evaluated by a panel of practitioners before the case can go to court. The case then only goes to court if one of the parties disagrees with the panel’s decision.

Pharmacists may not think much about the financial risks from an animal claim because there are no damages for emotional distress. While this is true, the other exposures can still be significant. Market values for race horses that have died as the result of prescription errors can reach six figure settlements. This can be multiplied if more than one animal is killed or injured. A case in Florida in 2009 resulted in the deaths of 21 polo ponies from a compounded nutritional supplement. A jury awarded the owners of the horses $2.5 million.

Pharmacists are health care providers because they want to help their patients. This is true whether the patient is human or an animal. The differences in the law for damages as the result of an error should not influence the way that a pharmacist approaches the care that they provide. There are groups advocating in several states for changes in these laws to allow for the owner to recover emotional damages.

Pharmacists will need to verify the law in their state. All patients deserve the same processes and safeguards. As with any aspect of their practices, pharmacists should be well informed of the standards and risks for any activity undertaken. § ____________________________________________________ © 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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UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF PHARMACY

Melanie Reinhardt, Pharm.D. Eddie Dunn, Pharm.D.

Who's Minding the Store?

This issue of Safety Nets once again examines the potential hazards associated with electronic prescriptions.

Thank you for your continued support of this column.

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he electronic prescription illustrated in Figure 1 was transmitted from a prescriber's office to a community pharmacy in Southeast Arkansas. A pharmacy technician entered the Armour Thyroid® patient directions into the computer as "take 1/2 tablet by mouth daily along with a 30 mg tablet (total dose 75 mg)". This information - along with the prescription image - was transmitted from the input queue to the pharmacist verification queue of the computer. While examining the order, the pharmacist realized the prescribed directions instructed the patient to take 1/2 of a 90 mg tablet ".5 times a day" instead of once daily. Confused by this unusual dosing interval, the pharmacist telephoned the prescriber's office for clarification. The prescriber's nurse told the pharmacist the patient was to administer 1/2 tablet of Armour Thyroid® 90 mg (i.e. 45 mg) once daily. The pharmacist immediately asked "what about the additional 30 mg tablet?" The nurse said she had no idea why "daily with 30 mg tablet" was included in the order. After this, the prescription was correctly filled and the patient appropriately counseled.

Figure 1

Over the past two years, the prescription examples illustrated in Safety Nets have switched from traditional handwritten prescriptions to the more prevalent electronic prescriptions. The authors of Safety Nets recognize that electronic prescriptions do have certain advantages compared to handwritten prescriptions, but do not necessarily "improve medication safety along with prescribing accuracy and efficiency" (HRSA statement). In fact, ERx's have actually introduced new types of medication errors into the health care system which would be extremely unlikely - or even impossible - with traditional handwritten prescriptions.

In this case, the prescriber wanted the patient to receive 45 mg of Armour Thyroid® daily - a relatively straightforward medication order.

Incredibly, the ERx in this case does not contain these specific patient directions anywhere in the Sig! Rather, the Sig. contains the meaningless phrase ".5 times per day", along with the erroneous and potentially hazardous "daily with 30 mg tablet." Fortunately, the errors contained in this order are so glaring the pharmacist was forced to contact the prescriber for clarification. In other electronic orders, the errors may be more subtle and harder to detect. In fact, the legibility of ERx's may reduce the level of scrutiny compared to handwritten orders.

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"Who's Minding the Store?" was a comedy film released in 1963.

Could this film title be used to describe prescriber's offices when transmitting electronic prescriptions? In this case, the obvious answer is yes. Unfortunately, however, it is definitely not funny. § STUDENT SPOTLIGHT

Technology Bridge - Brandon Bui

I am a second-year student pharmacist at UAMS. I earned a Bachelor of Science in Chemistry at California State University - Fullerton. Having grown up in southern California, I am frequently asked why I decided to relocate to Arkansas. I chose UAMS College of Pharmacy because I wanted to grow up a bit and find myself, with this campus being the best fit for me… I think it’s that southern hospitality, too!

In addition to being a full-time student pharmacist, I also supervise/mentor 20 international staff writers for my company Gamer Professionals, LLC. I found my niche in the games media sector after spending a decade as a video game reporter. My goal is to incorporate underrepresented voices in games media. One of my publications recently surpassed its millionth unique reader, less than two years after launching publicly.

I believe my future pharmacy career is bright and filled with potential. I want to someday own my own pharmacy and edit a large-scale healthcare publication. I want to develop my company into a media empire that extends beyond gaming and explores technology in healthcare. Despite the hesitations many pharmacists have regarding its use in practice, the sky truly is the limit regarding its potential.

With technology and help from my gaming tendencies, pharmacists can improve patient care by devising games and applications to encourage pharmacy visits and consults. We can use technology to create an application storing our health care information securely without the need for insurance cards. Technology should be our bridge, a bridge that connects the general population to an often-misunderstood profession. It’s time to look beyond our fears and create a better tomorrow for our patients, as well as ourselves.

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Yin and Yang of the Drug Approval Process This column, presented by the Harding University College of Pharmacy, aims to briefly highlight information on new molecular or biological entities, new indications, or significant new dosage forms recently approved by the FDA.

As part of the Trump administration’s effort to reduce drug prices, the FDA recently followed through on a promise to publicly name companies it says may be gaming drug laws to block generic competition.

This list, which can be found by searching “Reference Listed Drug Access Inquiries” at www.fda.gov, includes both generic (e.g.

Mylan, Ranbaxy/Sun, Teva) and brand-name (e.g. Actelion Pharmaceuticals, Celgene, Novartis) companies. Tactics that have been employed to block generic competition include: blocking access to samples which prevents the conduct of bioequivalence testing; making it hard to purchase drug at fair market value by putting restrictions in contracts on distributors, wholesalers, or specialty pharmacies; or claiming samples cannot be provided because the drug is subject to a REMS program with elements to assure safe use. However, new drug approvals have not been deterred with the following drugs gaining approval over the past three-months.

Targeted Biologicals: Aimovig™ (erenumab) is a first-in-

class once-monthly self-injected human mAb that prevents migraines by antagonizing the calcitonin gene-related peptide; Crysvita® (burosumab), a breakthrough orphan drug approved through priority review as the first therapy directed toward correction of renal phosphate wasting in patients with a rare X-linked hypophosphatemia form of rickets; Ilumya™ (tildrakizumab-asmn) is an interleukin-23 monoclonal antibody antagonist for treating moderate-tosevere plaque psoriasis; Olumiant® (baricitinib), following a stormy approval process and a boxed warning against serious infections, malignancies, and thrombosis, was approved for moderate-to-severely active rheumatoid arthritis; Palynziq™

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(pegvaliase-pqpz, PEGylated), approved as an orphan drug, is a novel enzyme substitution therapy that reduces uncontrolled blood phenylalanine concentrations in patients with phenylketonuria; and Tavalisse™ (fostamatinib) is a tyrosine kinase inhibitor approved as an orphan drug to treat persistent or chronic immune thrombocytopenia.

Antidotes: Andexxa® (coagulation factor Xa[recombinant]

inactivated-zhzo) received accelerated approval but with boxed warnings for potentially life-threatening adverse events as the first antidote indicated for patients treated with Xarelto® and Eliquis®; and Lokelma™ (zirconium cyclosilicate), a selective potassium ion trap, was approved for acute and extended use in rapidly restoring normal potassium levels in patients with hyperkalemia.

Chronic Care: Doptelet® (avatrombopag), approved as an

orphan drug through priority review, is a 2nd-generation oral thrombopoietin receptor agonist approved for the treatment of thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure; and Lucemyra™ (lofexidine), an alpha 2-adrenergic receptor agonist, received fast-track designation through a priority review process to became the first FDA-approved non-opioid drug to treat opioid withdrawal.

New Dosage Forms: Significant new dosage forms approved

this quarter include: Akynzeo® (fosnetupitant, palonosetron, IV) for acute and delayed chemotherapy-induced nausea/ vomiting; Apadaz™ (benzhydrocodone/acetaminophen, new combination) for short-term management of acute pain; Cimduo™ (lamivudine/tenofovir, new combination) for HIV1 infection; Fulphila™ (pegfilgrastim-jmdb) a biosimilar to Neulasta®; Imvexxy™ (estradiol, vaginal insert) for moderate-to-severe dyspareunia due to menopause; Jynarque™ (tolvaptan, new formulation) for autosomal dominant polycystic kidney disease, available through a REMS program; Plenvu® (PEG 3350, 1-liter, low-volume) as a bowel cleansing preparation; Retacrit™ (epoetin alfaepbx) a biosimilar to Epogen®/Procrit®; Symfi™ (efavirenz/ lamivudine/tenofovir, new combination) and SymfiLo™ (efavirenz/lamivudine/tenofovir, lower dose of efavirenz) for HIV-1 infection; and Ztlido™ (lidocaine, topical patch) for post-herpetic neuralgia. §

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LEADING the Way STEPHEN CARROLL, Pharm.D. 2018-2019 PRESIDENT

By Jordan Foster

Y

ou know the saying – the Chinese use the same word for ‘crisis’ as they do for ‘opportunity.’ It may be overused (and also incorrect, depending on whom you ask) but that phrase can be applied to Arkansas pharmacy in 2018. Out of a reimbursement crisis came many opportunities to lead the nation in the fight against abuse at the hands of the PBMs. Now, as Stephen Carroll ascends to the role of APA President, he’s looking to continue the wave of opportunities that the crisis has brought to advance APA and the career of every Arkansas pharmacist.

The Journey So Far

Born and raised in Jonesboro, Stephen Carroll had influences in leadership and healthcare from a very early age – his father is an athletic trainer at Arkansas State University in Jonesboro and his mother is a registered nurse. Between the two, he learned first-hand about teamwork, effective leadership skills, the positive power of helping your community, and the important role healthcare workers have to their patients.

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“Growing up in an environment where medicine was an important part of the culture of our family sparked an interest in me early on,” Stephen says.

The decision to enroll at ASU was an easy one for Stephen – being close to home helped keep him close to his parents and siblings, and the ASU scholarships he was awarded along with a faculty discount on tuition made financial sense.

After completing his pre-required courses for a pharmacy degree, Stephen headed to UAMS College of Pharmacy where a new program offered him a unique opportunity. “I was on a student panel that met with Stephanie Gardner when she was applying for the dean position at UAMS. One of the things she shared with us during the interview was her desire to offer dual degrees for pharmacy students. On here first day as dean, I went to her office and asked about the program since I was in my third year and I knew I would have to work quickly to make it happen.”

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The Pharm.D./MBA program at UAMS was instituted that year and Stephen got to work in his 3rd year doing double duty on his final didactic year of pharmacy and his first year of a two-and-a-half-year MBA program. Upon graduating from UAMS, he completed the MBA program and was later presented with the option of completing a bachelor program in biological sciences, resulting in the somewhat unorthodox track of Stephen earning a doctorate degree, followed by a master’s degree, and finally a bachelor’s degree.

“I would recommend to any student that wants to own a pharmacy or even has any interest in the business side of a pharmacy to look into the dual Pharm.D./ MBA program. Understanding the business behind what pharmacists do, understanding reimbursements and cash flow and how to build a business – there’s not enough time to focus on that in pharmacy school, but it can be a really helpful tool for owning or operating a pharmacy.”

Post-graduation, Stephen entered the pharmacy workforce at East End Pharmacy. Within six months, he was recommended for a position at AllCare Pharmacy where he worked for 10 years before transitioning to his current position with AllCare Specialty Pharmacy, an organization he has been a partner in since its inception in 2012. “I’m incredibly proud of what AllCare Specialty Pharmacy has become. We’ve grown tremendously in the past six years and have expanded our reach to be licensed in all 50 states, allowing us to service the entire country.”

With his wife of 10 years and his three sons under the age of five, Stephen’s home life can be just as busy as his office life, but after serving as an APA district president for several years, he decided to take a leadership role in the association and ran for Vice President in 2016. Now, as his year as President begins, Stephen is taking all he’s learned about pharmacy and leadership to lift APA to new heights.

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“We have to focus on how we mold the practice into what’s coming in the next few years and how we can help healthcare in general in the future."

Innovation and Escalation

The past two years have seen drastic changes in Stephen’s professional career. An unexpected appointment thrust him to the statewide spotlight as his leadership role within APA began to expand, but Stephen says he’s ready to take this next year as APA President and move the organization forward. “It’s incredibly important that we maintain a vision of what we’re here to do and how to do it – how do we take care of patients in the face of mounting pressures, whether they be regulatory or competitive – and how do we express the advantages of being an APA member and how that can help pharmacists. Sometimes it’s hard to see the big picture because there is so much to talk about when it comes to the value of being a member of APA.” In the year ahead, Stephen has two main goals for APA he would like to see accomplished: building membership from the strong engagement at the beginning of the year and positioning the organization so that members understand what APA does for them. “We’ve always had an active organization, but because of the reimbursement issues that affected so many of us at the beginning of the year, we’ve seen a new level of engagement that allows us to reach more pharmacists and share the value of an APA

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2017-2018 APA President Lynn Crouse gives 2018-2019 President Stephen Carroll the oath of office during the 2018 APA Convention.

membership. I never questioned my membership with APA when I graduated from pharmacy school. But what I soon realized after my first few years of being a pharmacist is that the relationships with other pharmacists that are nurtured through APA allowed me to learn from people I had looked up to going through school and allowed me to learn how to do something better. The camaraderie among members makes this a great organization and a great fit for Arkansas pharmacists.”

Along with growing APA, Stephen wants to lead the charge for all pharmacists, in Arkansas and beyond, to embrace innovation and change. In past years, new technology and new legislation that allow pharmacists to practice at the top of their license have created opportunities to push the practice forward, but pharmacists must be willing to embrace the future. “We have to focus on how we mold the practice into what’s coming in the next few years and how we can help healthcare in general in the future. Pharmacists have got to be accepting of automation and technology to streamline innovation and open up doors. Our practice settings have evolved, some settings that were very small when I was in school have grown into career paths now.”

Bottom line: innovation has brought huge opportunities for pharmacists that are willing to embrace it but “the hardest thing for people to do is to figure out what they want to do and then put their focus into it.”

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An Unexpected Appointment

On November 9, 2016, the US Presidential election overshadowed a surprising story in the Natural State: after narrowly defeating a similar initiative in 2012, Arkansas citizens voted 53% to 46% in favor of legalizing medical marijuana, making Arkansas the first state in the South to do so. As laid out by the approved amendment, the creation of the Arkansas Medical Marijuana Commission was the first step of a multi-faceted inception process. The Commission was charged with determining the qualifications for receiving a license to operate a dispensary or a cultivation facility, as well as awarding the licenses for each group. To determine the makeup of the commission, two members would be chosen by the Speaker of the House, two would be chosen by the President Pro Tempore of the Senate, and one would be chosen by the Governor. A few months after that November vote, Stephen received a phone call from Speaker of the House Jeremy Gillam.

“I think it is incredibly important to have a pharmacist on that commission because pharmacists, in addition to physicians, should be part of the medical marijuana process for the safety of the patients,” Stephen says. “All other medications go through a pharmacist and I think the legislature made a wise decision by ensuring patients have access to a pharmacist if they use medical cannabis so that they can be informed of potential drug interactions."

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Stephen and his wife Lauren with their three sons, William, Jacob, and Andrew

According to the Medical Marijuana Amendment, three groups will oversee medical marijuana in Arkansas.

In addition to the Medical Marijuana Commission determining rules for cultivation and dispensing licensing, the Department of Health will oversee the registration of patients with qualifying medical conditions and the Alcohol Beverage Control Division will administer and enforce the rules over the dispensaries and cultivation facilities.

According to Stephen, “the biggest misconception about the Medical Marijuana Commission is what we are tasked to do and what role the MMC plays, which is solely to setup a process to choose cultivation facilities and dispensaries.

However you may feel about medical marijuana, this was voted through by the citizens and it must be done in a responsible fashion.”

While the past few years have brought many changes, Stephen’s passion to push APA forward has not diminished.

Now, coming off a hectic first half of 2018, he is ready to lead pharmacists in the continued fight to protect their patients, their businesses, and their careers. §

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UAMS SCHOOL OF PHARMACY & HARDING UNIVERSITY REPORT

Keith Olsen Pharm.D., FCCP, FCCM Dean and Professor UAMS

Jeff Mercer, Pharm.D. Dean Harding University

2018 UAMS and Harding Colleges of Pharmacy Salary Survey

O

n behalf of the UAMS and Harding University Colleges of Pharmacy, we offer our sincere congratulations to the Arkansas Pharmacy Classes of 2018. As they take the NAPLEX and start their new jobs or postgraduate work, we certainly wish them all the best.

As in previous years, we appreciate the students’ willingness to complete a salary survey during the week of graduation.

We also thank Dr. Schwanda Heldenbrand and Dr. Sarah Griffin for compiling the data. The information indicates the job market for our 2018 Arkansas pharmacy graduates is stable. However, due to changes in what a pharmacist’s work week looks like and varying amounts of hours worked, we present these findings as an hourly rate to reflect an accurate and objective representation of salaries.

Overall, the average hourly salary for accepted pharmacy positions is $55.72, a slight decrease from 2017’s $55.80 per hour. Trends from previous years have also seen some changes. A majority (62%) of the students accepted a

position at a place where they had served as an intern or spent time during an experiential rotation, an increase over the 52% in 2017 who had the same outcome. When it comes to practice setting, 47% accepted positions in a community/retail setting, 36% have accepted residency/ fellowship positions, and 13% plan to own a pharmacy in the future, the highest number since 2015.

Graduates who have student loans make up 88% of the group with an average amount of debt of $161,149 per student.

In summary, our graduates enter the workforce at a time when pharmacy is changing and many of our new pharmacists will need to adapt to an evolving healthcare landscape. Though some may rush to compare the current climate with the past, the faculties of UAMS and Harding Colleges of Pharmacy are confident that our graduates are prepared to conquer the challenges ahead and begin their long, successful careers in pharmacy.

Arkansas College of Pharmacy Graduates Salary Survey Results 2018 Compiled by: Sarah Griffin, Pharm.D., BCPS, Harding University College of Pharmacy Schwanda Heldenbrand, Pharm.D., University of Arkansas for Medical Sciences College of Pharmacy

Summary • 155 Arkansas graduating pharmacy students completed the survey • University of Arkansas for Medical Sciences (n=109) • Harding University (n=46) • 75% of respondents completed a bachelor’s degree and 7% earned a Ph.D. or master’s degree prior to admission • 50% of respondents accepted a position prior to graduation • The average salary for graduates (excluding residency) is $55.72/hour • Overall 68% of graduates who accepted positions will practice in Arkansas, with the majority settling in central Arkansas.

Excluding residency positions, 22% percent will practice pharmacy outside of Arkansas with the majority going to Texas, Oklahoma, and Missouri • 47% of graduates who accepted a position did so in a community setting (chains, independent pharmacies, ambulatory care clinics, compounding, etc.)

• Twenty-eight out of 77 respondents (36%) are completing a PGY1 residency or fellowships, mean salary is $43,146 • Twenty-six out of 80 respondents (33%) believe position opportunities are excellent or good • Approximately 13% plan to own a pharmacy in the future and 26% are undecided • According to respondents, the most sought after job characteristics are good working conditions, fair pay, and job security • Top benefits offered by employers: health insurance, paid vacation, and paid holidays • 88% of graduates have student loans with an average of $161,149 and totals ranging from $35,000 to $350,000 (continued) WWW.ARRX.ORG

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Graduate Demographics

Position Information

Employer Benefits by Rank

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Position Location Information

Salary Information by Position

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

Times Are Changing David Fortner, Pharm.D. President

I

t is obvious to anyone following the profession of pharmacy that change is inevitable, and it comes quickly. This has never been more evident than in the past several months where we’ve seen significant changes in our state and around the country that have already, or very soon will, affect our daily operations. We are extremely fortunate to have a professional association with the APA that advocates for positive changes for pharmacist in Arkansas and with AAHP focusing these same efforts on health system pharmacy.

Recently, we’ve seen our state come together to positively affect changes related to oversight of PBMs. At a federal level, we continue to see discussion around changes to the 340B drug purchasing program that would significantly impact many hospitals and health-systems across our state.

Additionally, regulations such as USP 797/800 updates and FDA guidance to 503B outsourcing facilities have prompted change to sterile compounding practices that have the attention of hospital pharmacist around the nation. Again, change cannot be avoided and comes fast!

I have been very fortunate in my career to have people that pushed me to embrace change. I frequently say that “change brings opportunity.” As many pharmacists did before us, we need to look at pending changes to our profession as an opportunity to expand the footprint of pharmacy and be innovative as we seek new ways to be involved in patient care. We frequently see examples of this mentality across Arkansas. For example, facilities have developed and expanded the pharmacist’s role in antimicrobial

stewardship programs; expanded clinical services to emergency departments, patient centered medical homes, and population health management roles; and continue to optimize ways we engage in an interdisciplinary, teamfocused approach to patient care. These are just a few examples of ways pharmacists have used clinical skills and medication expertise to positively impact the lives of patients throughout their communities.

As an organization, I believe AAHP is also well positioned to embrace change. I would like to thank Brandy Owen for her hard work as president during the past year and look forward to continuing to work with her through the board of directors of AAHP. Additionally, Susan Newton should be recognized for her consistent leadership provided as Executive Director of the board for AAHP. We are a strong organization and the hard work of those before us has paved the way for a bright future for health-system pharmacists in our state.

As I mentioned earlier, “change brings opportunity.” AAHP has various opportunities for you to get involved. There has likely never been a better, or more important, time for you to support your health-system pharmacist association.

If you would like to learn more about volunteer or service opportunities, feel free to contact me at david.fortner@mercy.net.

I am optimistic about what pharmacists across Arkansas will continue to do and look forward to the chance to work with you in the coming years. §

AAHP Board

Arkansas State Board of Pharmacy

Executive Director............Susan Newton, Pharm.D., Russellville

President................................Lenora Newsome, P.D., Smackover

President..................................David Fortner, Pharm.D., Rogers

Vice President/Secretary...............Debbie Mack, P.D., Bentonville

Immediate Past President.........Brandy Owen, Pharm.D., Conway

Member..........................................Steve Bryant, P.D., Batesville

President-Elect............Erin Beth Hays, Pharm.D., Pleasant Plains Treasurer...........................Kendrea Jones, Pharm.D., Little Rock Secretary..................................Melissa Shipp, Pharm.D., Searcy Board Member at Large.....Kimberly Young, Pharm.D., Little Rock

Board Member at Large........Chad Krebs, Pharm.D., Little Rock Board Member at Large...........Joy Brock, Pharm.D., Little Rock

Member................................Lynn Crouse, Pharm.D., Lake Village

Member...........................Rebecca Mitchell, Pharm.D., Greenbrier Member....................................Ken Lancaster, P.D., Arkadelphia

Public Member........................................Carol Rader, Fort Smith Public Member............................................Amy Fore, Fort Smith

Technician Representative.....BeeLinda Temple, CPhT, Pine Bluff

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LEGISLATOR PROFILE

Representative Greg Leding DISTRICT 86

Represents: Part of Washington County Years in Office: 2011 to present (7.5 years) Occupation: Marketing and graphic design Your hometown pharmacy: Collier Drug Stores What do you like most about being a legislator:

Learning so much about so many different issues. It never gets dull.

Most admired politician: This is difficult, but I'll go with Senator Dale Bumpers. If you haven't read Best Lawyer in a One Lawyer Town, grab a copy today and don't put it down until you've finished.

Advice for pharmacists about the political process and working with the AR Legislature: Get to know

your state lawmakers. Don't wait until an issue arises or session starts. Develop those relationships now.

Your fantasy political gathering would be: Another

What do you like least about being a legislator: It's a

strain on family even in the best of circumstances.

tough one. Let's say RFK, Hattie Caraway, Dale Bumpers, and Alexandria Ocasio-Cortez over burgers and cold beer at Cotham's.

Most important lesson learned as a legislator:

Hobbies: Running, cooking, and outdoor activities. §

Get involved. Too often, I see people who start paying attention to politics only when something is affecting them personally—and by then it's sometimes too late. We all have busy lives, and it can be easy to want to tune out, especially when things get so jammed up and toxic— but the only way we make life better for everybody is if everybody's involved and weighing in.

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2018-2019 New APA Board Members Kristen Riddle, Pharm.D. VICE PRESIDENT

Larry McGinnis, Pharm.D. COMPOUNDING PRESIDENT

GREENBRIER

SEARCY

Greta Ishmael, Pharm.D. REGION 2 REPRESENTATIVE

Tyler Shinabery, Pharm.D CONSULTING PRESIDENT

CHEROKEE VILLAGE

SHERWOOD

Stacy Boeckmann, Pharm.D. AT LARGE REPRESENTATIVE

David Fortner, Pharm.D. AAHP PRESIDENT

WYNNE

ROGERS

Arkansas Pharmacists Association Welcomes New Executive Fellow APA Executive Vice President and CEO Scott Pace has named Lauren Jimerson, Pharm.D., as the Association’s 2018-2019 fellow for the APA Executive Fellowship in Association Management.

“Growing up in Searcy, I’ve seen firsthand how pharmacists work to make communities healthier,” Jimerson said. “I’m proud to join a profession that focuses on improving lives and changing communities and I’m excited for the opportunity to work for the pharmacists of our state in furthering the impact our profession can have in advancing the health and wellbeing of every Arkansan.”

Jimerson earned a B.A. in General Studies from Harding University in Searcy and recently graduated from the Harding University College of Pharmacy with a Doctor of Pharmacy. As a student, Jimerson was active in the American Pharmacists Association – Academy of Student Pharmacists and the Arkansas Pharmacists Association. She joins the APA staff for a one-year fellowship, developing her skills in association management and working with the Association to advocate for Arkansas pharmacists and patients. The Executive Fellowship is being funded jointly by the Harding University College of Pharmacy, the UAMS College of Pharmacy, and the Arkansas Pharmacists Association.

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2018 Calendar of Events

SEPTEMBER ———————— September 4, 2018 APA Regional Meeting Harding University Searcy, AR

September 6, 2018 APA Regional Meeting The Old Bank Sports Grill Russellville, AR

September 19, 2018 APA Regional Meeting NWA Holiday Inn Springdale, AR September 20, 2018 APA Regional Meeting Courtyard by Marriott Downtown Fort Smith, AR

September 10, 2018 APA Regional Meeting St. Bernard’s Auditorium Jonesboro, AR

September 24, 2018 APhA Immunization Delivery Certificate Training Program APA Office Little Rock, AR

September 11, 2018 APA Regional Meeting Chenal Country Club Little Rock, AR

September 27, 2018 APA Regional Meeting Monticello Country Club Monticello, AR

September 13, 2018 APA Regional Meeting Embassy Suites Hot Springs, AR September 18, 2018 APA Regional Meeting Big Creek Country Club Mountain Home, AR

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OCTOBER ————————— October 6-10,2018 National Community Pharmacists Association Annual Convention Boston, MA October 11-12, 2018 AAHP Fall Seminar Holiday Inn Airport Little Rock, AR

October 23, 2018* APA Board Meeting Conference Call October 25, 2018* APA Golden CPE Hosto Center Little Rock, AR

NOVEMBER ———————— November 1-4, 2018 American Society of Consultant Pharmacists Annual Meeting and Exhibition Gaylord National Harbor National Harbor, MD November 30, 2018* APA Committee Forum TBA November 30, 2018* APA Board Meeting TBA

DECEMBER ————————— December 2-6, 2018 American Society of Health-System Pharmacists Midyear Clinical Meeting Anaheim, CA

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Thank You to Our 2018 APA Annual Convention Exhibitors and Participants!

Pharmacists from across the state and across the pharmacy spectrum gathered at the 2018 APA Annual Convention in Rogers this June to earn CPE hours, network with other pharmacists, learn about practice updates, and enjoy camaraderie among their peers.

The three-day event covered topics from medical marijuana to point of care testing. During the convention, awards were presented to some of the state’s leading pharmacists and convention attendees enjoyed a special night at Crystal Bridges Museum of Art. Thank you once again to all our attendees, sponsors, and exhibitors!

APA CEO Scott Pace names 2018-2019 NCPA National President Nicki Hilliard of UAMS as an honorary APA President.

Governor Asa Hutchinson delivers the keynote address at the 2018 APA Convention in Rogers. Governor Hutchinson was also presented with the Guy Newcomb award in recognition of his leadership and help during the reimbursement crisis at the beginning of the year.

Representative Justin Boyd describes a pledge map to Paul Holifield and Billy Gammel during a special fundraising event for his re-election bid.

APA would like to extend a special thank you to Governor Asa Hutchinson for speaking at the APA Awards Ceremony.

Governor Hutchinson is the first sitting Arkansas governor to speak at the APA convention in the past 40 years.

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Convention attendees listen to one of 11 presentations at the 2018 APA Convention. Fifteen hours of CPE were available to earn at the event.

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Rep. Boyd leads a legislative roundtable discussion with guest panelists Rep. Dan Douglas, Rep. Michelle Gray, Rep. Greg Leding, and Sen. Bart Hester.

AAHP Executive Director Susan Newton swears in new AAHP Board members Erin Beth Hayes and Chad Krebs.

Ashford Advisors

APCI WWW.ARRX.ORG

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Incoming APA Board members Stacy Boeckmann, Brandon Achor, Spencer Mabry, Kristin Riddle, and Dean Watts take their oaths of office.

APA welcomed 40 exhibitors from the pharmacy field to talk to convention attendees about new products and services to help pharmacists serve their patients more effectively and efficiently.

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Convention by the Numbers:

3...........................................Days 325...........................Attendees 15...............................CPE Hours 19...............................Presenters 40.................................Exhibitors 8.........................Award Winners

Bio-Tech Pharmacal

CBI Team

CPESN 30

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Beautiful Blings Plunder Jewelry

Cardinal Health

Compliant Pharmacy Alliance

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HD Smith Forevercare

Liberty Software

Harding University College of Pharmacy

Independent Pharmacy Cooperative

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Louisiana Wholesale Drug Company

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MassMutual Financial Group

Medela

Merck Vaccines

McKesson

NovoNordisk

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Mountain Soaps

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PioneerRx

Pharmacists Mutual

Prescribe Wellness QS-1

Quidel

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Retail Designs, Inc

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RxMaster Pharmacy Systems

Sanofi

SpartanNash Buying Group

TZMO USA, Inc

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RxSystems, Inc

Smith Drug Company

Stone Bank

UAMS College of Pharmacy

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