ARRX - The Arkansas Pharmacist Summer 2015 by Arkansas Pharmacists Association

SUMMER 2015 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

JOHN VINSON APA's New President Sets His Sights On The Healthcare Horizon APA 2015 Convention Wrap-Up Arkansas Faces Low Immunization Ranking UAMS and Harding 2015 Salary Survey

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 Eric Crumbaugh, Pharm.D. Director of Clinical Programs Eric@arrx.org Jordan Foster Director of Communications Jordan@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: Mark Riley 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 72.

CONTENTS

Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org

4 Inside APA: Legislative Task Force

20 FEATURE: Low Vaccination Rate

5 From the President: The Inevitability

22 UAMS and Harding Report:

7 Legislator Profile: Representative

25 Arkansas Academy of Health-

Looks for Healthcare Answers of Change

Michelle Gray

President Sets His Sights On the Healthcare Horizon

System Pharmacists: AAHP Collaborations Highlight Importance of Synergy

26 APA Consultants Academy Report:

The Fundamentals of Consulting Pharmacy

12 Member Spotlight: Ashley Earley 13 New Drugs: FDA Approves Four

27 APA Congratulates 2015 Award

14 Rx and the Law: West Virginia

30 2015 APA Convention Exhibitor

New Molecular Entities/Biologics Case Offers Cautionary Tale For Pharmacists

15 Safety Nets: E-Prescriptions Don't

Guarantee Error-Free Orders

16 2015 Calendar of District Events

and Meetings

18 Compliance Corner: Best Practices

To Prevent and Detect Diversion

Winners

and Participant Photos

36 Editor's Note 37 Member Classifieds 37 Arkansas Business—40 Under 40 38 AAHP Board Members 38 Arkansas State Board of

Pharmacy

19 Clinical Programs: Multiple Factors

Lead to Unusually Intense Flu Season

DIRECTORY OF ADVERTISERS 2

Pace Alliance

Pharmacy Quality Commitment

Pharmacists Mutual Insurance

Arkansas Pharmacy Support Group

EPIC Pharmacies

26 WWW.ARRX.ORG

2015 Salary Survey Results

8 FEATURE: John Vinson - APA's New

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.

Puts Arkansas in National Spotlight

Retail Designs, Incorporated

Law Offices of Darren O'Quinn

UAMS Alumni Association

Back Cover: APA Honors AmerisourceBergen

APA Board of Directors

INSIDE APA

2015 - 2016 Officers

INSIDE APA

President - John Vinson, Pharm. D., Bryant President-Elect - Eddie Glover, P.D., Conway Vice President - Lynn Crouse, Pharm.D., Eudora Past President - Brandon Cooper, Pharm.D., Jonesboro

Area Representatives Area I (Northwest) Michael Butler, Pharm.D., Hot Springs Area II (Northeast) Brent Panneck, Pharm.D., Lake City Area III (Central) Clint Boone, Pharm.D., Little Rock Area IV (Southwest/Southeast) Dean Watts, P.D., DeWitt

District Presidents District 1 - Denise Clayton, P.D., Mayflower District 2 - Max Caldwell, P.D., Wynne District 3 - Chris Allbritton, Pharm. D., Springdale District 4 - Betsy Tuberville, Pharm. D., Camden District 5 - James Bethea, Pharm. D., Stuttgart District 6 - Stephen Carroll, Pharm. D., Arkadelphia District 7 - C.A. Kuykendall, P.D., Ozark District 8 - Darla York, P.D., Salem Academy of Consultant Pharmacists Anthony Hughes, P.D., Little Rock Academy of Compounding Pharmacists Lee Shinabery, Pharm.D., Jonesboro Arkansas Association of Health-System Pharmacists Rob Christian, Pharm.D., Little Rock

Ex-Officio APA Executive Vice President & CEO Mark Riley, Pharm.D., Little Rock Board of Health Member Gary Bass, Pharm.D., Little Rock AR State Board of Pharmacy Representative John Kirtley, Pharm.D., Little Rock UAMS College of Pharmacy Representative (Interim Dean) Kathryn Neill, Pharm.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 Elisabeth Mathews, Little Rock Harding COP Student Meredith Mitchell, Searcy

Find the APA on Facebook, or visit our website at www.arrx.org

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

Legislative Taskforce Looks for Healthcare Answers

egislators have numerous duties outside of the General Assembly meeting at the first of each year. Those duties include special legislative sessions and numerous committees and taskforces that meet on various issues. The Healthcare Reform Legislative Taskforce is taking a look at the healthcare landscape in general and specifically the two faces of Medicaid – traditional and private option. Senator Jim Hendren and Representative Charlie Collins are co-chairing a taskforce (consisting of about 15 total legislators and Surgeon General Greg Bledsoe) that is spending many hours delving into all facets of healthcare delivery to determine how to contain costs and improve quality. There are a few directions that the committee could recommend to the full legislature and Governor Hutchinson. The system could employ full blown managed care where a management company (probably from outside the state) would oversee and implement process and payment for the whole system, or the managed care aspects could be targeted for specific high cost areas. Long term care (LTC) and mental health are two areas that are frequently addressed in discussions. Pharmacy could be affected also but, in general, I believe that the pharmacy program is in pretty good shape. We will certainly stay involved in the conversation about what is best for the pharmacy program. There are always ways to improve and save money. The other major option is to continue the current system, both traditional and private option, with tighter controls, accountability, and efficiencies. That is the direction we would prefer so that the process and decisions stay local and the money stays in the Arkansas economy.

To facilitate the decision making process, the taskforce has hired a consultant, the Stephen Group out of New Hampshire, to help evaluate the various aspects of the Medicaid program and make suggestions. Other consultants may be brought in as well on specific issues. The taskforce is having meetings to hear from all sectors of healthcare providers.

Arkansas’s community pharmacies have $2.4 billion dollars of annual revenue and they employ 9,000 Arkansans. Our presentation, done in mid-July, included the economic impact of pharmacy in Arkansas based on information that we received from many of you in response to our survey. Arkansas community pharmacies, chain and independent, have a staggering impact on the Arkansas economy. For instance, Arkansas’s community pharmacies have $2.4 billion dollars of annual revenue and they employ 9,000 Arkansans. Moreover, the jobs that exist in Arkansas community pharmacies have an average annual income of $45,000. We emphasized what an important economic driver pharmacy is for the state of Arkansas and how keeping these dollars in state is vital not only to the health of our patients, but also to the health of our economy. We also talked about enhanced services that pharmacists can provide such as adherence, MTM, and immunizations. Finally, we recommended taking a serious look at combining all of the state-funded pharmacy programs for

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THE ARKANSAS PHARMACIST

FROM THE PRESIDENT

efficiencies and tighter management. We believe a program like the one the state employees have could save considerable money for the state. As stated earlier, the members of this committee have put in a lot of time and their effort is to be commended. They are looking for answers and I encourage you to not only tell us your ideas but communicate directly with your representative and senator about how you think healthcare can be improved. The right decisions are crucial if we are to have a quality, sustainable healthcare system in the state of Arkansas and

we must provide the right answers in the area of pharmacy management. Stability and savings is good for the state, our patients, AND for us as pharmacists. When costs are under control, we all win. After all, pharmacists are the medication experts and know both the therapeutics and economics of medication. Those two facts afford us the knowledge of how to save money in prescriptions services better than any other entity. Get involved – help us and the legislature find real answers. §

FROM THE PRESIDENT

The Inevitability of Change

lbert Einstein once said: “In the middle of difficulty, lies opportunity.” This quote comes to mind as I reflect on the continuing pharmacy education, networking, and discussions that occurred at the 133rd Arkansas Pharmacists Association meeting in Little Rock in June. The theme of the APA convention this year was "Navigating the Healthcare Landscape." This theme was very appropriate as the entire healthcare landscape and healthcare delivery models are rapidly changing. A few highlights at convention included learning more about measuring pharmacy performance, understanding Direct Indirect Remuneration (DIR) Fees in Medicare Part D, using pharmacist consulting with pharmacogenomics to guide medication prescribing decisions, and Dr. Alison Gray’s experiences of implementing integrated primary care pharmacy services within a private practice family medical center in Little Rock, AR. In addition, Arkansas pharmacists continue to “navigate” through the difficulties in implementing the workflows for Medicare star ratings, adherence programs, immunizations, transitions of care, medication reconciliation, and medication therapy management. All of these services require innovation and the ability to change or adapt to the new healthcare landscape. Consider this example of dramatic change in healthcare delivery and payment. In January of 2016, Health and Human Services (HHS) set a clear goal of tying 30 percent of traditional, or fee-for-service, Medicare provider payments to quality or value. These payments will be paid out through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016. Medicare will then increase the stakes and tie 50 percent of payments to these models by the end of 2018. In health systems, HHS also will tie 85 percent of all Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Readmissions Reduction Program and Hospital Value Based Purchasing. Health and Human Services will also work with state Medicaid programs, private payers, employers,

consumers, providers, and other partners to expand alternative John Vinson, Pharm.D. payment models into their President programs. This historic decision by Health and Human Services is the first time in the history of the Medicare program that HHS has set system wide specific goals for value-based payments and alternative payment models. In addition, all 3rd party payors in Arkansas including Arkansas Medicaid are currently developing patient centered medical homes with monthly care management fees and opportunities for shared savings in exchange for improved health outcomes at a lower overall cost. How will these historic changes bring new opportunities for pharmacists? Change is hard. It has been said that people don’t like “change.” There are many reasons for this. In fact, you can find masters programs, seminars, books, and certificate programs for teaching you change management skills to be successful businessmen and leaders. I don’t have a master’s degree in change management, but I do know that a key in the ability to change is understanding the reason for the need for change. Many times, the reason for change can be financial, ethical, or efficiency driven but it can also be a very personal, altruistic, or spiritual reason. I would like to challenge Arkansas pharmacists to consider what their personal reason is for any changes in pharmacy services in response to navigating this evolving healthcare landscape. What do you need to start, continue, or stop in your current practice to remain essential and successful healthcare providers? What is it that engages your hearts and minds as pharmacists? How can APA help you to be more successful in your practices? What services should we embrace with patient centered care in mind? The Institute for Healthcare Improvement's "Triple Aim" initiative is the driving theme behind all of the new (Continued)

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FROM THE PRESIDENT

payment models. Where are our opportunities with the Triple Aim in mind as a guiding principle? What future opportunities make the most sense for Arkansas pharmacists in community settings, consultant roles, health systems, and patient centered medical homes? Consider America’s Healthcare Rankings with Arkansas coming in at #49. How can we make a difference? Our patients deserve our best. Finally, I am very blessed to serve as the 113th President of the Arkansas Pharmacist Association. Brandon Cooper did an amazing job as the 112th President, and I appreciate his mentorship. Thank you to all of the membership, the staff at APA, the past Presidents,

and the Board of Directors for having confidence in me. I am excited to get started and really look forward to meeting each of you at the district meetings this fall. I also look forward to visiting with student pharmacists and encouraging them to get involved in pharmacy associations, advocacy, and patient service projects. The future of the profession of pharmacy depends on the energy, passion, and ideas that are often generated by student pharmacists. Feel free to share your ideas and thoughts by email to javinson@uams.edu. I look forward to hearing from you. §

INSTITUTE FOR HEALTHCARE IMPROVEMENT’S “TRIPLE AIM”: 1. Improved patient experience (including quality and satisfaction) 2. Improved health outcomes for the population (using patient registries and evidence-based medicine) 3. Reducing per capita costs (better care coordination, eliminating waste, using cost effective therapies, increasing preventive care, as well as reducing preventable ER visits, hospitalizations and disability)

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THE ARKANSAS PHARMACIST

LEGISLATOR PROFILE

Representative

Michelle Gray District: District 62 Represents: All of Izard County and parts of Independence, Sharp, and Stone Counties Years in Office: This is my first term Occupation: Chief Financial Officer for Gray Family Practice Clinic, PLLC and its subsidiaries Your hometown pharmacist: Lisa Cone and Mark Herrington What do you like most about being a legislator: I love helping people, especially those that don't always have a big enough voice to get things done for themselves. I also enjoy getting to participate in the lives of my constituents in a way that I wasn't able to before. I am generally a shy person and being a legislator has helped me come out of my shell. What do you like least about being a legislator: I dislike the "politics" of being a legislator. I feel that if all legislators did what was right, and what their constituents asked of them, the process would be much more efficient and effective. Most admired politician: There are several political figures that come to mind. I have studied many of them and their philosophies. I like Emperor Napoleon Bonaparte mostly for his military genius and unwillingness to admit defeat. I also like Prime Minister Margaret Thatcher and President Ronald Reagan, and have studied both "Thatcherism" and "Reagonomics." Some of their policies worked and some did not. That's the beauty of having history at our fingertips - we can learn from others' victories and defeats without enduring them ourselves. Advice for pharmacists about the political process and working with the AR legislature: My biggest piece of advice for everyone is to simply work with us. We all want what is best for our constituents and our state. Personally, all I ask for is honesty. As long as I know the whole story and how I can help, I will be the first one to step up when necessary. What I like least is self-serving people and industry. For example, if the pharmacists had come to me because their gross profit margins were at 10%, down from 11%, I probably wouldn't have been so eager to help. A profit margin of 1.5% that had declined to -1.5% in six months (as was the case with many pharmacies in the state) warranted intervention.

You were a sponsor for APAâ&#x20AC;&#x2122;s bills last session, what drew you to those bills? My local pharmacists came to me for help shortly after I was elected. It took several meetings with them for me to fully understand the issues they were facing. I found out that the Association had 3 bills to run this session and I offered to sponsor or co-sponsor any of them as needed. I knew that as a freshman legislator it would be unlikely they would ask me to be primary sponsor, but I promised my pharmacists I would help and I wanted it to be an option. To my surprise, I was asked to run the most controversial bill regarding PBMs. I learned so much through the process and am honored that I was able to help my pharmacists in such a huge way. Â§

What do you do for fun: Being a legislator is fun for me, so I actually get to do what I enjoy every day. On my down time, I enjoy antique shopping and spending time with my children.

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PCMH EVOLVES IN ARKANSAS

John Vinson

Sets His Sights On The Healthcare Horizon By Jordan Foster

NEW PRESIDENT TACKLES FRESH LEADERSHIP ROLES IN HIS CAREER AND IN THE ARKANSAS PHARMACISTS ASSOCIATION

AR•Rx

THE ARKANSAS PHARMACIST

JOHN VINSON SETS HIS SIGHTS ON THE HEALTHCARE HORIZON

”

any paths lead from the foot of the mountain, but at the peak we all gaze at the single bright moon.” – Ikkyu The path to success can be a tough road to travel. Every step in the journey puts you closer to the top of the mountain, but even upon reaching the pinnacle, the only way to measure your success is to look down and see how far you’ve come.

My job is to engage the hearts and minds of our clinicians, providers, nursing staff, and the healthcare team in primary care to improve patient outcomes and improve the patient experience through the healthcare system.

In the medical field, success is measured in something that is sometimes challenging to quantifiably measure. Success is improvement in quality of life. Success is days added to a patient’s years. Success is breakthroughs in the battle of diseases that end lives far too soon. As part of a patient’s healthcare team, pharmacists share in the responsibilities, the breakthroughs, and the successes of improving a patient’s life. 2015-16 Arkansas Pharmacists Association President John Vinson has already shared in successes that affect Arkansans each day. Through his role as Director of Pharmacy Education for University of Arkansas for Medical Sciences West in Fort Smith, Vinson has overseen an initiative to raise vaccination rates. Through his commitment to evidence-based results, Arkansas has seen staggering improvements in some of those rates and has been able to measure marked improvements in the health of patients. Now Vinson finds himself in two new roles - president of APA and UAMS regional programs medical director – and is leading Arkansas’s healthcare community down a new path to success.

The Road to Results In 2012, a program was started to target patients for HPV and pneumococcal vaccinations. “When we started the program, Arkansas was 49th in the country for HPV vaccination and preventable cervical cancer rates were the highest in the country, not that HPV vaccines are the only answer, but they are part of the solution. We measured our baseline rate and I believe it was around 21% of females that had documentation of completion of the series and around 40% that had at least gotten 1 dose. Over 2 years (2012-2014), we rose our baseline rate from 21% to high 30s for completion, and we rose the first dose from 40% to the 70s. Pneumococcal vaccines in people with diabetes was another area we targeted. The baseline rate when we started was 24% and now it is 80%.” Although Vinson led the charge in raising the rates, he is quick to note that the success was a collaboration of many healthcare professionals. “Most of the work, honestly, was done by the nursing supervisors and the nursing staff. My role was simply to recognize it was a problem and we need to take it on. I did a number of educational sessions with the nurses, but the actual implementation of the work was done by the nurses. It was a team approach between QI,

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Past President Brandon Cooper presents the gavel to President John Vinson at the APA Annual Convention in Little Rock in June.

nursing staffs, physicians, and me, as a clinical pharmacist with interest in vaccines.” Vinson parlayed that success into a new position that began January 1 of this year – medical director for UAMS regional programs. “It’s mostly an administrative position, more leadership and support for the centers, for clinical outcomes, and patient safety. My job is to engage the hearts and minds of our clinicians, providers, nursing staff, and the healthcare team in primary care to improve patient outcomes and improve the patient experience through the healthcare system.”

Growing Up From an early age, pharmacy has been a part of John Vinson’s life. As a child, he spent summers visiting family members that owned two pharmacies in Paris, AR. “When I would go visit they had a little backroom play area, so I spent some time in the summers learning about pharmacy and during my 10th grade year, my teacher asked each of us to write an essay about a career in which we might be interested. I wrote an essay about becoming a pharmacist and that essay actually led me to apply to local pharmacies for a summer/part-time job, (my first pharmacy job was in high school with Coker Drug community pharmacy, as a clerk and delivery driver,

JOHN VINSON SETS HIS SIGHTS ON THE HEALTHCARE HORIZON

I credit those experiences in student government for learning about strong leadership and good communication, which ultimately led to my interest in the APA leadership.

changes in your industry. With the advent of the Affordable Care Act and the seemingly daily updates in technology, the healthcare field seems to see more change than the typical work environment. “There is so much new technology that is emerging in our field. From hospital and community pharmacists utilizing technology to help prepare and dispense products, to the use of robots, to using electronic signature capture - computer software has gotten better to improve speed and efficiency for both processing prescriptions and getting paid on claims.” Not only has Vinson seen technology evolve and improve the pharmacist’s daily responsibilities, he’s seen an evolution in the role of the pharmacist as well. “There has been a big change in vaccinations. When I started pharmacy school I never even considered the thought that I may be giving someone a shot, but that has become routine practice in the majority of pharmacies."

As UAMS Regional Programs medical director, Vinson develops healthcare strategies that can affect Arkansans throughout the state

prior to the hospital technician jobs), which led to me working at a hospital pharmacy as a technician at Sparks Regional in Fort Smith and then at Washington Regional in Fayetteville while I was in college.” After a stint at West Arkansas Community College in Fort Smith (now University of Arkansas at Fort Smith), Vinson transferred to the University of Arkansas at Fayetteville to work on his biology degree before attending UAMS for pharmacy school. “When I came to pharmacy school, I got a lot of good advice from people in college that I had known or been friends with. One of them was John Kirtley, who is now at the Board of Pharmacy, and one was Justin Boyd, who is a state representative and who I’ve been friends with since a young age. They advised me about ASP and student government, so I got really involved with ASP, NCPA, Kappa Psi Pharmacy Fraternity, and other student organizations in pharmacy school. I credit those experiences in student government, and Dr. Charles Born, for learning about strong leadership and good communication, which ultimately led to my interest in the APA leadership.”

Changes and the Future of Pharmacy

An important part of any field is not just knowing how to do your job, but also knowing how to adapt to the inevitable

“When I began in pharmacy, MTM did not exist. In community pharmacies, medication therapy management (MTM), or face to face drug therapy discussions with patients, is now an integral part of community pharmacy practice. In addition, an emerging practice model based on the concept of MTM is the idea of comprehensive medication management embedded in a provider’s office for patients with complex medication regimens. The first opportunity I saw for reimbursement for that was the CMS Comprehensive Primary Care Initiative and a significant amount of my salary was actually budgeted from CPCI revenue for team-based care and medication management within a physician’s office. It expanded my role from just teaching and consulting to more direct patient care in a complementary and interdisciplinary team.”

Goals for APA “APA really does represent all practicing pharmacists in Arkansas. They provide key leadership in shaping the future of our profession, being the voice for our profession - regulatory, news media, print, and legislatively. They are here to ensure that we all have a successful career in serving our patients, a good professional career and the ability to earn an income to support our love for our profession. That’s what APA means to me.” As the 2015-16 president, Vinson has started crafting his goals for the next 12 months, with two issues at the forefront of his agenda. “There are several things that I am really excited about shepherding through in the next year. First, the MTM certificate program that Board Member Denise Clayton is championing. I’d like to see that be successful and that our members have more opportunities to participate in MTM beyond the Medicare program.

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THE ARKANSAS PHARMACIST

APA really does represent all practicing pharmacists in Arkansas. They provide a key leadership in shaping the future of our profession, being the voice for our profession - regulatory, news media, print, and legislatively. They are here to ensure that we all have a successful career in serving our patients, with a good professional career and the ability to earn an income to support our love for our profession. That’s what APA means to me.

John Vinson and Carol Graham, Associate Vice Chancellor and Executive Director at UAMS Regional Programs.

“Second, I want more of our members to understand the Institute for Healthcare Improvement’s triple aim for improved health, which is to improve individual patient outcomes, to improve population health as a whole, and to decrease costs, safely, through better care. I really want to emphasize the triple aim and challenge my colleagues and friends to think of ways in their practice they can help to improve the goal of the triple aim in some of these value-based payment systems. I don't know what they are going to be yet, but the more we understand the better chances we have to succeed.”

Message to Members As president of the APA, one role that Vinson has taken on is maintaining open communication to members of plans, ideas, and important information regarding the association and the profession. Vinson plans on keeping an open door policy with members to hear ideas and thoughts on how the APA can better serve them and the patients they take care of, while at the same time sharing advice he feels is important. “One of the things I would like to tell members, especially ones that are just starting out, is don’t be afraid to dream big. Realize that there will be opportunities that you never even knew existed. Seize opportunities when they make sense for you and for the patients you serve.”

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While juggling a new job and his duties as president may seem like a tall order, Vinson is prepared for the challenges ahead and expressed his gratitude for APA members giving him such a momentous honor, noting that without a committed membership, APA would not be the strong, influential organization that it has become.

One of the things I would like to tell members, especially ones that are just starting out, is don’t be afraid to dream big. Realize that there will be opportunities that you never even knew existed. Seize opportunities when they make sense for you and for the patients you serve.

“Thank you for being members. I appreciate each and every one of you and I’m humbled to be part of this profession with so many hardworking and caring individuals. Rest assured that the staff, myself, and the board of directors will continue working on your behalf so you’ll have a successful, professional business environment in which to practice.” §

MEMBER SPOTLIGHT

Ashley Earley, Pharm.D. Assistant Professor at Harding University College of Pharmacy

Pharmacy/Academic Practice: Assistant Professor at

Harding University College of Pharmacy; Clinical Pharmacist at Joe’s Pharmacy Express in Searcy, AR; Relief Pharmacist at Wal-Mart Pharmacy.

Pharmacy School & Year: University of Arkansas for

Medical Sciences College of Pharmacy in 2002. Completed a Pharmacy Practice Residency at the Central Arkansas Veterans Healthcare System in 2010.

Years in business/teaching: At Harding University College

of Pharmacy since 2010; Joe’s Pharmacy Express since 2013; Wal-Mart Pharmacy since 2000 (intern, staff pharmacist, pharmacy manager, relief pharmacist).

Favorite part of the job: I enjoy being able to share my

Oddest request from a student: A student asked me to email

him a copy of an upcoming exam so he could print it and bring a paper copy on exam day. He was having trouble with the software we use to administer online exams. Needless to say, his request was denied and I referred him to someone who could help with his computer issues.

Recent reads: Jesus Calling by Sarah Young, Rhinoceros

Success by Scott Alexander, Living Well Spending Less by Ruth Soukup.

Fun Activities: I am a self-proclaimed foodie and I am

currently training for my third half-marathon (I have to run so I can eat more). My children and I love to garden and we raise chickens.

passion for pharmacy with others. I am blessed to have played a small role in the development of some amazing new practitioners.

Ideal Dinner Guests: I would combine three things that are

Least favorite part of the job: The fear of teaching out of

If not a pharmacist then..: I would open a farm-to-table

date information since guidelines and policies are constantly being updated.

very important to me: faith, family, and laughter by inviting Jesus, my grandparents, Jimmy Fallon and Jim Gaffigan.

restaurant and teach gardening and cooking classes. §

What do you think will be the biggest challenges for pharmacists in the next 5 years? The continual need to prove ourselves as healthcare providers and educate others regarding our importance as part of the healthcare team.

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THE ARKANSAS PHARMACIST

FDA Approves Four New Molecular Entities/Biologics

hings have been relatively slow at the FDA but there have been four new molecular entities/biologics and several new dosage formulations approved over the past quarter.

Chronic Care: Corlanor® (ivabradine), the first new chronic

heart failure drug to be approved in nearly a decade, is for patients who are at significantly greater risk of hospitalization due to worsening heart failure. Corlanor® can be used in stable patients with heart failure and a heart rate ≥ 70 beats per minute while on maximally tolerated beta-blockers. Because of its unique mechanism of action that works to slow the heart rate with no effect on ventricular repolarization or myocardial contractility, it can be used to complement standard heart failure therapies. Jadenu™ (deferasirox, tablets) received accelerated approval as the first once-daily iron chelator that can be swallowed whole and is indicated to treat chronic iron overload due to blood transfusions and non-transfusion dependent thalassemias. ProAir® RespiClick (albuterol, inhalation powder) is the first breath-actuated, multi-dose, dry-powder, short-acting beta-agonist inhaler to be approved by the FDA. ProAir® RespiClick is indicated for the treatment or prevention of acute asthma symptoms and for the prevention of exercise-induced bronchospasm. Stiolto™ Respimat® (olodaterol/ tiotropium, inhalation spray), a combination of a long-acting beta2-agonist and an anticholinergic already on the market, is approved for once-daily maintenance of COPD. Viberzi™ (eluxadoline) is a first-in-class treatment for hallmark symptoms of abdominal pain and diarrhea in patients with IBS-D. Viberzi™ has mixed opioid receptor activity and works to reduce bowel contractions.

Procedure-Related Products: Kybella™ (deoxycholic acid),

an endogenous cytolytic agent that destroys fat cells, is approved to reduce double chins. Kybella™ is administered subcutaneously into the fat tissue under the chin, with patients receiving up to 50 injections per treatment with up to six treatments administered at least 1-month apart. Ionsys™ (fentanyl iontophoretic transdermal system) is a novel needlefree, patientcontrolled, preprogrammed fentanyl delivery system for the short-term management of acute postoperative pain. Ionsys™, which uses a credit-cardsized self-adherent device that em-

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ploys an imperceptible electric current to deliver on-demand fentanyl, is only for use in hospitals enrolled in the Ionsys™ REMS program. Raplixa™ (fibrin sealant human, spray powder) is the first ready-to-use, biologically active, powdered fibrin sealant that provides hemostasis in a wide range of bleeding settings. Raplixa™ is delivered to bleeding surfaces in difficult to reach areas using the low-pressure RaplixaSpray applicator.

Specialty Products: Anthrasil™ (anthrax immune globulin human, IV), made from the plasma of individuals who have been immunized with BioThrax® (anthrax vaccine adsorbed), is indicated to treat patients with inhalational anthrax in combination with appropriate antibacterial drugs. Efficacy of Anthrasil™ was studied in animals because it was not feasible or ethical to conduct adequately controlled efficacy studies in humans. Anthrasil™ will be stored in the US Strategic National Stockpile to facilitate its availability in response to an anthrax emergency.

Rx-to-OTC Switch: Rhinocort® Allergy (budesonide, nasal

spray) made the switch from prescription to over-the-counter for the treatment of allergic rhinitis. This follows on the heels of Flonase® Allergy Relief and Nasacort® Allergy 24HR having made the same switch.

New Dosage Forms: Significant dosage forms that were approved include: Aptensio XR™ (methylphenidate, ER capsule) containing multi-layered beads composed of immediate-release (40%) and controlled-release (60%) layers for ADHD; Elepsia™ XR (levetiracetam, ER tablets) containing 1gm and 1.5gm higher-strengths for the treatment of partial onset seizures; Tuzistra XR (Chlorpheniramine/codeine polistirex 2.8/14.7 mg/5ml extended-release oral suspension) indicated for the relief of cough and symptoms associated with upper respiratory allergies or a common cold; Kalydeco® (ivacaftor) oral granule packets to treat a rare form of cystic fibrosis; Albenza® (albendazole) chewable tablets; and new 640mg strength Metaxalone tablet. §

West Virginia Case OffersConduct CautionaryRule Tale For Pharmacists Wrongful 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.

recent decision in West Virginia1 is garnering a lot of attention in the pharmacy profession and beyond. The eight cases involve suits by 29 patients alleging that actions by physicians and pharmacists have caused them to become addicted to and abuse controlled substances. They also alleged that the pharmacies acted in concert with the prescribers by such actions as refilling prescriptions early and filling contraindicated prescriptions. After some years of prescribing by the 4 physicians involved, and dispensing by the 3 pharmacies involved, an FBI raid resulted in arrests of some of the health professionals. Some physician licenses were revoked and some were convicted and served prison time. However, only one pharmacy and one pharmacist were disciplined (the court decision does not indicate that there were any criminal charges). As the cases progressed, the plaintiffs all admitted to various crimes during the time that they were receiving and filling prescriptions for the various controlled substances. These included criminal distribution, buying drugs off the street in addition to those prescribed, acquiring prescriptions through misrepresentation, fraud or forgery, and doctor shopping. Because of these criminal activities, some of the defendants filed a motion to have the case dismissed on the basis of the Wrongful Conduct rule or the in pari delicto (in equal fault) doctrine. These two concepts have similar origins, but in pari delicto is used more commonly in contractual or transactional disputes. The premise of the Wrongful Conduct rule is that someone who is injured while performing an immoral or criminal act should not be able to recover damages for that injury. The Court quoted another case to explain the rationale for the rule; “... public policy that courts should not lend their aid to a plaintiff who founded his cause of action on his own illegal conduct.”2 The trial court agreed to dismiss the cases, but then sent certified questions to the Supreme Court of Appeals. The Supreme Court of Appeals declined to invoke the Wrongful Conduct rule in West Virginia because the majority believed the rule was too ambiguous and difficult to apply. They ruled that the jury would take the criminal activity into account when

apportioning fault under West Virginia’s comparative fault laws. In West Virginia, if the plaintiff is 50% or more at fault, then they cannot recover any damages. The Court said that comparative fault will essentially take the wrongful conduct of the plaintiff into account, so the Wrongful Conduct rule is unnecessary. There were two dissenting opinions that disagreed with the majority that the rule would be difficult to apply. The dissenting opinions said that it is straightforward; a person should not be able to recover for injuries sustained while committing a crime. Thirteen other states have already adopted the rule. By not invoking the rule, the Court will encourage other criminals to file suits to attempt to profit from their criminal activity. In these particular cases, they contend that the Court is allowing these plaintiffs to clog up the court docket and waste the court’s time. What does this mean for pharmacists? It’s important to recognize that there has been no trial and no judgment on the facts of these cases. The decision does not mean that the pharmacists or physicians are liable. This opinion is a procedural one that places the eventual resolution of the case in the jury’s hands instead of the judge’s hands. Many readers have probably already formed an opinion about the correctness of the decision. For pharmacists, the real issue is to try not to get involved in such a case in the first place. While this is not always possible, it should be a goal. The monitoring and dispensing of controlled substances is difficult at best. Pharmacists are no longer “order takers” subservient entirely to the doctor’s orders. Pharmacists should be active and diligent in monitoring all of their patients, but especially those with unusual controlled substance needs. Pharmacists need to educate themselves about their patients’ needs. There are plenty of reference articles about effective pain management to consult. Pharmacists also need to educate themselves about their responsibilities as health care professionals. The tightrope between patient needs and good stewardship of controlled substances is not easy to navigate, but ignoring the issue is not a solution. §

__________________________________________________________________________________________________________________________________________________ © Phillip J. Schieffer, PharmD/J.D. is a Dual-Degree Candidate at Drake University. 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. 1

Tug Valley Pharmacy, LLC, et al. v. All Plaintiffs below in Mingo County Cases, No 14-0144 (Supreme Court of Appeals of West Virginia, May 13, 2015).

Orzel v. Scott Drug Co., 537 N.W.2d 208, 213 (Mich. 1995).

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THE ARKANSAS PHARMACIST

UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF PHARMACY

E-Prescriptions Don't Guarantee Error-Free Orders Welcome to another issue of Safety Nets. This issue of Safety Nets highlights the potential hazards associated with E-prescriptions. Thank you for your continued support of this column.

he E-Prescription illustrated in Figure One was transmitted from a prescriber's office to a community pharmacy in Central Arkansas. The pharmacy technician entered the gabapentin patient directions into the pharmacy computer as "take three capsules by mouth three times a day, then take two capsules three times day". This information - along with the prescription image - was transmitted from the input queue to the pharmacist Figure One verification queue of the computer. While verifying the accuracy of the prescription, the pharmacist noticed a second sig. was contained in the Admin Instructions section of the order which instructed the patient to only take Figure One "two gabapentin three times a day." Confused by this discrepancy, the pharmacist telephoned the prescriber's office for clarification. The prescriber's nurse confirmed the patient was to administer two gabapentin 300 mg capsules three times a day. The nurse went on to remark "I'm not sure why those other directions were included." After this, the prescription was correctly filled and the patient appropriately counseled. The E-Prescription illustrated in Figure Two was transmitted from a prescriber's office to a community pharmacy in Northwest Arkansas. The technician entered the gabapentin directions into the pharmacy computer as "take one capsule by mouth two times a day and two capsules at bedtime." This information and the prescription image were transmitted to the pharmacist verification queue. While verifying the accuracy of this order, the pharmacist noticed two additional sigs - "take one capsule in the morning and 2 in the evening" in the Comments section, and "2 capsules at bedtime" in the Admin Instructions section. The pharmacist in this case

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also telephoned the prescriber's office for clarification. The prescriber's nurse confirmed the patient was to administer the sig listed in the Comments section - "take one capsule in the morning and two in the evening." After this, the prescription was correctly filled and placed in the will-call bin for patient pick-up. These two cases clearly demonstrate the hazards associated with electronic prescriptions. While this type of medication order may have certain advantages over traditional handwritten prescriptions, their use does not guarantee an error-free order. In these two cases, the electronic prescriptions themselves are the problem. The order in Figure One contains two different patient directions. The order in Figure Two contains three different patient instructions in a single medication order. In neither case are the intended directions listed in their traditional locations following the abbreviation "Sig." These two electronic prescriptions are confusing, hazardous, and diametrically opposed to patient safety. Whoever devised sections on medication orders such as Admin Instructions in addition to the traditional "Sig" abbreviation, has never heard of USP requirements for a valid, safe prescription. It is clearly not in the interest of patient safety to create this type of software. Electronic prescriptions are not guaranteed to be error-free. In fact, the legibility and neatness of E-Prescriptions may increase the risk of error compared to handwritten orders which may by more carefully examined by pharmacy staff. Pharmacists must remain careful to scrutinize all prescriptions - handwritten and electronic. ยง

2015 Calendar of Events & District Meetings District 6 Wednesday, September 24 Lake Point Conference Center Russellville

AUGUST August 6-7 APA Board of Directors Retreat Mount Magazine State Park Paris

District 5 Tuesday, September 29 Grand Prairie Center Stuttgart

APA District Meetings District 6 Tuesday, August 25 Embassy Suites Hot Springs

OCTOBER October 8-9 Arkansas Association of HealthSystem Pharmacists Marriott Hotel Little Rock

District 4 Thursday, August 27 Camden Country Club Camden

SEPTEMBER

October 10-14 National Community Pharmacists Association Annual Convention Gaylord National Harbor Washington, DC

District 1 Thursday, September 3 Embassy Suites Hotel Little Rock

Thursday, October 22 APA Golden CPE Hosto Center Little Rock

District 5 Thursday, September 10 Monticello Country Club Monticello

October 30-November 1 American Society of Consultant Pharmacists Annual Meeting and Exhibition Las Vegas

District 3

Monday, September 14 Doubletree Hotel Bentonville District 7 Tuesday, September 15 Holiday Inn City Center Fort Smith

DECEMBER December 6-10 American Society of Health-System Pharmacists Midyear Clinical Meeting and Exhibition New Orleans

District 8 Tuesday, September 17 Harding University Founders Room Searcy

December 5-6 APA Committee Forum and Board Meeting Location TBD Little Rock

District 2 Monday, September 21 St. Bernards Auditorium Jonesboro District 3 Thursday, September 22 Big Creek Golf and Country Club Mountain Home

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THE ARKANSAS PHARMACIST

APA HOSTS LEGISLATIVE DAY JANUARY 28

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Best Practices To Prevent and Detect Wrongful Conduct Rule Diversion

s the former attorney for the Board of Pharmacy, I have seen first-hand how devastating the diversion of controlled drugs can be to a pharmacist. That’s why I am focusing this series of Compliance Corner articles on the best practices to prevent and detect diversion. In the last installment, I discussed tips for improving the physical and site security measures at your pharmacy. In this edition, I’ll concentrate on policies and procedures you will need for ordering, receiving and tracking controlled substances. First, the ordering and receiving procedures used in your pharmacy are a crucial area that is often overlooked. Most of the serious instances of diversion that I’ve seen are where the same employee ordered the controlled drugs and received the order. That type of policy makes it very easy for your employees to divert drugs before you even knew that they had come in the door.

Have a robust inventory control system in place. It can be difficult to find the time to run reports and reconcile invoices but it really is the best way to detect diversion in progress. Recommended policies: • • •

•

• •

Restricting the authorization to order and receive controlled drugs to only the most trusted employees. Under no circumstances should the same employee order and receive controlled drugs. If you use a website-based ordering method, make sure that each authorized employee has an individual log in/ password. If you allow the entire pharmacy staff to use one log in, you will not be able to trace unusual ordering patterns. Conduct an initial check-in to confirm quantities against the invoice upon receipt of the controlled drug order. Where possible, make sure that pharmacists are doing the initial check-in. A different employee than the one conducting the initial check-in should confirm the quantities and put away the controlled drug order. Both employees should sign the invoice to confirm the check in process was followed.

Second, you should have a robust inventory control system in place. It can be difficult to find the time to run reports and reconcile invoices but it really is the best way to detect diversion in progress.

Recommended policies: • •

•

• •

•

Consider perpetual inventories for all CII, CIII and other drugs with a high street value. On a monthly basis, the PIC should reconcile the invoices received with the controlled drug orders with printouts from your wholesaler of controlled drugs shipped to the pharmacy. Ensure that employees are following the “check in” policy and that no invoices are missing. On a monthly basis, the PIC should run a “shrink report” on at least the top 5 drugs diverted. You can do this manually, use your own software or download an Excel spreadsheet shrink report from the Board of Pharmacy at http://pharmacyboard.arkansas.gov/faqs/Documents/ ShrinkReportToolbackup2.xls. Conduct annual inventory for all controlled drugs. The permit holder, if different than the PIC, should ensure that the PIC trains the employees on the controlled drug policies and that all of the diversion prevention and protection measures in place are mandatory. The permit holder and PIC should have a plan and policy in place for how suspected diversion will be reported and investigated.

In the next installment of this series, we will discuss employee management and how to protect yourself from diversion by properly hiring and training your employees. § _____________________________________________________

About the author: Erika Gee represents clients in government relations, regulatory and compliance matters at Wright, Lindsey & Jennings LLP. She previously served as general counsel to the Arkansas State Board of Pharmacy for 6-1/2 years and as Chief of Staff and Chief Deputy Attorney General for Attorney General Dustin McDaniel. She uses her experience as general counsel for state agencies and licensing boards to assist clients to resolve regulatory and disciplinary disputes with state government.

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CLINICAL PROGRAMS

Multiple Factors Lead to Unusually Intense Flu Season Haytham Safi, MD, MPH; Jennifer Dillaha, MD; Dirk Haselow, MD, PhD; and Gary Wheeler, MD, MPS

rkansas's 2014-2015 influenza season was unusually intense for two reasons - it started early and had a long duration. Starting the week of November 22, it remained elevated for 20 consecutive weeks, seven weeks longer than the average duration of 13 weeks. The season was also atypical because the mismatch of viruses for the vaccine caused a vaccine effectiveness of only 23 percent overall. In the 2014-2015 season, Influenza A subtype H3N2 was predominant – accounting for 83 percent of reported cases. Influenza B was the second most common type at 17 percent of reported cases. Next season’s vaccine will have a new Influenza A strain to better match the circulating H3N2 viruses (A/Switzerland/9715293/2013H3N2-like virus). It will also contain a new Influenza B strain (B/Phuket/3073/2013-like virus). Surveillance in Arkansas showed an unusually intense 20142015 season. The total number of cases (reported as positive antigen tests) doubled to over 30,000 compared to the prior season. A major factor was a drift in the H3N2 subtype identified in March 2014 after the production of the influenza vaccine had begun. Notable during the 2014-15 flu season were high rates of hospitalization and death occurring among adults aged 65 and older. Of the 97 deaths reported in Arkansas, 77 were people aged 65 years and older. This is the highest number of flu deaths in four decades. In contrast, during the 20132014 season when H1N1 was the predominant subtype, the majority of deaths occurred among adults younger than 65 (Figure 1). Figure 1

Influenza Mortality by Age Group Arkansas 2000-2015 (Provisional) Report updated 6/23/15

APA's Eric Crumbaugh administers a vaccination.

One reason the 2014-15 influenza season was atypical was because the mismatch of viruses for the vaccine caused a vaccine effectiveness of only 23 percent overall. Influenza kills more people than any other vaccinepreventable disease. Vaccination is our first line of defense and is recommended for all persons ages six months and older. Vaccination should begin as soon as the vaccine becomes available in the early fall. Protective immunity is not present until two weeks after the vaccine is administered. It is strategic to vaccinate before influenza is in the community. Anti-viral medications also play an important role in decreasing severity of illness, reducing hospitalizations and preventing deaths. Due to poor VE, the CDC encouraged treatment with antivirals as soon as possible during the 2014-15 season for patients at higher risk for complications without waiting for confirmatory testing. We encourage all providers in Arkansas to make a strong recommendation for annual vaccination to all their patients and encourage them to seek early care for influenza-like illnesses. §

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Low Vaccination Rate Puts Arkansas in National Spotlight By Jordan Foster

ith the recent multistate outbreak of measles, a disease once declared eliminated from the US with vaccinations in 2000 is now making a staggering comeback. Unfortunately, Arkansas has some of the lowest childhood immunization rates in the country, exposing Arkansans to a potential outbreak.

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THE ARKANSAS PHARMACIST

LOW VACCINATION RATE IN ARKANSAS

The most recent National Immunization Survey (conducted by phone with a follow up mailed survey to the children’s provider) found that Arkansas was ranked number 51 for completion of infant vaccines. Although there is plenty of speculation as to why so few children in Arkansas are getting immunized when compared to the rest of the country, the focus has shifted now to what is being done to raise the rate of immunized children and protect not just younger generations but the entire population from an outbreak.

The focus has shifted now to what is being done to raise the rate of immunized children and protect not just younger generations but the entire population from an outbreak.

One of the biggest hurdles to clear regarding the low vaccination rates are the barriers that prevent providers from offering immunizations. One of those barriers, especially in rural communities, may be limited access to immunization providers. Patients in highly populated cities in Arkansas usually have no issue finding an immunization clinic but those facilities tend to be sparser in rural areas of the state. Currently, there are 17 Arkansas counties where the health department is the only public Vaccines For Children (VFC) immunizing clinic, and even then an appointment is required. However, there is at least one pharmacy in all of Arkansas’s 75 counties. By adding pharmacists as VFC providers, Arkansans could have more access to these life-saving vaccines. In Arkansas, childhood immunizations are paid for through public programs (Vaccine for Children) and private payers (such as Arkansas Blue Cross Blue Shield). Currently, pharmacists can give immunizations to children 7 to 17 years of age with a prescription from their primary care provider or pediatrician (except flu which can be done pursuant to protocol). Several changes in these programs now allow for pharmacists to bill and be reimbursed for these vaccines. For example, Arkansas Blue Cross Blue Shield now allows for childhood and adult vaccines to be processed through their prescription plan for most of their plans. Also, Arkansas Medicaid is in the process of setting up pharmacists to bill for administration fees for public programs such as Vaccines for Children Providers. So what can pharmacists do to raise immunization rates in Arkansas? Eric Crumbaugh from the Arkansas Pharmacists Association and Arkansas Immunization Action Coalition says, “Arkansas pharmacists should educate, recommend, and administer all immunizations for children according to the Centers for Disease Control and Prevention schedule which includes vaccines beyond what are required for school entry, such as HPV. Enrolling your pharmacy in the Vaccine for Children Program will allow pharmacists to administer these vaccines to the childhood Medicaid population." Combining these efforts can be the first steps to getting Arkansas children immunized and making sure the Natural State is protected from vaccine preventable disease such as measles. §

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Arkansas ranks 51st for completion of infant vaccines, falling far below the US rate in several categories.

UAMS AND HARDING UNIVERSITY

Kathryn Neill Pharm.D. Interim Dean

2015 Survey Presents Positive View of Market for Pharmacists

e offer our sincere congratulations to the Class of 2015 at both UAMS and Harding University. As they take the NAPLEX and start their new jobs or postgraduate work in the coming weeks, 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 Flowers for compiling the data for both schools. The information indicates the job market for our 2015 Arkansas pharmacy graduates is very good. Overall, the average salary is $120,657 (1.2% increase over 2014). Of the 151 students who completed the survey prior to graduation, 88% had already accepted a position and the majority (68%) characterized the position opportunities as excellent or good. Some trends from previous years have

Julie Hixson-Wallace Pharm.D., BCPS Dean

remained relatively constant. Fifty-two percent of the students accepted a position at a place where they had served as an intern or spent time during an experiential rotation. The majority (75%) accepted positions in a community/retail setting, 15% have accepted residency/fellowship positions, and 14% plan to own a pharmacy in the future. Eighty-seven percent of graduates have student loans. The average amount of debt continues to rise from $113,284 in 2013 and $138,725 in 2014 to $145,000 this year. 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!

Arkansas Colleges of Pharmacy 2015 Salary Survey Results Summary • 151 AR graduating pharmacy students completed the survey (UAMS (n=110); Harding (n=41)). • 88% of respondents have accepted a position. • 68% of respondents believe the position opportunities available were excellent or good. • 75% of those who have accepted a position did so in a community/retail setting. • 22 students have accepted a residency/fellowship position. • 9% will receive a sign-on bonus and the average reported sign-on bonus is $18,000. • Overall, 37% of the students accepting positions will practice pharmacy in central Arkansas. Excluding residencies and graduate programs, 36% of the students accepting positions will practice pharmacy in central Arkansas. • Overall, 29% of the students accepting positions will practice pharmacy or do a residency out-of state. Excluding residencies and graduate programs, 25% of the students accepting positions will practice pharmacy out-of state. • Top benefits include: health insurance, paid vacation,

Of the 151 students who completed the survey prior to graduation, 88% had already accepted a position and the majority (68%) characterized the position opportunities as excellent or good. Approximately 87% have student loans, with an average amount of $145,000. retirement, and paid holidays. These were unchanged from 2014. Almost 5% of graduates will have their APA membership dues paid by their employer. • Average salary for a graduating pharmacy student from an Arkansas College of Pharmacy (excluding residency) is $120,657; an increase of $1,402 (1.2% increase) from 2014. • Approximately 14% plan to own a pharmacy in the future. • Approximately 87% have student loans, with an average amount of $145,000.

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THE ARKANSAS PHARMACIST

2015 SALARY SURVEY RESULTS

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THE ARKANSAS PHARMACIST

ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

AAHP Collaborations Highlight Importance of Synergy Rob Christian, Pharm.D. President

s I start out my year as AAHP President, I would first like to say thank you for this opportunity to serve you. I would also like to congratulate the following new Board Members and Council Chairs, as well as those that were reappointed to serve another term. (*) Dr. Kendrea Jones President Elect

Dr. Erin Beth Hayes Board Member at Large Holly Katayama

Dr. Lindsey Dayer

Technician Representative Membership and Communication

Council Dr. Amber Powell

New Practitioner, Resident, and

Student Council

Dr. Niki Carver*

Program and Education Council

Dr. Susan Newton* Executive Director

Dr. Maggie Williams* Hospital Advisory Council As I have been contemplating over the last couple of months about my term as President and what I hope to accomplish, I kept coming back to the word “synergy.” So what do I mean by synergy? Well, Mr. Webster defines it as, “the increased effectiveness that results when two or more people or businesses work together” and Wikipedia states it is, “the creation of a whole that is greater than the simple sum of its parts.” Based on the work that has been underway in our organization over the last 12-18 months in particular, I think we are truly reaping the benefits of some great strategic collaborations. While working with other groups is not new to AAHP, I believe a few of our latest collaborations have really made a huge impact on multiple practice sites throughout the state, so I wanted to highlight a few examples with you, and give credit to those that have done the lion's share of the work. The first example is the work that Dr. Niki Carver has done over the last two years with the Arkansas Hospital Association (AHA) Collaborative. This started out with a statewide campaign to reduce adverse drug events and has now grown to address Antimicrobial Stewardship in various practice settings. In a recent meeting held in Little Rock, pharmacists, physicians, nurses, and infection control specialists from across the state came together to share their current program outcomes, ideas on how to initiate a program, and to brainstorm on how we as a state can make

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the most impact on the use of antimicrobials. This is such an exciting campaign, and it is so great to see how multiple organizations and health systems are using this synergy to achieve better outcomes for their patients. The next example is the work that Dr. Kendrea Jones has done while chairing the New Practitioner, Resident and Student Council. While in her position, she has worked with numerous residency program sites, as well as ASHP, to offer Residency Preceptor Development webinars and live educational sessions. From these offerings, residency preceptors are equipped with the tools they need to successfully precept residents. The programs are not only applicable to new programs, or facilities that are initiating a program, but they also ensure seasoned preceptors stay current on the latest teaching methods and ASHP program guidelines. This work too is bringing colleagues from multiple organizations, colleges of pharmacy, and practice settings together to “create a whole that is greater than the simple sum of its parts.” Last, but certainly not least, is the work being done by the Hospital Advisory Council, which is lead by Dr. Maggie Williams. As mentioned in a previous article, this group, in conjunction with two health systems and the Arkansas State Board of Pharmacy (ASBOP), has been working on a Tech Check Tech pilot program. To date the two facilities have been able to gather data from their pilots and are now preparing to present their findings at an upcoming ASBOP meeting. The intent of these efforts is that Arkansas hospital pharmacies will be able to meet the ASHP Pharmacy Practice Model Initiative (PPMI) goal of educating technicians to the point that they can distribute medications and perform other functions that require less pharmacist supervision. Again, this is a great example of how AAHP has brought multiple resources together to help achieve a common goal. In closing, I would just encourage you to see how you too can get plugged in to what AAHP is doing, as you can see there is definitely strength in numbers. I think most would agree that resources in general will not be increasing anytime soon, so it is more important than ever to make sure we are maximizing any resource we have, be it staff, programs, knowledge, etc. With this said, my goal for the coming year is that we can continue to make AAHP a major source of synergy to help improve healthcare in Arkansas. §

APA CONSULTANTS ACADEMY REPORT

The Fundamentals of Consulting Pharmacy

have been a pharmacist for many years and a consultant pharmacist for the majority of Anthony Hughes, P.D. those years. Some have even said President that I became a pharmacist when there were only four elements in the periodic table (Earth, Wind, Fire and Water). Since that time, no matter where I go or to whom I am speaking, I get asked what I do for a living. I will say, “I am a consultant pharmacist.” Even from other pharmacists, I get the same second question. “What is that? Just what do you do?” Each field of pharmacy is special and requires additional expertise. Consulting pharmacy is no exception. I would like to provide an overview of today’s consultant pharmacist and help define just what we do, where we work and some of the pros and cons. What is a consultant pharmacist? As a consultant pharmacist we strive to be a patient care advocate. A consultant pharmacist is a pharmacist who is paid to provide expert advice on the use of medications or provisions of pharmacy services to patients, prescribers, nurses and institutions. This could be therapy recommendations or even a review of a patient's prescriptions looking for polypharmacy or mistakes. In the institutional setting we assist in patients’ rights with reviews of each patient’s medication for regulatory compliance along with proper indication, dose, duration, and monitoring for the presence of adverse consequences.

What are some of the issues with consulting? The hardest part is getting started. Most consulting positions come up quickly and are filled just as fast. A special license is required in Arkansas and is provided after a successful exam from the Board of Pharmacy. You should always check with the major nursing home pharmacy providers. They will have firsthand knowledge of employment opportunities and in many cases can provide a consulting opportunity. They can provide basic training and shadowing with an experienced consultant. Being a consultant pharmacist has opened doors of opportunity that I never would have known existed. It has allowed me to work in many different settings. I have been lucky enough to lecture on therapy and regulations across the United States in the public setting and pharmacy schools. Consulting helped me be recognized in the industry which allowed me to participate in senior management in two of the nation’s largest nursing home companies. Consulting Pharmacy has been special for me and I hope for you too. I am more than happy to discuss consulting pharmacy with interested parties. I can be reached at 419-575-1303 or TXH4110@aol.com. §

Where do we perform these services? Normally you would think nursing homes. This is correct and most consultant pharmacists perform their medication reviews there. However, there are other opportunities that may be overlooked. These could be ambulatory surgical centers, assisted living communities, correctional institutions, intermediate care facilities for the developmentally disabled, senior centers and subacute care to name a few, and the list goes on. In today’s discussion with third party payors and Medication Therapy Management (MTM), the consultant pharmacist is a natural. One major benefit of consulting is scheduling and working at your own pace. You have a number of sites or facilities you need to review each month or every 90 days. You normally can set your own schedule with the facilities as to when you will be there. When you arrive at your destination you work at your own pace and when finished you leave. There are minimal, if any phone interruptions and you don’t see an impatient customer wanting to know just why their prescription has gone up or is not covered now. You know that somehow, it must be your fault! Most of the time there are no weekends or nights unless there is some crisis that is unexpected. These are usually exceptions. 26

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APA Congratulates the 2015 Award Winners

t the 2015 APA Convention in June, the Arkansas Pharmacists Association, along with other sponsoring organizations, presented eight awards to pharmacists and students from across the state who exemplify the dedication and trust for which the pharmacy community is known. “The extraordinary contributions of these award winners in their pharmacies and communities is matched only by their passion for the health of all Arkansans,” Arkansas Pharmacists Association Executive Vice President and CEO Mark Riley said. “Arkansas pharmacists remain the most accessible health care professionals and these winners are a great example of why pharmacists also rank among the most trusted professionals.”

2015 Pharmacist of the Year Award

Distinguished Young Pharmacist of the Year

Bowl of Hygeia Award

Wayne Padgett, P.D., owner of Woodard Drug in Glenwood, was presented with the 2015 Pharmacist of the Year Award. This award recognizes a pharmacist for his outstanding contributions to the profession of pharmacy and activities in the advancement of pharmacy.

Rachel Stafford, Pharm.D., UAMS

Nicki Hilliard, Pharm.D., UAMS faculty

Rachel Stafford knew from an early age she liked science and wanted to help people. From there, it was a short jump to the field of pharmacy. After completing her pharmacy pre-requisites at UALR, Rachel began pharmacy school nervous about whether or not she would actually like pharmacy.

After earning a pharmacy degree and while in school for a master’s degree, Nicki began managing a nuclear pharmacy before starting the nuclear pharmacy program at UAMS in 1991. Soon after, she started the online education program at UAMS so that pharmacists outside central Arkansas could get training in nuclear pharmacy.

Described as a “late-blooming” pharmacist, Wayne had early intentions of being a veterinarian before his interest turned to pharmacy. After earning a degree in chemistry and a brief stint working as a chemist, he started pharmacy school as a “non-traditional” student at the age of 30. A few years after completing his pharmacy degree at UAMS in 1984, Wayne and his wife Mary bought Woodard Drug in Glenwood in 1989, transforming the store into a thriving family business with Wayne and Mary running the store and their daughter, Tara, as pharmacy technician. Wayne has stayed proactive within the pharmacy field by serving as a former APA President and District 6 President, an Area Representative for the UAMS College of Pharmacy Alumni Association, as well as being a member of the National Community Pharmacist Association and the Arkansas Pharmacist Foundation. His passion remains taking care of his customers and providing quality healthcare to his community. He and Mary have been married 43 years and have one daughter and son-in-law and two grandchildren. They are members of Glenwood Methodist Church.

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faculty member and Pharmacy Patient Care Specialist for Kroger, was awarded the 2015 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.

Not only did she like pharmacy, she excelled at it. She now splits her time between the Kroger pharmacy where she serves as the Pharmacy Patient Care Specialist and UAMS where she teaches several courses. Because she spends her time in both the classroom and the pharmacy setting, Rachel’s passion has been translating big picture ideas into real world solutions. Rachel graduated from UALR with a Bachelor of Arts degree in Professional and Technical Writing in 2006 and graduated UAMS College of Pharmacy in 2010. She is a member of the Arkansas Pharmacists Association, the American Pharmacists Association, and the American Association of Colleges of Pharmacy. She enjoys spending time with her husband David and their 8-month old son, and running her graphic design business.

member, was presented with the 2015 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 BoehringerIngelheim. This award was established to honor pharmacists who have compiled an outstanding record of community service.

Nicki’s passion for pharmacy advocacy is rivaled only by her passion for community service. A former LRSD Volunteer of the Year, she has committed her time and skills to working with the Aldersgate Free Medical Clinic, the Susan G. Komen Race for the Cure, the St. James Golf Classic, and the Barbara Netherton Memorial Scholarship Golf Tournament, named for her mother. Nicki attended the University of Arkansas, graduated from the UAMS College of Pharmacy in 1983, and earned a master’s degree in healthcare administration from UALR in 1990. She is currently a UAMS faculty member. Nikki and her husband Joe live in Little Rock and have two daughters. They are members of St James Methodist church.

APA 2015 AWARD WINNERS

NASPA Excellence in Innovation Award

Cardinal Health Generation Rx Award

Percy Malone Award for Public Service

Taylor Franklin, Pharm.D. of Fort

Aduston Spivey, P.D., owner of Hot

Lenora Newsome, P.D., President

Smith, was presented with the 2015 Excellence In Innovation Award. This award was established in 1993 by the APA in cooperation with the National Alliance of State Pharmacy Associations to annually recognize a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy. Starting as a pharmacy delivery girl in high school, Taylor Franklin became interested in the healthcare field and quickly discovered that pharmacists are the most accessible healthcare providers, especially in small, rural areas. Though she’s only been out of pharmacy school for a year, Taylor has been hard at work developing an MTM program that benefits multiple pharmacies in her area. “I feel like MTM (Medication Therapy Management) is something that everyone knows we should be doing but it’s hard to find a way to work it into the normal workflow,” Taylor says. Recognizing MTM as a key piece of a pharmacist’s healthcare strategy, Taylor developed a system to help multiple pharmacies fill the MTM void that often occurs. “Pharmacies usually want their staff pharmacist to do MTM but it can be difficult for them to find the time to sit down with patients for an hour and give them your full attention, so I spend one day a week at several different pharmacies so I’m able to keep all their appointments and give the customers the special attention they need.” Taylor attended the University of Central Arkansas and graduated from the UAMS College of Pharmacy in 2014. She is a member of the Arkansas Pharmacists Association, the American Pharmacists Association and sits on the Board of Directors for the Fort Smith Girls Shelter. She and her husband Thomas live in Fort Smith with their son.

Springs Pharmacy, was awarded the 2015 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. The award is also intended to encourage educational prevention efforts aimed at patients, youth, and other members of the community. At the age of 13, Aduston Spivey was already working in a pharmacy. A native of Alabama, she worked for a man who she says taught her a philosophy of compassion and generosity that she adheres to in her career as a pharmacist. “My passion has always been helping people. That’s what I got in it for,” Aduston says. “I want to talk to people and find out what’s going on. I don’t think we can truly help them by just giving them a pill; if they don’t know why they’re taking it, they’re not going to get better.” Aduston’s philosophy of care and compassion was reinforced when she learned of what was going on in her own town. “There’s a big drug problem in Hot Springs but there’s also a big recovery community.” When Aduston recognized the need in her community to help struggling addicts, she went above and beyond to help her patients detox off of opioids and focused on helping her community to make sure that anyone in need would always have her help. Aduston attended the University of Alabama and earned her pharmacy degree from Samford University in Birmingham, Alabama. She is married to Steve and together they have three children, two of which are also in the pharmacy profession. She attends First Presbyterian Church of Hot Springs. AR•Rx

of the Arkansas Board of Pharmacy, was presented with the 2015 Percy Malone Award for Public Service. The Percy Malone Award for Public Service was established in 2009 by the APA and first presented to former Senator Percy Malone, a pharmacist from Arkadelphia. The recipient must have made a contribution to public service in Arkansas by displaying an interest in the people of Arkansas. Lenora Newsome had no intentions of being a pharmacist when she graduated from Smackover High School and headed to college. She arrived at Southern Arkansas University with aspirations to be a nurse, but it didn’t take long for her to realize that pharmacy was the right healthcare field for her. After graduating from UAMS CoP, she worked at the Union Medical Center hospital pharmacy in El Dorado, Walgreens in El Dorado, Brookshires and now at the Walgreens in Camden. According to Lenora, her time in pharmacy school, working in pharmacies, and being on the pharmacy board serves as a base of knowledge that she uses to help the people of Arkansas. “Being able to take the knowledge that I’ve learned over the years and pass that on to everyday people is my passion,” Lenora says. “We learn so much and can do so much that the general public doesn’t realize. It’s a very rewarding career.” Lenora attended Southern Arkansas University, the University of Arkansas, and graduated from the UAMS College of Pharmacy in 1980. She has served on the Arkansas Medical, Dental, and Pharmaceutical Association, the National Association of Boards of Pharmacy, the South Arkansas Regional Health Center board, the Boys and Girls Club of El Dorado board, the Arkansas Pharmacists Association, and is currently the President of the Arkansas State Board of Pharmacy. She and her husband Dr. Carlton Newsome live in Smackover and have two sons, two daughters, and three granddaughters. They attend New Providence Baptist Church in Norphlet.

THE ARKANSAS PHARMACIST

APA 2015 AWARD WINNERS

Charles M. West Student Leadership Award

AR Pharmacy Foundation Scholarship Award

Brett Bailey, University of Arkansas for

Brandi Bowers, University of Arkansas

Nora Martin, Harding University

Medical Sciences College of Pharmacy student, was named winner of the 2015 Charles M. West Student Leadership Award. The Charles M. West Student Leadership Award was established in 2004, honoring former APA and NARD (now NCPA) Executive Vice President Charles M. West. The award recognizes two students that demonstrate outstanding potential in pharmacy and leadership. Brett has served as President of the American Pharmacists Association – Academy of Student Pharmacists chapter at UAMS COP from 2014-2015 and Vice President of Communications from 2013‐ 2014. He was the 2014-15 Board of Directors Student Representative for the Arkansas Pharmacists Association, the class representative for the UAMS Honor Council, serves on the UAMS College of Pharmacy Alumni Association Board of Directors, and is a member of the National Community Pharmacists Association and the Rho Chi Honor Society. Brett is a UAMS Jordin Scholar (2013—2014) and is on the UAMS Dean’s List (2012—2014). His volunteer activities at UAMS COP include: the Legislative Health Fair (2015), the Amboy Food Pantry (2014), Kroger Health Screenings (2014), Our House Shelter (2014), Adult Vaccination Screening (2014), and the Bryant Health Fair (2014). Brett has worked as an intern at the UAMS College of Pharmacy in Little Rock, Walgreen’s Pharmacy in Maumelle, and Arkansas Research Alliance in Conway. He graduated from the University of Central Arkansas with a Bachelor of Science Degree in Economics in 2012 and graduated from Beebe High School in 2008.

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for Medical Sciences College of Pharmacy student, was named winner of the 2015 Charles M. West Student Leadership Award. The Charles M. West Student Leadership Award was established in 2004, honoring former APA and NARD (now NCPA) Executive Vice President Charles M. West. The award recognizes two students that demonstrate outstanding potential in pharmacy and leadership. Brandi has served as President of the NCPA chapter at UAMS COP from 2014 to 2015 and Secretary from 2013 to 2014. She is currently Vice President of Patient Care and has previously served as Vice Chair of Finance for the American Pharmacists Association – Academy of Student Pharmacists. She is Secretary/Treasurer for Phi Lambda Sigma Leadership Society and is a member of Rho Chi National Honor Society. She’s received the UAMS APhA— ASP Outstanding Executive Committee Member Award (2014—2015), the UAMS APhA—ASP Outstanding Member Award (2014), and the Student Government Association Senator of the Year from Missouri State University (2010). She is a UAMS Jordin Scholar (2014) and is on the UAMS Dean’s List (2012—2015). Brandi has worked as an intern as part of the Kroger Summer Internship Program in Little Rock and at Baptist Health Medical Center, and as a pharmacy technician at Taylor Health and Wellness Center Pharmacy in Springfield, MO and Harps Pharmacy in Mountain Home, AR. She graduated from Missouri State University with a Bachelor of Arts Degree in Mathematics in 2012 and Mountain Home High School in 2008.

College of Pharmacy student, received the 2015 Arkansas Pharmacy Foundation Scholarship Award. The award was established in 2014 to honor a Harding University College of Pharmacy student who demonstrates outstanding potential in pharmacy and leadership. Nora is a member of the American Pharmacists Association – Academy of Student Pharmacists, the National Community Pharmacists Association, and the Arkansas Pharmacists Association. She has served as NCPA – Vice President of Community Service, and Committee Chairs for the NCPA – Community Health Initiative and Lock Your Meds Campaign. She’s received the NCPA Dedication Award (2015), the NCPA Outstanding Student Member of the Year Award (2014), and the APhA – ASP Professionalism Achievement Award (2014). Her volunteer activities at Harding COP include: Broadway Bridge Ministries (2014), NCPA Canned Food Drive (2013, 2014), and Valley Baptist Church Free Clinic (2011, 2012). Nora has worked as an intern and pharmacy technician at Lowery Drug in Searcy since 2005. She completed her pre-pharmacy curriculum at ASU-Beebe in 2012, graduated from Arkansas State University – Beebe with an Associate’s Degree of Arts in 2003, and graduated from White County Central High School in 2001.

Thank You to Our

2015 APA Annual Convention Exhibitors & Participants!

harmacists from across the state and across the pharmacy spectrum gathered at the 2015 APA Annual Convention in Little Rock in June to earn CPE hours, network with other pharmacists, and learn about practice updates. During the convention, awards were presented to some of the stateâ&#x20AC;&#x2122;s leading pharmacists and convention attendees were entertained at the Ernie Biggs Dueling Piano Lounge. The 2016 134th Annual Convention will be held in Hot Springs on June 23-25. Attendees gained more than 15 CPE hours learning about new drugs, new laws, and more.

Alkermes, Inc.

AmerisourceBergen

Amgen

Brandon Cooper (Past President) and Mark Riley (Executive VP & CEO) showing off their Elvis impersonation talents during the Dueling Piano Lounge at Friday evening's reception.

ARâ&#x20AC;˘Rx

THE ARKANSAS PHARMACIST

Board members being sworn in by Past President, Brandon Cooper.

APCI

Arkansas Foundation for Medical Care

Arkansas Prescription Monitoring Program

AstraZeneca Diabetes

Cardinal Health

Chattem, a Sanofi Company

Data Rx Management

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EPIC Pharmacies

39 exhibitors from the pharmacy field were on hand to talk to convention attendees about new products and services to help pharmacists serve their patients more effectively and more efficiently.

Harding University College of Pharmacy

374 pharmacists, technicians, students, and guests attended the three day conference in Little Rock.

ICU Medical, Inc.

First Financial Bank

iMedicare

Liberty Software

H.D. Smith

Thank You To All 2015 APA Annual Convention Exhibitors and Participants!

ARâ&#x20AC;˘Rx

THE ARKANSAS PHARMACIST

APA’s Ernie Biggs Dueling Piano Lounge

Convention By The Numbers

Mass Mutual Dallas-Fort Worth

McKesson

3 DAYS 374 ATTENDEES 15.5 CPE HOURS 11 PRESENTERS 39 EXHIBITORS AWARD 9 APA WINNERS 1 ICE SCULPTURE

Medicine On Time

Morris & Dickson

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Merck

Novo Nordisk

133rd Arkansas Pharmacists Association Annual Convention

PBA Health

Tripp Logan, Pharm.D. explains performance measures for pharmacies.

Pfizer

Pharmacists Mutual Companies

Regions Bank

Retail Designs Incorporated

RxMaster Pharmacy Systems

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THE ARKANSAS PHARMACIST

Sanofi

Selling Arkansas Pharmacies

Smith Drug Company

Teva Respiratory

John Kirtley, Pharm.D. provides an update on pharmacy law.

Wright, Lindsey & Jennings

UAMS College of Pharmacy

Thank you to all of our 2015 APA Annual Convention exhibitors and participants! Next year's convention will be in Hot Springs. We hope to see you there!

XenoPort Pharmaceuticals

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Editor's Note

ello! My name is Jordan Foster and I am proud to be the new Director of Communications for the Arkansas Pharmacists Association. After graduating from Harding University, I started my career in communications in 2005 at the Central Arkansas Fox affiliate, KLRT Fox16, and at River Rock Communications which produces Talk Business with Roby Brock. From there, I worked at the Arkansas state capitol for the Honorable Charlie Daniels in the Secretary of State’s and Auditor of State’s offices. In the four short months since I’ve begun my journey here, I’ve experienced my first AR•Rx issue, my first convention, my first board meeting, and countless other firsts that have taught me more and more about this wonderful organization.

I would like to thank Mark Riley, Scott Pace, the APA staff, and the board of directors for being so welcoming and helpful while I’ve been establishing myself in this new role. I would especially like to thank former Director of Communications Eileen Denne for her help during the transition. Eileen revolutionized the communications department at APA and I plan on continuing her work and bringing in my own perspectives and ideas to further the work of the association and how it communicates to its members. There is not a single Arkansan whose life has not been touched in some way by a pharmacist. Over the last few months, I’ve had my eyes opened to a world that I once took for granted. Now, I’m ready to work with the rest of the APA staff to support and advocate for Arkansas pharmacists and to show the public the incredible resources available just around the corner at their local pharmacy.

– Jordan Foster

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THE ARKANSAS PHARMACIST

Member Classifieds

Member Classifieds are free to APA members and $65 per issue for non-members. Contact communications@arrx.org for more information.

Allied Health Services, a long term care pharmacy in Melbourne, Arkansas, has a full-time pharmacist position opening. E-mail mbpic@alliedhc.net. Phone 870-368-3100 (07/06/15)

extremely customer service oriented, efficient, and outgoing; also a certified immunizer with some MTM experience and very familiar with all aspects of PBM's and third party billing. Please call 501730-4075. Will travel reasonable distances. (6/18/15)

Pharmacy For Sale: Located in Clinton, AR. High traffic area located directly in front of Wal-Mart. 3500 sq. ft. store with a drivethru. Store is fully stocked and staffed. Will sale or lease. Owners are downsizing their workload. Call or text Scott at 501-412-7786.

Non-Tenure Track Faculty – Experiential Education Coordinator. UAMS College of Pharmacy is recruiting a fulltime non-tenure track faculty member responsible for planning, managing, and implementing aspects of the Experiential Program (IPPEs and APPEs). Candidates must have an earned Pharm.D. with residency or equivalent experience. Further qualifications include a commitment to teaching, excellent communication skills, and willingness to travel to sites. Please contact Dr. Seth Heldenbrand for application information at 501-686-6392 or HeldenbrandSeth@uams.edu. (5/21/15)

Part-time Pharmacists needed at Cantrell Drug Company in Little Rock. Cantrell Drug Company needs to fill 2 (two) part-time pharmacist positions. The timing of the shift is very flexible and can be anywhere between 6 am – 12 am, Monday - Saturday. The position is non-retail and hourly based. Work responsibilities will be devoted to compounding of intrathecal syringes with associated batch record checks and calculations. The successful candidates will want to work in a lab-type environment while demonstrating strict attention to detail, documentation, and a focus on quality. Please send your resume to chutts@cantrelldrug.com (06/29/15).

Non-Tenure Track Faculty – Medication Therapy Management. UAMS College of Pharmacy is recruiting a full-time non-tenure track faculty member to participate in the expansion of phonebased MTM services within the Medication Therapy Services Center. Candidates must have an earned Pharm.D. with residency or equivalent experience. Completion of a community pharmacy residency or experience in the development of innovative services is strongly desired. Please contact Dr. Dwight Davis for application information at 501-686-5582 or ddavis2@uams.edu. (5/21/15)

Pharmacists needed at Cantrell Drug Company in Little Rock. We are growing again! Cantrell Drug Company needs to fill 2 (two) pharmacist positions during the evening shift (3:30 pm - 12 am). The position is non-retail and is full-time with a great benefit package. Work responsibilities will be devoted to compounding of intrathecal syringes, supervision of day-to-day compounding activities, and batch record verification checks. The successful candidate will want to work in a lab-type environment while demonstrating strict attention to detail, documentation, and a focus on quality. Preference will be given to candidates with experience and past leadership responsibility. Please send your resume to chutts@cantrelldrug.com (06/17/15).

Independent pharmacy in historic town of Helena seeking full-time pharmacist. Excellent hours and competitive salary for high-volume independent store. Send resume or further questions to:hhpharmacy@suddenlinkmail.com or contact Ed Pat Wright at (870) 338-8351. Walgreens is hiring Pharmacists & Pharmacy Interns in Ft. Smith, Arkansas! Contact Bret.weatherford@walgreens.com for more information or apply online now at www.walgreens.jobs. §

Experienced pharmacist available for steady or relief work 2-3 days per week or would consider full time. Candidate is

40 Under 40

n June, Arkansas Business recognized 40 Arkansans under the age of 40 that are shaping the landscape of business and politics in the Natural State. APA’s Chief Operating Officer Scott Pace was designated as one of those honorees for his dedication, leadership, and service to pharmacists across the state and for his continued impact on the health of all Arkansans. We in the Arkansas Pharmacists Association have seen first hand what Scott has done for the pharmacy field and we are proud that Scott is now recognized outside of our organization. Congratulations Scott!

Send us your news!

We want to celebrate our members and their moments! Send us your news of awards, volunteering, accomplishments, weddings, babies, graduation, etc… anything that you are proud of. Email a little description of your moment and a picture in the moment! Submit your moments to jordan@ arrx.org so that you can be featured in the next AR•Rx The Arkansas Pharmacist.

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AAHP Board Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Susan Newton, Pharm.D., Russellville President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rob Christian, Pharm.D., Little Rock President-Elect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kendrea Jones, Pharm.D., Little Rock Past President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marsha Crader, Pharm.D., Jonesboro Treasurer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rayanne Story, Pharm.D., Searcy Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Wendy Jordan, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brandy Owen, Pharm.D., Conway Member-at-Large. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Niki Carver, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Erin Beth Hays, Pharm.D., Pleasant Plains Technician Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Holly Katayama, CPhT, Little Rock

Arkansas State Board of Pharmacy 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 Public Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sheila Castin, Little Rock

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THE ARKANSAS PHARMACIST