ARRX - The Arkansas Pharmacist Spring 2016

SPRING 2016 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

ENHANCED PHARMACY NETWORK:

CONNECTING THE PHARMACY DOTS FOR A WIN-WIN-WIN (-WIN) APA Updates Bylaws, Boundaries, and Board of Directors

APA Staff

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Scott Pace, Pharm.D., J.D. Executive Vice President and CEO Scott@arrx.org John Vinson, Pharm.D. Vice President of Practice Innovation John@arrx.org Jordan Foster Director of Communications Jordan@arrx.org Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Celeste Reid Director of Administrative Services Celeste@arrx.org

Office E-mail Address Support@arrx.org Publisher: Scott Pace Editor: Jordan Foster Design: Gwen Canfield - Creative Instinct Arkansas Pharmacists Association 417 South Victory Street Little Rock, AR 72201-2923 Phone 501-372-5250 Fax 501-372-0546 AR•Rx The Arkansas Pharmacist © (ISSN 0199-3763) is published quarterly by the Arkansas Pharmacists Association, Inc. It is distributed to members as a regular service paid for through allocation of membership dues ($5.00). Non-members subscription rate is $30.00 annually. Periodical rate postage paid at Little Rock, AR 72201.

Current edition issue number 75. © 2016 Arkansas Pharmacists Association.

POSTMASTER: Send address changes to AR•Rx The Arkansas Pharmacist 417 South Victory Little Rock, AR 72201 Opinions and statements made by contributors, cartoonists or columnists do not necessarily reflect the attitude of the Association, nor is it responsible for them. All advertisements placed in this publication are subject to the approval of the APA Executive Committee. Visit us on the web at www.arrx.org.

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CONTENTS

Debra Wolfe Director of Government Affairs Debra@arrx.org

17 2016 Annual APA Convention Insert

4 Inside APA: Enhanced Networks

Growing in Popularity

24 FEATURE: APA Updates Bylaws,

5 From the President: Eddie Glover

Boundaries, and Board of Directors

Assumes Role of APA President

26 UAMS: Marketing and the Science of

6 2016 Calendar of Events

Implementation

28 Harding: Don't Just Get a Job, Create

7 Member Spotlight:

a Practice

Rachael McCaleb, Pharm.D, UAMS Faculty Member – Little Rock

30 AAHP: Getting Geared Up for Fall

8 FEATURE: Enhanced Pharmacy

Seminar

Network: Connecting the Pharmacy Dots for a Win-Win-Win (-Win)

31 APA Consultants Academy: What is

NEXT with PPI and Adverse Events, Dementia?

11 Legislator Profile:

Senator John Cooper - District 21, Jonesboro, AR

32 Staff Spotlight:

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

13 New Drugs: Less Drugs but Lots of

Drug News to Open 2016

15 Safety Nets: Trailing Zeroes Can Have

Drastic Consequences

16 Compliance Corner: Ins and Outs of

the Substance Abuse Reporting Act

33 2016 Arkansas Pharmacists

Association Scholarship Golf Tournament

37 Member Classifieds

DIRECTORY OF ADVERTISERS 2 Pace Alliance 6 Law Offices of Darren O'Quinn 6 Retail Designs, Incorporated 12 Pharmacists Mutual 14 Pharmacy Quality Commitment 36 Cardinal Health 37 UAMS

38 EPIC 38 Arkansas Pharmacy Support Group 39 Save the Date: 2016 CPE in Paradise Back Cover: APA Honors Morris & Dickson Company

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APA Board of Directors

INSIDE APA

2015 - 2016 Officers

INSIDE APA

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

Enhanced Networks Growing in Popularity

Area Representatives Area I (Northwest) Michael Butler, Pharm.D., Hot Springs Area II (Northeast) Brent Panneck, Pharm.D., Lake City

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

Area III (Central) Clint Boone, Pharm.D., Little Rock

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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 Scott Pace, Pharm.D., J.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 (Dean) Keith Olsen, 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

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

he concept of a pharmacy network has been around for many decades. The conventional definition of a pharmacy network involves geographically aggregating providers on a state, regional and national basis. In the pharmacy space, building a network has, over time, become exclusively focused on access to patients and payment terms. Admittedly, these have historically been the terms that have been essential to the business of how pharmacy makes money within the retail class of trade.

In the health system space, DRGs (Diagnosis Related Groups) have provided bundled payments to hospitals based on specific diagnoses since 1983. While DRGs are far from perfect, the predictability in payment for the overall treatment of a patient has allowed health-system pharmacists to stretch their clinical wings as the medication experts to take greater ownership of medicationrelated care. This has grown to be a standard of practice within the healthsystem setting. Services such as renal dosing of medications, anticoagulation management, parenteral nutrition service and medication reconciliation have pushed the envelope of practice.

The innovation has been slower within the community practice, but it is present. Just two decades ago, it was not possible for pharmacists to provide immunizations. Today, over 70% of community pharmacists offer immunization services. Before 2003, the term Medication Therapy Management did not exist, now it is a required component of Medicare Part

D plans. As fee-for-service payment begins to give way toward a valuebased payment, another new and exciting trend is beginning to take shape and it builds on the concept of the pharmacy network.

The concept is called an “enhanced pharmacy network.” The enhanced network brings willing pharmacists together to focus on high-cost targeted populations with a goal of adding both clinical and financial value to the overall treatment of a patient. The services offered within an enhanced network include services such as: medication therapy management, medication synchronization, adherence packaging, care coordination, patient education and engagement. The most notable of the enhanced networks is Community Care of North Carolina (CCNC). CCNC is entering its 25th year of existence and is working with payers, such as the North Carolina Medicaid program, NC State Employees, and Medicare, as well as within the Patient-Centered Medical Home model in North Carolina.

Building a similar concept in Arkansas will be time and resource consuming, but we need to be on the leading edge of this model to ensure a healthy and vibrant future for the citizens and pharmacists of our state. §

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THE ARKANSAS PHARMACIST

FROM THE PRESIDENT

FROM THE PRESIDENT

Eddie Glover Assumes Role of APA President

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am thrilled to come on board as your Arkansas Pharmacist Association President for the next year and a half. On behalf of the membership, I would like to thank John Vinson for his service as President. I know he will do a fantastic job on staff with APA. I would also like to thank Mark Riley for his leadership both in Arkansas and in the nation.

Eddie Glover, P.D. President

We have been entrusted by God with a great profession. It is our responsibility to be a good steward of the profession we have been given. A steward is someone who is responsible for looking after something of value and serving others. In most organizations the 80/20 rule applies, where 80% of your results come from 20% of your actions. Let's beat the 80/20 rule in Arkansas!! I call on all members of APA to be involved with time, money, and effort!

I am very thankful for our profession of pharmacy. I have been a pharmacist for over 40 years and in those We have had many great 40 years I have never been without a job. I think that trail blazers go before us. is a testament to the solid It is your turn to be a trail We have been entrusted by God with a great profession of pharmacy. blazer for the pharmacists profession. It is our responsibility to be a good I have also seen a lot of in Arkansas and continue steward of the profession we have been given. changes in pharmacy during to make APA the best my career. I remember when pharmacy association in we got our first computer in the nation! Two ways we our pharmacy. I have watched changes in 3rd parties can blaze trails within our state and nationally is through and PBMs, expanded patient counseling, and overall involvement and unity. Please help me think of other ways and let's make it happen, or as Nike says "Just do it!" expansion of the pharmacist role in the health care system. We have had a record number of pharmacists and jobs in our state, an unbelievable number of new Together we can accomplish much. We have a great drugs, and more government intervention (both in control profession. Let's keep it great! ยง and as a customer). Many changes have been positive; however, some changes have been challenges. Let's make the most of the changes!

APA Executive Vice President and CEO Scott Pace swears in Eddie Glover of Conway as APA President.

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2016 CALENDAR OF EVENTS JUNE ——————————————————————————— June 11-15 - American Society of Health-System Pharmacists Summer Meeting - Baltimore, MD June 23-25 - APA 134th Annual Convention - Hot Springs Convention Center/ Embassy Suites Hot Springs, AR

AUGUST —————————————————————————— August 4-6 - APA Board Retreat - Mountain Magazine - Paris, AR August 18-31 - APA District Meetings - Around the State

SEPTEMBER ———————————————————————— September 6-22 - APA District Meetings - Around the State September 29-30 - AAHP Fall Seminar - Arlington Hotel - Hot Springs, AR

OCTOBER —————————————————————————— October 15-19 - National Community Pharmacists Association Annual Convention - New Orleans, LA October 26* - APA Golden CPE - Hosto Center, Little Rock, AR

NOVEMBER ————————————————————————— November 4-6 - American Society of Consultant Pharmacists Annual Meeting and Exhibition - Dallas, TX November 7-12 - CPE at Disney - Walt Disney World Resort, Orlando, FL

DECEMBER ————————————————————————— December 3* - APA Committee Forum - TBA December 4* - APA Board Meeting - TBA *Dates not finalized

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THE ARKANSAS PHARMACIST

MEMBER SPOTLIGHT

Rachael McCaleb, Pharm.D. UAMS Faculty Member – Little Rock

Pharmacy/academic practice: Assistant Professor in

the Department of Pharmacy Practice at the University of Arkansas for Medical Sciences College of Pharmacy in Little Rock; Clinical Specialist in Internal Medicine at UAMS Medical Center; Clinical Consultant for the United States Food and Drug Administration National Center for Toxicological Research

Graduate pharmacy school and year: University of

care professionals on the value and impact of pharmacists in the health care system.

Recent reads: Being Mortal by Atul Gawande Fun activities/hobbies: Showing American Quarter Horses,

upcycling furniture, and spending time with family and friends

Ideal dinner guests: Malal Yousafzai, Mahatma Gandhi,

Arkansas for Medical Sciences College of Pharmacy in 2014. Completed a Pharmacy Residency at Georgia Regents Medical Center/University of Georgia College of Pharmacy in Augusta, Georgia in 2015.

Meryl Streep, and Ellen DeGeneres

Years in business/years teaching: At UAMS College of

About running for office at APhA: I am honored to have

Pharmacy since August 2015 following the completion of a PGY1 pharmacy residency in Georgia.

Favorite part of the job and why: Using my knowledge and experience to improve patient outcomes and teach future pharmacists that will do the same. I love being a pharmacist!

If not a pharmacist then…. I would be a professional doit-yourselfer with a show on HGTV.

been slated as a candidate for APhA-APPM New Practitioner Officer. If elected, I will serve a two year term on the Academy’s Executive Committee. My goal is to promote new practitioners’ involvement in APhA and continue the legacy of strong Arkansas leadership within the association. §

What do you think will be the biggest challenges for pharmacists in the next 5 years? As a profession, we need to continue to strive for the advancement, recognition, and compensation of pharmacists as health care providers. As well as continue to educate policy makers and other health

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ENHANCED PHARMACY NETWORK :

Connecting the Pharmacy Dots for a Win-Win-Win(-Win)

By Jordan Foster

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“This (CMS) grant is about paying pharmacists for the value we bring to health care.

It’s about how pharmacists can do something different that capitalizes on the value we bring.”

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THE ARKANSAS PHARMACIST

ENHANCED PHARMACY NETWORK

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n 2014, guided by the triple aim to improve patient experience of care, improve the health of the population, and reduce the cost of health care, Community Care of North Carolina (CCNC) created the Community Pharmacy Enhanced Services Network (CPESN), an open network of 246 North Carolina pharmacies dedicated to expanding pharmacists’ services available to patients in a way that was beneficial to the patient, the pharmacist, and the payer.

What began as a plan to save the state money in Medicaid became a concept to unite pharmacies throughout North Carolina into a new enhanced network of pharmacists, practicing at the top of their licenses, who were making a significant impact on healthcare in North Carolina.

Now, the Arkansas Pharmacists Association is beginning work with the UAMS College of Pharmacy to develop a blueprint that could bring that same type of enhanced network to the Natural State. The enhanced network would unite cooperating pharmacies into an engaged network capable of providing services that are above and beyond core prescription dispensing and basic patient education services. These additional services will benefit the patient’s health, the payer’s bottom line, and the pharmacist's ability to thrive in a shifting healthcare environment.

An essential branch of health care reform is controlling costs.

Although prescription drugs account for a small percentage of the overall health care cost, pharmacists have the ability to significantly reduce the burden of health care spending by broadening the availability of medication services that are offered and offering those services through an enhanced pharmacy network, simultaneously improving overall population health. That was the idea developed by CCNC that won them a $15 million Centers for Medicare and Medicaid Services (CMS) Center for Medicare & Medicaid Innovation (CMMI) Health Care Innovation Award to demonstrate community pharmacist’s role in cutting cost.

Joe Moose, Pharm.D., the Lead Community Pharmacy Coordinator for CCNC and a fourth generation pharmacist, develops the services that community pharmacies participating in the program will deliver to their patients and manages the work flow of the pharmacists. “This (CMS) grant is about paying pharmacists for the value we bring to health care.

It’s about how pharmacists can do something different that capitalizes on the value we bring,” Moose said. “The missing piece is connectivity with community pharmacy.”

CCNC established a standard protocol to engage with patients as they are discharged from the hospital and develop a care plan in conjunction with community partners, including community pharmacists, to prevent the patients from being readmitted, which lead to the creation of the Community Pharmacy Enhanced Services Network. The CPESN has

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The Arkansas Pharmacists Association has begun work on its own enhanced network concept with the hopes of uniting pharmacies under a quadruple aim: • • • •

Decreased overall total healthcare costs Increased population health outcomes Increased individual patient outcomes Increased pharmacist provider engagement & satisfaction

united 246 community pharmacies across North Carolina as of December 1, 2015 (up from 72 one year before) and provides them with training and technology to communicate and share information with other care teams throughout the state, and to serve their patients in new ways such as adherence packaging, medication synchronization programs, nutritional counseling, and 24-hour emergency services for dispensing and non-dispensing. CCNC is banking on these new services, better communication, and concerted efforts with other healthcare professionals to lower the hospital readmission rate and improve the overall population health, leading to lower healthcare costs. This 3-year pilot project will result in a CCNC paper demonstrating the importance of community pharmacy and the return on investment that it can bring.

North Carolina’s CPESN model has shown that bringing together pharmacies into an enhanced network elevates the level of care that patients receive and can prevent emergency care that’s not needed. Closer to home the Arkansas Pharmacists Association has begun work on its own enhanced network concept with the hopes of uniting pharmacies under a quadruple aim: decreased overall total healthcare costs, increased population health outcomes, increased individual patient outcomes, and increased pharmacist provider engagement and satisfaction – a win, win, win, win. The network, known as Arkansas Patient Centered Community Pharmacy Program, could serve as the platform for improving value and quality in community pharmacy services for patients and the plan. Patients would reap the benefits with better health care access and better medical outcomes, while pharmacists provide more services, creating more opportunities to be compensated. While it’s important to remember that this plan is just a concept at the moment, it’s breadth of value could provide a powerful weapon in the Arkansas pharmacist's arsenal of services.

The UAMS College of Pharmacy has recently hired Megan Smith, Pharm.D. from the CCNC program and Dr. Smith will be working on bringing the core elements of CCNC to practice in Arkansas.

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ENHANCED PHARMACY NETWORK

• Proactively synchronizing a pick-up date for chronic medicines (Appointment-based Medication Synchronization) and confirming the patient is receiving and taking the correct medications each month with patient registry level medication adherence monitoring and individual coaching.

• Improving vaccination rates & coordination of immunizations by using Department of Health Statewide immunization registry. Improving rates, particularly in adults for pertussis (whooping cough), tetanus, diphtheria, influenza (flu), herpes zoster (shingles), hepatitis B, (a liver cancer causing virus), and pneumococcal infections (pneumonia, sepsis, meningitis, death). Being proactive with vaccinations is an incredibly important piece of the “increased population health outcomes” branch of the quadruple aim as flu and pneumonia are the #8 cause of death in the United States and in many cases can be preventable by getting vaccinated.

The enhanced network services include: The network will provide enhanced pharmacy services that are above and beyond core prescription and basic patient education services and encourage pharmacists to expand the breadth of their pharmacy knowledge to become a greater asset in the health care team. These will be services that have been shown to improve patient health, increase patient accountability and responsibility in their own well-being, and decrease overall costs from patients who are non-adherent to their therapy plan.

Guided by the quadruple aim to improve patient experience, improve population health, increase provider engagement and lower overall total medical costs, the Arkansas Pharmacists Association’s Patient-Centered Community Pharmacy Program is designed as a comprehensive, patient-focused, accessible program. Over the next three to five years, the multiple phase program could be implemented to align the incentives of all involved, fostering an environment where patients, pharmacists, and payers will all see improvements and creating an opportunity for a win-win-win-win. § _______________________________________________________ APA recently hired John Vinson, Pharm.D. to lead its practice transformation initiative. This initiative will be focused on, among other pharmacist preventative services, development and implementation of Arkansas’s Enhanced Pharmacy Network.

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• Able to screen for and monitor existing high blood pressure in an effort to assist patients and the plan prevent complications and early death from heart disease, stroke, and kidney disease. These three chronic diseases are #1, #5, and #9 in causes of death in the United States, and heart disease accounts for nearly $500 billion dollars in annual spending. Any concerted attempt to monitor warning signs and prevent complications from these diseases could have a critical impact on population health and the cost of health care in America.

• Assisting patients understand pharmacy benefits design as well as cost effective alternatives. The network will be capable of executing therapeutic substitution allowed orders from the physician or prescriber.

• Capability of delivering personalized medication therapy management for specific disease states or transitions of care from hospitalizations • Increased ability to detect potential fraud, waste, diversion, and abuse of controlled substances by using the prescription drug monitoring program and electronic prescribing of controlled substances.

• Offering alternative patient centered packaging and appropriate language for patient instructions. For every $1 spent on medication in this country, there is a $3 healthcare burden from patients being non-adherent or non-compliant to their prescription therapy plan.

Creating an easy to follow plan, from redesigned packaging that is more user-friendly to instructions that are easier for the patient to understand, could keep patients engaged and actively following their prescription therapy plan, thereby helping to chip away at the enormous non-adherence burden that’s weighing down healthcare.

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THE ARKANSAS PHARMACIST

LEGISLATOR PROFILE

Senator John Cooper DISTRICT 21, Jonesboro, AR

Time in Office: I have been in office since January 2014 and running unopposed this time.

Occupation: I am retired from the telephone industry where

I worked for 35 years in electronics in switching, radio, fiber optics, special services and data.

Hometown Pharmacist: Walgreens What do I like most about being a legislator: Constituent

services is the area that we can often have an immediate impact with helping someone with a problem. Sometimes people just don't know where to turn when something has gone amiss. They are usually pretty frustrated by the time they call a legislator. It is very satisfying to help resolve those kinds of issues.

What I like least about being a legislator: Actually, I

thoroughly enjoy the job so there is not much that I don't like. Occasionally, we all wish things would move faster, but also something can be said for the fact that it is good that they don't.

Most important lesson learned: The sheer volume of

Advice for pharmacists: It is the same as with anyone

else. Just remember that legislators are normally very busy even during non-session time. They appreciate a contact that gets to the point and does so clearly. This is true of both written and verbal contact. They don't need a six page letter concerning an issue. If it is an issue-related contact, the legislator might already know the basics.

Normally, a support letter for an issue should be three paragraphs max unless there is a need for technical analysis.

Technical analysis, graphs and studies should be separate documents or links to information.

Dream Political gathering: It would be interesting to get most any of our founders together with some of the present generation and see what kind of conversation would take place.

Toughest issue of the past session: We just finished up

the special session and had only Arkansas Works to deal with. In my opinion medicaid and/or other medical related issues will dominate the political landscape for a long time.

I just don't see it going away any time soon.

information and the complexity of it is sometimes astounding.

You often have a huge amount of information to absorb in a short time and you have to get used to that and sometimes operating on very short time schedules.

Hobbies: I enjoy hunting, especially deer and rabbit. I also enjoy playing chess and keep several online games going.

I don't spend much time watching tv except for news and some sports.

Most admired politician: In Arkansas I would say Senator

While they aren't hobbies, I really enjoy my family and church activities and watching the grandchildren in their activities when we can be with them. ยง

Jim Hendren who runs a business, serves our country in a military position, serves our state in the Senate and as majority leader, and has a great family. In addition to that, he seems to always have time to answer a question from his colleagues (like me).

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THE ARKANSAS PHARMACIST

Less Drugs but Lots of Drug News to Open 2016 This column, presented by the Harding University College of Pharmacy, aims to briefly highlight information on new molecular or biological entities, new indications, or significant new dosage forms recently approved by the FDA

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he FDA finished out 2015 on a high-note with the approval of 26 new molecular or biological entities and a bevy of significant new drug formulations.

Drugs in the News: Although things are slow out of the gate so far this year, 2015 was a good year for innovation in medicine with the FDA approving 45 novel drugs, four more than in 2014 and the most since the all-time record of 53 was set in 1996. Full drug pipelines at many companies suggest the strong rate of new drug approvals is likely to continue with 225 new drug approvals forecast through 2020. But despite the rosy statistics and the prospect for further progress in 2016, the FDA and pharmaceutical industry face challenges.

• Despite criticism drug-makers continue to raise prices (9-10%), citing their struggle to get a decent return on billions spent on R&D and the need to fund risky research. Increased political focus on drug pricing has hit both biotech and specialty company valuations in recent months.

• Related, somewhere deep within the FDA 4,300 generic drug applications await approval. Drug companies are threatening to abandon generics altogether if the FDA doesn’t speed things up, while the FDA says sloppy and incomplete applications are slowing the approval process. This backlog of unapproved drugs has been attributed as a reason for high drug prices.

• The FDA and CDC both recently made the news related to their efforts to curb the epidemic of opioid drug abuse. The CDC released new opioid prescription guidelines amid backlash that the guidelines were not clinically astute and were authored by only three individuals. The FDA has unveiled sweeping changes to opioid policies with plans to: reexamine the risk-benefit paradigm; develop a framework for pediatric opioid labeling; change immediate-release opioid labeling; update REMS requirements; and improve access to naloxone, to name a few.

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New Drugs: Briviact® (brivaracetam) is an anticonvulsant approved as add-on therapy for partial onset seizures in patients >16 years old, and must be dispensed with a Med Guide. Idelvion® (coagulation factor IX-recombinant, albumin fusion protein), modified to last longer in the blood, is the first coagulation factor-albumin fusion protein product indicated for congenital Factor IX deficiency (hemophilia B) and on-demand control and prevention of bleeding episodes. Ninlaro® (ixazomib), dosed on 3-days of a 28-day cycle, is the first oral proteasome inhibitor and received priority review as an orphan drug to treat multiple myeloma in patients who have received at least one prior therapy. Uptravi® (selexipag) received orphan drug status to treat rare but progressive pulmonary arterial hypertension. Zepatier ™ (elbasvir/grazoprevir), given as a 12-16 week course of treatment, was approved through priority review as a combination drug for chronic hepatitis C. Zurampic® (lesinurad) was approved for use with a xanthine oxidase inhibitor (e.g. allopurinol, febuxostat) to treat hyperuricemia associated with gout; the drug carries a black box warning for renal failure.

New Dosage Forms: Significant new dosage forms that were approved this quarter include: Adzenys XR-ODT™ (amphetamine, orally disintegrating extended-release tablet) for ADHD; Cetylev™ (acetylcysteine, effervescent tablet) for acetaminophen overdose; Odefsey® (emtricitabine/rilpivirine/tenofovir/alafenamide) for HIV-1 infection; Onzetra Xsail™ (sumatriptan, inhalation powder) for migraine headache; Quillichew ER™ (methylphenidate, chewable extended release tablet) for ADHD; Sernivo™ (betamethasone, topical spray) for plaque psoriasis; Vistogard® (uridine, oral granules) for fluorouracil or capecitabine overdose/toxicity; Xeljanz XR® (tofacitinib, extended-release tablet) for rheumatoid arthritis; and Zembrace SymTouch™ (sumatriptan, subcutaneous injection) for migraine. §

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THE ARKANSAS PHARMACIST

Trailing Zeroes Can Have Drastic Consequences 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.

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rescription transfers are common- Figure One place in community pharmacy. In this case, a patient's mother requested a transfer of her child's prescription to a pharmacy closer to the family's new address. The prescription was transferred electronically (illustrated in Figure One) to a community pharmacy in Central Arkansas. The prescription was for a two year-old child.

Figure Two The transferred prescription was for furosemide oral solution, 10 mg/mL, with directions to the patient of "take 10 mg (10 mL) per GT twice daily." The pharmacist who received the transferred prescription immediately questioned the patient directions. She realized if this patient received 10 mL of furosemide solution at this concentration, they would receive 100 mg of furosemide per dose for a total daily dose of 200 mg. On its face, 200 mg/day represents a significant furosemide overdose for a two year-old child.

The pharmacist decided to telephone the pharmacy where the prescription was originally dispensed. First, she expressed her concerns about the furosemide dose to the pharmacist at the transferring pharmacy. Next, she asked the pharmacist to review the original prescription to ensure it had been correctly interpreted. After a few moments, the pharmacist returned to the telephone and said the prescription information had been entered into their computer system exactly as written by the prescriber. The pharmacist also revealed the child had received this furosemide dose for the previous month. After this, she asked for a copy of the original prescription to be FAXED to her pharmacy (illustrated in Figure Two).

Still concerned a medication error had occurred, the pharmacist decided to telephone the prescriber for absolute confirmation of this extremely high furosemide dose. After speaking with a nurse, she learned the patient was to receive 10 mg of furosemide twice daily (total daily dose of 20 mg).

She then realized the prescriber had intended the patient to receive "1.0" mL of furosemide per dose, not 10 mL. After this, the prescription was correctly filled and the patient's mother appropriately counseled about the quantity of furosemide to administer.

This prescription illustrated in this case actually contains good and bad elements. When writing prescriptions for oral WWW.ARRX.ORG

liquid medications, it is best practice to indicate the quantity to be administered per dose in milligrams or milliliters rather than teaspoonful(s). Unfortunately, the prescription also illustrates the dangers associated with trailing zeros.

The prescriber correctly indicated the furosemide dose in milligrams (10 mg), but followed it with what was clearly intended to be a trailing zero (i.e. 1.0 mL) to indicate the quantity of furosemide to be administered. The prescription would have been safer if the trailing zero had not been used and the volume simply written as 1. In this case, however, since the dose to be administered was written in milligrams, the milliliter quantity to be administered was completely unnecessary.

The pharmacist who received the transferred prescription is to be commended for detecting this medication error. Since the majority of transferred prescriptions have been previously dispensed, many times the receiving pharmacist assumes the prescription is correct and may not review it for accuracy as carefully as they would a new, original prescription. This case clearly demonstrates the dangers of this attitude.

The pharmacist could have simply filled the prescription without question and continued to provide this child with a ten-fold furosemide overdose. Thankfully, she examined the prescription with the same degree of care she would an original prescription.

One final step that could close the quality circle entirely would involve the pharmacist contacting the parents about the dose.

It is likely they were instructed to administer the correct dose, and had been doing so, despite the incorrect directions to give 100 mg in a 10 mL dose. It is likely the correct dose has been administered all along, since the child remained at home and was not hospitalized.

Health care professionals are required to successfully complete a variety of pre-requisite college coursework before starting their professional studies. Some of this coursework involves the use of significant figures (i.e. chemistry, physics) which requires students to use trailing zeros (1.0 or 10.0 rather than simply 1 or 10). While trailing zeros may have an appropriate place in these courses, their use - in the interest of patient safety - must be completely avoided in patient care. ยง

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Ins and OutsWrongful of the Substance Abuse Conduct Rule Reporting Act

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n this issue, we will take a look at the reporting requirements established by the Substance Abuse Reporting Act (Act 411 of 2015, now codified as Ark. Code Ann. § 17-80-117), and make some recommendations on how best to comply with the new rules.

Until Representative (and pharmacist) Justin Boyd introduced this Act, Arkansas law contained no meaningful requirements for a health care facility to report diversion or abuse of controlled drugs by its employees to state authorities. This meant that a facility might terminate an employee after suspecting that they were stealing or abusing controlled drugs, but neither law enforcement nor the relevant licensing authority would be made aware of the issue. The terminated employee was then free to go down the street to the next job—taking their diversion habits with them.

Act 411 has changed all that. This Act, which became effective last fall, requires “required reporters”—licensed health facilities and entities that employ or contract with health professionals to provide healthcare—to report certain events to the state licensing authorities. The obligation is triggered when a healthcare professional at a facility has been terminated, lost their contract or privileges, or was allowed to resign “as a result of the diversion, misuse, or abuse of illicit drugs or controlled substances.” Ark. Code Ann. § 17-80-117(b).

If one of these events occurs, the facility is required to file a report within 7 days of the termination with the professional’s state licensing authority, which is the “government agency or board charged with licensing, certifying or authorizing” the person to administer health care. Ark. Code Ann. § 1780-117(c). The report must include a description of the facts that led to the termination, as well as the name, address and telephone number of the healthcare professional.

It is important to note that licensed facilities and entities covered by this Act are also obligated to file reports in some circumstances even if the employee is not a “healthcare professional.” This obligation arises if the termination of the employee was as a result of the diversion of controlled drugs to a third party. In that instance, the CEO or designated agent of the facility must report the identity and circumstances of the incident to local law enforcement. Ark. Code Ann. § 1780-117(e).

In turn, if the licensing authority receiving the information determines that a healthcare professional may have diverted controlled drugs to a third party, the Act also requires that the licensing authority report the suspected criminal act to the local office of DEA. Ark. Code Ann. § 17-80-117(d). This requirement is not triggered until the licensing authority has investigated and given the professional due process, however. In most cases, this will not occur until the authority has held a hearing and taken final disciplinary action against the professional’s license.

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As always, there are some caveats to these reporting requirements. The Act exempts the reporting of any information learned in connection with drug or alcohol prevention or treatment by an agency of the federal government or by an entity that is assisted by federal funds. Ark. Code Ann. § 17-80-117(f) (1); 42 USC § 290dd-2. Although this only exempts information that is obtained in connection with substance abuse treatment, the definition of “assisted by federal funds” is very broad— including Medicare providers and, in some circumstances, a registrant with the DEA—so if your entity provides any sort of alcohol or drug treatment, consider this very carefully. For more information on whether and how this exemption may apply to your entity, review 42 USC § 290dd-2 and 42 CFR 2.12 and consult your attorney.

The Act also exempts information that is learned while providing healthcare services to the affected employee and all information from quality of care or peer review committees that is protected under Ark. Code Ann. § 16-46-105, § 16-46-109, and § 20-9503. It also provides immunity from civil liability for the reports required by the Act. Ark. Code Ann. § 17-80-117(i).

If your entity has not yet revised its policies and procedures in light of this Act, I recommend that you do so immediately.

Although the Act itself does not provide for any penalties against entities which do not comply with the required reporting, by definition, the facilities and entities subject to its provisions are ones that are regulated by state licensing authorities themselves.

This means it is very likely that facility that fails to comply may be subject to disciplinary action by its own licensing authority for a violation of state law.

The reporting requirements imposed by the Act are new to our state and your existing policies likely do not require your managers and supervisors to take any action beyond termination in connection with suspected diversion by your employees. At a minimum, you should implement a policy that requires all supervisory staff to report suspected diversion by an employee to senior management for a determination of whether it is reportable under this Act. You should also consider providing training on the Act’s requirements to all supervisory staff in your facility.

To read the full text of the Act, visit the Arkansas General Assembly’s website at: ftp://www.arkleg.state.ar.us/acts/2015/ Public/ACT411.pdf. For advice on how best to ensure compliance in your facility, consult your attorney. § ________________________________________________________________________ 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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THE ARKANSAS PHARMACIST

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134TH APA ANNUAL CONVENTION —JUNE 23-25, 2016

CHANGE CHALLENGE COLLABORATE

The APA annual conference will welcome up to 350 pharmacists, pharmacy technicians, exhibitors, students, and special guests.

134TH APA ANNUAL CONVENTION JUNE 23-25, 2016 The Arkansas Pharmacists Association’s (APA) 134th Annual Convention will be held at the Hot Springs Convention Center and Embassy Suites in Hot Springs from June 23-25, 2016. The conference theme, Change, Challenge, Collaborate, reflects the environment of constant change for pharmacists and other healthcare providers.

Pharmacists can stay up-to-date and informed with the Continuing Pharmacy Education sessions and networking opportunities planned at the convention.

The annual conference will welcome up to 350 pharmacists, pharmacy technicians, exhibitors, students, and special guests.

Photo Courtesy of Arkansas Department of Parks and Tourism

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WHY ATTEND

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Continuing Pharmacy Education: APA will offer many hours of Continuing Pharmacy Education credit with highly-regarded instructors on topics ranging from Opioid Use Disorders to Motivational Interviewing.

Comprehensive Exhibition: Exhibitors including pharmacy wholesalers, manufacturers, insurers, Colleges of Pharmacy, hospital, and software vendors will be on hand to discuss their newest products and services that will benefit the practice of pharmacy in Arkansas. Be sure to visit with these professionals to learn about their innovative products.

Social and Networking Events: Join old and new friends at the convention social events. In addition to the always popular Opening Reception at the Exhibit Hall, the Friday evening reception will be held at the Gangster Museum of America where guests will enjoy food, drinks, and table games. ________________________________________________

ACCOMMODATIONS ________________________________________________

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The host hotel for the 134th APA Annual Convention is The Embassy Suites at 400 Convention Blvd in Hot Springs. Check-in is at 3:00 PM and checkout is 12:00 PM. For reservations, call 501-6249200. Room rate starts at $154.00 plus tax. Mention Arkansas Pharmacists Association Group for group rate. Cut-off date for rooms is May 29, 2016.

WWW.ARRX.ORG

Photo Courtesy of Arkansas Department of Parks and Tourism

WE APPRECIATE THE SUPPORT OF OUR WHOLESALE BUSINESS PARTNERS! * AmerisourceBergen Cardinal Health McKesson Morris & Dickson Company, LLC Smith Drug Company * These organizations did not provide any financial support for continuing education activities.

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2:00 - 5:00 PM

AFTERNOON CPE BLOCK • From Start-up to Industry Leader... What I Learned Along The Way • New Drugs 2016

4:45 - 5:30 PM

Arkansas Pharmacists Foundation Board Meeting

5:30 - 6:00 PM

Presidents Reception

6:00 - 8:00 PM

Opening Reception in Exhibit Hall

(Schedule is subject to change) ________________________________________________

WEDNESDAY, JUNE 22, 2016

________________________________________________ 9:00 AM - 12:00 PM

APA Board of Directors Meeting

1:00 PM

APA Annual Golf Tournament DeGray Lake Resort State Park

THURSDAY, JUNE 23, 2016

__________________________________________________

FRIDAY, JUNE 24, 2016

________________________________________________

________________________________________________

7:00 AM - 4:30 PM

Registration

7:00 AM - 4:30 PM

Registration

7:30 - 8:45 AM

Breakfast

7:30 - 8:45 AM

9:00 AM - 12:00 PM

MORNING CPE BLOCK • Pharmacy Law Update • Celiac Disease: What Pharmacists Should Know

AP-PAC Breakfast and Speaker

9:00AM - 12:00 PM

12:15 - 1:45 PM

Luncheon & Awards Ceremony

MORNING CPE BLOCK • The Role of the Pharmacist in Population Health • Motivational Interviewing

10:00 AM - 12:00 PM

Arkansas Association of Health-System Pharmacists (AAHP) Board Meeting

10:00 AM - 12:30 PM

Spouse Trip Garvan Woodland Gardens (lunch provided)

APA 2014-2015 President Brandon Cooper with 2015 Pharmacist of the Year Wayne Padgett WWW.ARRX.ORG

Nestled in the picturesque Ouachita Mountains of Southwest Arkansas, the Gardens are a wonderful gift to all people from local industrialist and philanthropist Verna Cook Garvan. Garvan Woodland Gardens is an example of The Natural State at its best: a canopy of pines reaching skyward providing protection for delicate flora and fauna, gentle lapping waves that unfold along the 4½ miles of wooded shoreline, and rocky inclines that remind us of the surrounding Ouachita Mountains.

HOT SPRINGS CONVENTION CENTER & EMBASSY SUITES • HOT SPRINGS, ARKANSAS

SCHEDULE OF EVENTS

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134TH APA ANNUAL CONVENTION —JUNE 23-25, 2016

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SATURDAY, JUNE 25, 2016

________________________________________________ Registration

7:30 - 8:45 AM

Continental Breakfast & State of the Association Address Swearing in of New Officers

Spouse Trip: Garvan Woodland Gardens

Photo Courtesy of Arkansas Department of Parks and Tourism

12:15 - 1:45 PM

Luncheon in Exhibit Hall

2:00 - 5:15 PM

AFTERNOON CPE BLOCK • Medication Assisted Treatment for Opioid Use Disorders • Digital Media: The Opportunity for an Effective SEO and Social Media Marketing Strategy

6:30 - 9:00 PM

Casino Night at the Gangster Museum of America

— Honoring APA’s Wholesale Partners — AmerisourceBergen, Cardinal Health, McKesson, Morris & Dickson, and Smith Drug

9:00 AM - 12:30 PM

MORNING CPE BLOCK • Immunization Update 2016 • Getting to Know Biosimilars

12:30 PM

Convention Adjourns

CONTINUING PHARMACY EDUCATION SESSIONS ________________________________________________

THURSDAY MORNING

________________________________________________ PHARMACY LAW UPDATE – John Kirtley, Pharm. D., Arkansas State Board of Pharmacy ACPE # 0004-9999-16-026-L03-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Analyze recent changes in pharmacy regulations in Arkansas • Discuss the reasoning behind changes to pharmacy regulations • Describe recent pharmacy regulatory changes and challenges • Identify three practice changes to protect your controlled substance inventory

Photo Courtesy of Arkansas Department of Parks and Tourism

Take yourself back to the days of the 20’s, 30’s, and 40’s when mineral water, gambling, bootlegging, and other extreme pleasures brought visitors from all over the world to Hot Springs, Arkansas. The Gangster Museum of America is an historic and entertaining account of how some of the most notorious criminals in America coexisted with the quaint population of this little valley town in the mountains of central Arkansas. The audiovisual experience of the seven galleries is in itself worth the price of admission. Play in the antique casino and hear the historian in the museum theater relate who, what, when, and where stories that are fascinating, informative, and educational.

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7:00 - 10:00 AM

WWW.ARRX.ORG

CELIAC DISEASE: WHAT PHARMACISTS SHOULD KNOW – Steven Plogsted, Pharm.D., BCNSP, CNSC, Clinical Pharmacy Specialist, Nutrition Support Service, Nationwide Children’s Hospital ACPE # 0004-9999-16-018-L01-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • List characteristics of the various cytochrome P-450 enzymes involved in the metabolism of the most commonly prescribed drugs • Identify medications subject to significant drug-gene interactions • Given a patient case, identify medication related problems (MRPs) based on drug-gene interactions 20

THURSDAY AFTERNOON

_______________________________________________ FROM START-UP TO INDUSTRY LEADER... WHAT I LEARNED ALONG THE WAY – Ryan Herget, Founder and CEO of Chef Shuttle ACPE # 0004-9999-16-019-L04-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Choose and develop the right business model • Find and manage quality employees • Utilize strategies for marketing your business to new and current patients • Manage growth and expectations • Develop methods for overcoming obstacles to success NEW DRUGS 2016 – Tom Frank, Pharm.D., Area Health Education Center-Northeast ACPE # 0004-9999-16-020-L01-P 1.0 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Assess new trends in drug development • Discuss the indications, pharmacology, adverse effects and dosing of the new drugs • Determine the role these new drugs play in practice • Evaluate the economic implications of choosing to use the new drugs • Examine products in the short-term pipeline and their impact in daily practice _______________________________________________

FRIDAY MORNING

_______________________________________________ THE ROLE OF THE PHARMACIST IN POPULATION HEALTH – John Vinson, Pharm.D., Vice President of Practice Innovation, Arkansas Pharmacists Association and Jessica Binz, Pharm.D., BCACP, Director of Clinical Pharmacy Education UAMS West – Family Medical Center Assistant Professor- UAMS College of Pharmacy ACPE # 0004-9999-16-021-L04-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Define population health • Discuss where and how population health management is being implemented and measured • Identify opportunities for pharmacists in population health management • Examine the current and potential role of pharmacists in ACO/PCMH/CPCI/CMS Innovation Program

WWW.ARRX.ORG

• Apply clinical skills for medication management and preventive medicine care gap closure MOTIVATIONAL INTERVIEWING – Catherine O’Brien, Pharm.D., UAMS and Arkansas Children’s Hospital ACPE # 0004-9999-16-022-L04-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Compare patient-centered care with providercentered communication • Describe basic motivational interviewing skills • Discuss common challenges with motivational interviewing • Determine strategies for incorporating motivational interviewing skills into a busy practice • List methods for getting started with motivational interviewing skills _______________________________________________

FRIDAY AFTERNOON

_______________________________________________ MEDICATION ASSISTED TREATMENT FOR OPIOID USE DISORDERS – Michael J. Mancino, M.D., Assistant Professor & Director of the Center for Addiction Services and Treatment, UAMS ACPE # 0004-9999-16-023-L01-P 1.5 Contact This CPE activity will be knowledge based CPE Objectives: • Compare the significance and severity of the opioid use disorder epidemic nationally and in Arkansas • Recognize reasons and factors that influence opioid misuse • Discuss the importance of naloxone and the reasons why it is an important tool in combatting opioid overdose • Manage medication assisted treatment for opioid use disorders • Discuss the current state of the DEA waiver allowing physicians to prescribe buprenorphine for opioid use disorders DIGITAL MEDIA: THE OPPORTUNITY FOR AN EFFECTIVE SEO AND SOCIAL MEDIA MARKETING STRATEGY – Tim Whitley, President and CEO of Team SI ACPE # 0004-9999-16-024-L04-P 1.5 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Compare and contrast using Facebook and Twitter for business vs. personal purposes • Discuss the importance of search engine optimization • Determine how to drive organic leads in searches • Explain the role of online reputation management in today’s business and media landscape

HOT SPRINGS CONVENTION CENTER & EMBASSY SUITES • HOT SPRINGS, ARKANSAS

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134TH APA ANNUAL CONVENTION —JUNE 23-25, 2016

_______________________________________________

SATURDAY MORNING

_______________________________________________ IMMUNIZATION UPDATE 2016 – Rachel Stafford, Pharm.D., UAMS ACPE # 0004-9999-16-024-L04-P 2.0 Contact Hours This CPE activity will be knowledge based CPE Objectives: • Recommend pneumococcal vaccinations • Discuss new meningococcal vaccines • List new vaccines and vaccine schedules in the pipeline • Discuss strategies for improving immunization rates in Arkansas • Analyze vaccines in the news GETTING TO KNOW BIOSIMILARS – Scott Pace, Pharm.D., J.D., Executive Vice President & CEO, Arkansas Pharmacists Association ACPE # 0004-9999-16-017-L01-P 1.5 Contact Hours This CPE activity will be knowledge based

The University of Arkansas for Medical Sciences (UAMS) College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of Continuing Pharmacy Education.

Continuing Education Credit: The following educational activities have been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council of Pharmacy Education (ACPE) through the co-sponsorship of the University of Arkansas for Medical Sciences College of Pharmacy and the Arkansas Pharmacists Association. These activities will provide pharmacists up to 15 contact hours.

0004-9999-16-017-L01-P 0004-9999-16-019-L04-P 0004-9999-16-021-L04-P 0004-9999-16-023-L01-P 0004-9999-16-025-L01-P

0004-9999-16-018-L01-P 0004-9999-16-020-L01-P 0004-9999-16-022-L04-P 0004-9999-16-024-L04-P 0004-9999-16-026-L03-P

These programs are open to all pharmacists. To receive credit, the pharmacy participant must complete the presentation questions during each session and online program evaluation forms. If the attendance documentation is illegible then no credit can be issued. Partial credit will not be given for a session; you must attend each session in full to receive credit for that particular session.

Credit will be uploaded to CPE Monitor within 60 business days of completion of the program. Participants will be notified by APA via email when credit has been uploaded to the CPE monitor database. You may check the status of your CPE credit anytime by logging on to your CPE Monitor account at www.mycpemonitor.net.

This event is co-sponsored with the UAMS College of Pharmacy. For questions regarding CPE credit please contact the CPE office at 501-686-5396.

CPE Objectives: • Describe a biosimilar • Differentiate between a biosimilar and an interchangeable biosimilar • Describe the FDA process for approving and publishing biosimilar medications • List the currently approved biosimilar medications • Discuss the process for Arkansas law that allows for the substitution of biosimilars and compare with other states’ laws

Hot Springs Convention Center and Embassy Suites

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WWW.ARRX.ORG

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REGISTRATION FORM Register online at www.arrx.org

First Name: _________________________________________ Last Name: _________________________________________ Designation: P.D. Pharm.D. Technician Student Other Nickname (for badge): _______________________________ Home Address: _____________________________________ City: _________________ State: ___ Zip: _______________ Cell Phone:_____________ Work Phone: ________________ Email: ______________________________________________ Employer: __________________________________________ Pharmacist License # (e.g. PD01234): _________________ NABP E-Profile #:____________________________________

PHARMACIST FULL REGISTRATION PACKAGE

Includes: All education sessions and CPE, receptions, exhibit hall admission, prize drawings, breaks and social event tickets for Thursday, Friday and Saturday.

Cutoff Date for Early Bird Registration is May 23, 2016.

APA MEMBER

Before 5/23 After 5/23

NON MEMBER

Before 5/23 After 5/23

Full Registration

$279

$309

$374

$404

Full Registration

$379

$409

$474

$504

& Spouse/Guest

PHARMACIST DAILY REGISTRATION PACKAGE

Includes: All education sessions and CPE, receptions, exhibit hall admission, prize drawings, breaks and social events for the day of registration.

APA MEMBER NON MEMBER Thursday Only Registration

$199

$249

Thursday Only Registration and Spouse/Guest

$249

$299

Friday Only Registration

$199

$249

Friday Only Registration and Spouse/Guest

$249

$299

Saturday Only Registration

$149

$199

Saturday Only Registration and Spouse/Guest

$199

$249

TECHNICIAN REGISTRATION PACKAGE APA MEMBER NON MEMBER Full Registration

$175

$210

Thursday Only Registration

$120

$140

Friday Only Registration

$120

$140

Saturday Only Registration

$120

$140

PHARMACY STUDENT SPONSORSHIP Pharmacy Student Sponsorship - $85

Sponsor a student pharmacist to provide the opportunity for a UAMS or Harding College of Pharmacy student to attend the APA convention for free.

# of Students to Sponsor _____ @ $85 each = __________

ADDITIONAL CONVENTION ACTIVITIES Wednesday, June 22 Convention Golf Tournament, DeGray Lake Resort and State Park - $65 # of Golfers ______ at $65 per player = ________________ Name(s) of Golfers ________________ _________________ ________________ _________________ Friday, June 24 Spouse Trip to Garvan Woodland Gardens - $40 Name of Attendee: _________________________________

SOCIAL EVENT TICKETS - Friday, June 24

Social Event Tickets are included in the Full Registration Package. However, we need to know which event you want to attend so that we have correct numbers for reservations.

Casino Night at the Gangster Museum of America # of Additional Tickets: ________ @ $50 each = _________

RESERVATIONS

Please let us know the number of attendees for each event you plan on attending. _____ Thursday, June 23- Awards Luncheon and Ceremony _____ Thursday, June 23- Opening Reception _____ Friday, June 24- AP-PAC Breakfast _____ Friday, June 24 - Exhibit Hall Luncheon _____ Friday, June 24- Gangster Museum of America _____ Saturday, June 25- Breakfast & State of the Assoc.

PAYMENT

Total Amount: ______________________________________ Pymt. Type: __Visa __AmEx __MC __Discover __Check Card# ______________________________________________ Exp____________________ Sec Code___________________ Please make checks payable to Arkansas Pharmacists Association: 417 S. Victory St., Little Rock, AR 72201 Fax to: 501-372-0546. Or register at www.arrx.org.

Refund Policy Before June 10, 2016, 50 percent refund will be issued. After June 10, 2016, no refund will be issued. All refund/cancellation requests must be submitted to APA in writing. Registrations are non-transferrable.

WWW.ARRX.ORG

HOT SPRINGS CONVENTION CENTER & EMBASSY SUITES • HOT SPRINGS, ARKANSAS

APA 2016 Annual Convention

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APA Updates Bylaws, Boundaries, and Board of Directors

By Scott Pace, Pharm.D., J.D.

A DETAILED LOOK AT THE BYLAWS CHANGES THAT HAVE BEEN APPROVED BY THE BOARD FOR THE MEMBERSHIP’S CONSIDERATION IN JUNE. AN EXPLANATION OF THE CHANGES WILL OCCUR FOR EACH ARTICLE OF THE BYLAWS.

T

o ensure the success and longevity of any organization, bylaws are necessary to guide and govern. As time goes on, bylaws often must be updated to reflect changes within the organization. The Arkansas Pharmacists Association has undertaken a year and a half long review of our organizational structure. This review has been focused on two key areas: 1) updating our bylaws to reflect our current operating style, and 2) to review the structure of the APA Board of Directors, specifically the number of board members and how the board members are apportioned to most equitably represent the geographical location of the pharmacists throughout the state.

This intensive bylaws review was conducted by the APA Staff and the APA Organizational Affairs Committee, and the final

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changes were adopted by the APA Board of Directors at its March 2016 meeting. The changes will be voted on by the full membership at the APA Annual Convention June 22-24 at the Embassy Suites in Hot Springs.

This article will take a detailed look at the bylaws changes that have been approved by the board for the membership’s consideration in June. An explanation of the changes will occur for each Article of the Bylaws.

Article I – Membership The changes within the membership section of the bylaws defines the long standing practice of having pharmacist-incharge, staff pharmacists, first-year graduates, residents, out-of-state pharmacists, and pharmacy technicians as part of the definition of “Active Membership.”

Additionally, the Retired Membership category was added to be consistent with the long-held practice of allowing retired pharmacists to be members of APA.

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THE ARKANSAS PHARMACIST

APA UPDATES BYLAWS, BOUNDARIES, AND BOARD OF DIRECTORS

Article II – Board of Directors This area of the bylaws sees the largest and most substantive changes. The changes are necessary because it has been over two decades since the last time board of director’s seats were reapportioned to represent the location of pharmacists throughout the state. The changes will allow equitable (i.e. roughly equal pharmacist to board member ratio) representation for every pharmacist in the state, regardless of where they live.

To accomplish this, the old eight districts and four areas will be abolished and replaced with five new regions. We will retain the same twelve board members; however, they will be redistributed based upon population. The Northwest Region will have three regional representatives, the Central Region will have three regional representatives, the Northeast Region will have two regional representatives, the Southwest Region will have one regional representative and the Southwest Region will also have one regional representative. In addition, there will be two statewide at-large representatives that can come from any region in the state. Each Regional & Statewide Representative will serve three year terms.

It is the hope of the Organizational Affairs Committee and the APA Board of Directors that the proposed changes to the Board structure will create a more equitable opportunity for service on the Board for pharmacists throughout the state.

Further, the Executive Committee is given the powers to create special committees to address issues that arise and to appoint members to the special committees.

Article IV – Nominees and Delegates The Board of Pharmacy and Board of Health Nomination process would be changed to make them consistent with Arkansas law. To be eligible to run, the pharmacist shall have been in the active practice of pharmacy for the last five (5) years. In addition, the pharmacist shall have been an active member of the APA for the last three (3) years.

Article VII – Plan of Organization of Geographical Regions of the Arkansas Pharmacists Association The new APA Board of Directors Regions are defined by county. (See map below) While many of these modifications may seem trivial, they are important to continue to further advance and represent the members of the association, and we want to make the changes clear and transparent to the membership.

The vote to approve the bylaws will take place at the Annual Convention in Hot Springs this June. § * For a complete list of proposed bylaw changes, visit www.arrx.org/bylawrevisions

Other minor changes include allowing the President-elect to immediately assume the office and duties of the Presidency in the event of a vacancy.

The duties of the officers were clarified and the office of the Treasurer was formally added to the Bylaws. APA has had a Treasurer for years, but this formally creates the position.

Finally, the elected Board of Directors will be vested with the power to make future Bylaw changes upon a supermajority of the Board to allow for nimbler operation of the association.

Article III – Committees The proposed changes to the Bylaws requires the president to consider geographical and practice diversity when appointing members to committees. Additionally, the Executive Committee, which has acted as a sounding board for the Executive Vice President & CEO, is formalized in the Bylaws.

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UAMS REPORT

Marketing and the Science of Implementation

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ost of us actively engaged in Management). Every one of Arkansas’ 81 hospitals, including pharmacy practice, academia, 29 designated as Critical Access Hospitals, with additional administration, or industry would federally qualified community health centers, are interested admit that marketing is not in quality improvement and value-driven outcomes, whether necessarily our strong suit and they are currently in an accountable care organization (ACO), or not. Do you know the decision makers in your locale? it is not a major component in USA pharmacy colleges. In the midst of rapidly changing healthcare in our country, and the state of Arkansas, many are questioning what it will take Another example of a collaborative relationship involves knowing how the managed care providers for your area going forward to sustain business, develop non-drug revenue streams, and improve patient care outcomes. Implementation constituency are doing with their star ratings, and offering science is a new field of study emerging over the past few partnership in outcome resolution. CMS determines years. The intent of implementation science is to investigate reimbursement for Medicare Part C and D prescription drug coverage based on healthcare plans’ star ratings. A and address any major social, behavioral, economic, healthcare plan with a four or five star rating will receive management, and other barriers that impede effective health greater reimbursement. Community programming for patient impact. The pharmacies may improve healthcare UAMS COP Center for Implementation Research, headed by Geoffrey Curran, plans’ star ratings through collaborative PhD, is one of the first of its kind in a relationships, and will receive a portion college of pharmacy. The Center works of this reimbursement in return. Both on the complexities of translational Medicare Part C and D with prescription research to establish sustainable drug coverage have multiple measures and progressive pharmacy practice tied to drug therapy. Importantly, none models. Our emphasis is community of the 75 counties in Arkansas currently pharmacy. What does that mean for has a star rating greater than three! you, and what does that have to do That should provide ample intervention The UAMS COP Center for with marketing? opportunities for pharmacists.

Keith Olsen Pharm.D., FCCP, FCCM Dean

Implementation Research,

Until healthcare policy evolves to include The UAMS COP Center for headed by Geoffrey Curran, Implementation Research can help pharmacists with provider-designated PhD, is one of the first of its suggest other customized/local status, implementation science studies kind in a college of pharmacy. are helping community pharmacy approaches based on needs present bridge new innovative payer models in your market, such as integrating with traditional income by increasing medication therapy management, awareness of patient practice options. With the national immunizations, point-of-care testing or screenings. Over 60% shortage of primary care physicians, community pharmacists of our UAMS COP graduates enter community pharmacy. (particularly in rural areas) are among the most accessible Even with strong support from the Arkansas Pharmacy healthcare practitioners. Pharmacists remain one of the only Association to scale up reimbursable services and improve health-care professionals that are readily accessible without patient care, only community pharmacies committed to charging a fee. Though threatening drug cost reduction is at innovation will be able to meet patient needs in the future. the forefront of both governmental agencies and insurance Implementation science is working to affect the sustainability and success of community pharmacy. Make it your business companies, innovative billable models are slowly being added as pharmacists engage with chronically ill patients to have regular “marketing” conversations with your local toward guided self-care, and collaborate with employer and healthcare players: hospitals, clinics, skilled-care entities, managed care teams to achieve their outcomes. The extent of managed care partners, political advocates, and employer any implementation idea depends on your active participation group leaders. in community marketing.

We all benefit by sharing great ideas. The College is currently Implementation is a dynamic, in-motion, active process recruiting a pharmacist faculty member that will focus on assisting community pharmacists with implementation that requires pharmacies to know their healthcare markets. sciences. Please ask how we might help you collaborate Community marketing is simply relationship building and for sustainable implementation impact. In the following positioning to be in the right place at the right time, and knowing months, we will continue to share more about innovation who drives change. For instance, opening discussions with administration at hospitals concerned about readmission and implementation, and especially what that means for rates and value-based patient care for their reimbursement your bottom line in community pharmacy. Meanwhile, keep cultivating your “marketing” opportunities. § can lead to a potential partnership in providing transitional patient care services such as MTM (Medication Therapy 26

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THE ARKANSAS PHARMACIST

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HARDING UNIVERSITY REPORT

APA HOSTS LEGISLATIVE DAY JANUARY 28

Don't Just Get a Job, Create a Practice

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ost of you are probably familiar with Gallup, the company that for over 80 years has been surveying Julie Hixon-Wallace people from around the world on a Pharm.D., BCPS wealth of topics. As pharmacists, Dean we are most familiar with our high rating in Gallup polls related to honesty and ethical standards as compared to other professions. Gallup Chairman and CEO, Jim Clifton, has said, “We change the world one client at a time through extraordinary analytics and advice on everything important facing humankind.” Don’t pharmacists do the same thing? I would say that we do.

At Harding, we utilize one of Gallup’s tools known as StrengthsQuest to identify the strengths of each student, staff, and faculty member as a mechanism for optimal alignment of career and personal success. We all want to be successful, although our definitions may vary regarding what that looks like. Money, fame, power, job security, family, service, and legacy are just a few of the ways success is often identified.

Gallup defines educational success as having a great job and living a great life. No matter how it is defined, we must each take responsibility for our own fate by creating greatness in our jobs and in our lives rather than waiting for greatness to happen or feeling entitled to greatness by way of position. By capitalizing on the strengths God gave us, we can get to this greatness more efficiently and smoothly.

There has been much discussion recently in the pharmacy world regarding the balance in the supply and demand for pharmacists. Some of the discussion has been self-described as “gloom and doom” but I prefer to look at the strengths we possess as a profession. I would encourage all of us to

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consider how we can make our profession great rather than how to effectively defend our turf. As recently mentioned

by Lucinda Maine, Executive Vice President and CEO of the American Association of Colleges of Pharmacy (AACP), “Blunting innovation in pharmacy practice was the most negative consequence of [the Great Recession].” The much talked about pharmacy Aggregate Demand Index (ADI) is calculated based only on employers in traditional pharmacy practice settings such as chains and health systems. It omits the many other settings in which pharmacists work. Today’s graduates leave pharmacy school trained and ready to perform numerous direct patient-care tasks. As a profession, we need to be sure we are not discouraging the innovation that can blossom from the strengths of today’s graduates by pigeonholing them into the traditional roles pharmacists have filled. Rather than “looking for a job” upon graduation, we endeavor to launch young people who are going to “establish their practice,” more akin to the mindset of many other healthcare professionals such as physicians, physical therapists, and nurse practitioners.

I challenge each of us to identify our personal strengths to determine how we can best act to move our profession forward.

We need to take charge of our destiny as healthcare providers.

That may mean retooling some of our skills or launching into slightly unknown territory. But if we don’t ever try, we’ll never know what wonderful things might have happened. We all have strengths. Now is the time to use them to mold our own future into what we want it to be. AACP has adopted the slogan that pharmacists help people live healthier, better lives. If, as this slogan implies, we put our focus outwardly on others, I truly believe we will reap the benefits as well. Ultimately, the choice is ours. §

Join us in America’s oldest national park for the 2016 APA Annual Convention, to be held June 23-25 at the Embassy Suites Hotel and Convention Center in Hot Springs. APA will offer 15 hours of continuing pharmacy education (CPE) relating to pharmacy practices.

Members and guests will be able to learn about the latest product trends in pharmacy from more than 40 exhibitors who will showcase new products to potential customers while working to maintain and strengthen relationships with existing customers.

June 23-25, 2016

Embassy Suites Hotel / Convention Center Hot Springs, Arkansas

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Social events to mingle with fellow pharmacists, colleagues, and friends are planned as well as the annual golf tournament on Wednesday afternoon, June 22. Convention registration will open shortly so stay tuned for more information through InteRxActions and at www.arrx.org/ annual-convention.

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

Getting Geared Up for Fall Seminar Rob Christian, Pharm.D. President

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he Arkansas Association of Health-System Pharmacists will be hosting its 50th Annual Fall Seminar in Hot Springs, AR. The fall seminar will be held September 29-30th at the historic Arlington Resort Hotel and Spa. The seminar will include program for pharmacists, residents, technicians and pharmacy students. Offering up to 11 hours of ACPE-accredited continuing education for both pharmacists and technicians, programming will consist of clinical and operational topics that impact all areas of

2015 AAHP Fall Seminar presenter Buddy Newton

Pharmacy students discuss residency opportunities at the AAHP Fall Seminar

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practice. There will be concurrent sessions on both days, so you can select the program that corresponds with your learning needs.

The Hot Springs area offers many activities from championship golf to pristine lakes and walking trails. Just outside the hotel, you can enjoy a stroll through the city's many shops and downtown art galleries or visit bathhouse row. Come join us in America's Spa City for a few days of continuing education, networking, and relaxation. ยง

AAHP President Rob Christian presents award to former AAHP President Marsha Crader.

2015 AAHP Fall Seminar presenter Gary Wheeler

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APA CONSULTANTS ACADEMY REPORT

TITLE

What is NEXT with PPI and Adverse Events, Dementia?

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nteresting isn’t it? If your facility sees its share of admissions from an acute care setting you will see most likely patients are on a Proton Pump Inhibitor (PPI). Certainly we understand that the PPI order in most cases is a prophylaxis for a stress ulcer. The question is, do we still need the PPI? Is the continued administration of a PPI wise for the geriatric patient? Does that patient truly have gastroesophageal reflux disease (GERD) or is there a routine NSAID or steroid on board? After some 25 plus years we are now seeing issues with the prolonged administration of this medication class. According to some research, up to 70% of all PPI prescriptions could be inappropriate. Is it possible we have conditioned the system to associate GERD with all PPIs on the admission sheet?

History of PPIs

Omeprazole was discovered in 1979. In 1980, an Investigational New Drug (IND) application was filed and in 1982 omeprazole was taken into Phase III trials. By 1990 Prilosec, omeprazole (The Purple Pill) was released in the United States.

It quickly became one of the most prescribed medications in the United States and around the world. PPIs are indicated for GERD, esophagitis, acid hyper-secretory states, peptic ulcers and eradication of Helicobacter pylori. PPIs are also used for treating dyspepsia and prophylaxis of peptic ulcers in the intensive care setting, and among high-risk patients prescribed aspirin, NSAIDs, anti-platelets and anticoagulants.

As time always does, issues began to show themselves the more the PPIs were prescribed. Looking at Table ONE with F-Tag 329 of the State Operations Manual, it identifies that extended use of PPIs in the elderly is associated with

increased risk of clostridium difficile colitis.

Anthony Hughes, P.D. President

Even though the evidence could be better we are seeing discussions with the elderly that PPIs should be use with caution in patients at risk for bone fracture. The mechanism behind impaired bone strength is based on profound acid suppression and its triple effect of impairing vitamin B12 and calcium absorption. By reducing the B12 absorption this in turn decreases osteoblastic activity resulting in reduced metabolic bone density and strength. In addition we are hearing issues with deficiencies with iron and magnesium too.

From JAMA Neurol. Published online on February 15, 2016, a new study from Germany has confirmed an association between PPIs and increased risk for dementia in older patients.

Having diabetes and being prescribed five or more drugs other than the PPI were also associated with significantly elevated dementia risk.

Evidence suggests some PPIs may cross the blood–brain barrier and interact with brain enzymes and, in mice, may increase beta amyloid levels in the brain. Although the current study did not include vitamin B12 levels, other research has linked PPI use to vitamin B12 deficiency, which has been shown to be associated with cognitive decline.

This is only the beginning of the discussion associating dementia and PPIs. Much more needs to be done. Time will clarify this discussion with PPIs and point us in the right direction. §

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Vacant Public Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Carol Rader, Fort Smith Public Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . James Burgess, DDS, Greenwood WWW.ARRX.ORG

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APA STAFF SPOTLIGHT

Scott Pace, Pharm.D., J.D. CEO & Executive Vice President Arkansas Pharmacists Association Hometown: Paragould Education: Ridgecrest High School, ASU (BS in Biology),

UAMS (Pharm.D.), UALR Bowen School of Law (Juris Doctor), National Community Pharmacists Association (Executive Residency, Association Management)

Three words/phrases that describe your leadership style: Collaborative, data-driven, decisive Favorite project to work on at APA: Tearing down and rebuilding the association’s communications several years ago. Communication is such a vital part of an association’s success. I want us to exude excellence in communicating with our members. I also like relationship building – getting to know people, what makes them tick, and fulfilling the things they need to succeed professionally.

Five-year goal for APA: My 5-year goal is for APA to be

involved in developing an enhanced community pharmacy network (ECPN) that will allow pharmacists in community sectors to be paid for more than dispensing and will allow payers to see the value that pharmacists can provide and the care they give their patients. The effects of an ECPN are far-reaching and incorporate many areas of pharmacy, not just community pharmacists. It involves health-system pharmacists and transition of care and is an important part of the community pharmacy/health-system pharmacist relationship.

Most unusual/interesting job: Working at a baseball card

shop in junior high school.

Best vacation: My wife Anne and I went to London and

Paris in 2009. It was a spur of the moment trip that came about when we found really cheap airfare. We flew into London, spent 3 nights in London, took the train to Paris, spent 3 nights in Paris, all on a shoestring budget. We got to experience a little bit of the world, just the two of us.

Favorite meal: Tamales and chili from Heights Taco and Tamale Co in Little Rock

Favorite quote: “Some is not a number and soon is not a time.” - Anonymous

Recent Reads: Missoula, The Presidents Club, The 5th

grandparents who owned an extensive record collection. I would listen to old musicals with my grandparents and it was something that really bonded us and is a wonderful memory I have of them. My family would often go on vacation to St Louis and we would always go to the Muny Theater, the largest outdoor theater in America. We would always see a show and then see the Cardinals play every trip. There’s something about the suspension of disbelief and escapism that live theater can provide that is unmatched.

You are happiest when: I’m at home enjoying my family, being around wife and two kids.

Three favorite cities in America: DC, New York, San Diego Best piece of advice you’ve ever received: Stanley

Carmack, a pharmacist in Paragould once told me that when you’ve made an obligation, you need to honor it and see it through to the best of your ability. That’s something that’s always stuck with me. §

Assassin, The Vatican Diaries, The Litigators

People would be surprised to find out: That I love theater.

Growing up, I spent my summers in Southern Illinois with

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2016 APA Scholarship

Golf Tournament

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he 2016 Arkansas Pharmacists Association Golf Tournament was held at Tannenbaum Golf Course in Drasco, AR on April 14. Fifteen teams played the beautiful 18-hole course with prizes going to the longest drive and closest to the pin.

The winning teams of the tournament were (1st) Collier Drug Stores, (2nd) East End Pharmacy, and (3rd) Magee-Thomas Pharmacy. The four-player scramble golf tournament benefits the Arkansas Pharmacy Foundation and the Charles M. West Leadership Award Scholarship. The Arkansas Pharmacy Foundation promotes the profession of pharmacy in Arkansas through financial contributions and continuing education.

Special thanks to our generous sponsors – Smith Drug, Morris & Dickson, McKesson, Pharmacists Mutual, McKinney Drug, Magee-Thomas Pharmacy, Collier Drug Stores, Inc., Rose Drug, McCoy-Tygart Pharmacy, Cornerstone Pharmacy at Rogers, East End Pharmacy, US Compounding, UAMS College of Pharmacy, and Harding College of Pharmacy.

McKinney Drug - Steve Bell, John Norris, Ron Curran, Don Curran, David Bell

Winning Team – Collier Drug Stores, Inc. - Dylan Jones, Drew Stahl, Rane Dearing, Gary Fancher

Pharmacists Mutual - John Bradley, Tyler Soo, Josh Cummins, Jarrod King

Smith Drug - Buddy Strozyk, Paul Cheatham, Kerri Campbell, William Hamill

East End Pharmacy - Gary Bass, Mark Riley, Brent Panneck WWW.ARRX.ORG

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Cornerstone Pharmacy at Rogers - Chris Cooper, Taylor Burgess, Ben Ramsey, Andy Roller

Morris & Dickson - Bill Colvin, Nicki Hilliard, Charles Tarver, Henry Dannehl

Rose Drug - Gary Denton, Richard Harmon, Roy McSpadden, Mike Smith

The Arkansas Pharmacy Foundation promotes the profession of pharmacy in Arkansas through financial contributions and continuing education.

UAMS College of Pharmacy - Seth Heldenbrand, Will Arnold, Schwanda Flowers, Lindsey Dayer

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Magee-Thomas Pharmacy - Dana Friedland, Mike Magee, Jim Mitchner, Craig Thoren

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Smith Drug - Brandon Harris, Aaron Brown, Rick Rogers, Tony Rogers

McCoy-Tygart Pharmacy - Tony Bari, Sparky Hedden, John Manatt, Bill Crossley

SPECIAL THANKS TO OUR GENEROUS SPONSORS – Smith Drug, Morris & Dickson, McKesson, Pharmacists Mutual, McKinney Drug, Magee-Thomas Pharmacy, Collier Drug Stores, Inc., Rose Drug, McCoy-Tygart Pharmacy, Cornerstone Pharmacy at Rogers, East End Pharmacy, US Compounding, UAMS College of Pharmacy, and Harding College of Pharmacy.

East End Pharmacy - Daniel Price, Trent Shipley, Chad Riley, Chad Vance

US Compounding - Brian Wilson, Matt Frazier, Bobby Tiner, Eddie Glover

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Harding College of Pharmacy - Eric Shoffner, Erin Beth Hays, Wade Williams

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Member Classifieds Pharmacist Needed in Retail Setting: AllCare Pharmacy is looking for a full time pharmacist in Paris, AR to join a busy, energetic, new completely remodeled store. Customer service oriented store that offers immunizations, DME, delivery service and gift section. Come complete our team of a growing, pharmacist-owned, independent pharmacy company.

Please contact Dean atdean.sikes@allcarepharmacy.com or Michele at michele@allcarepharmacy.com or by mail at AllCare Pharmacy, P.O. Box 235, Arkadelphia, AR 71923 or call 870-246-5553. (3/30/16) Pharmacy Technician Wanted. Independent Pharmacy in Sherwood, AR looking for a part-time technician with the opportunity to turn into full-time. Experience preferred, but not required. Call 501-819-6300 or send resume to sherwood@ expressrx.net (3/29/16) Need a relief pharmacist for a few days a week for a couple weeks. Pharmacist had an emergency. Store hours are 8-6 Monday thru Friday and 8-1 on Saturday. Located in Gravette, AR. Contact Alisha 479-787-8150 (3/23/16) Little Rock retail pharmacy seeks experienced pharmacist.

5-10 hours / week, call 501-664-6161 (3/2/16) Experienced Pharmacist seeks 2 to 3 days per week.

Contact at 501-231-1130 or timothylacey@msn.com (2/19/16) Pharmacy tech needed in NWA. United Medical Home Infusion in Fayetteville is looking for a full-time pharmacy tech for a M-F 8am-5pm position. Certified techs preferred.

Contact Neil at 479-973-4889 or nbarker@live.com

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

Unguator e/s Electronic Mortar and Pestle with mixing blades for sale $1800. EXAKT 50 three roll ointment mill for sale $3200. Call Kenny at 501-580-1895 or email kenny-h@ sbcglobal.net (1/18/16) Omnicare, a CVS Health company, is hiring for a Pharmacy Manager/Pharmacist in Charge in Jonesboro. Contact michelle.buckley@omnicare.com for more information, or www.omnicare.com/careers to apply directly. (1/15/16) Omnicare, a CVS Health company, is hiring Pharmacists and Pharmacy Technicians for our Little Rock, AR pharmacy. Contact douglas.wedig@omnicare.com for more information, or www.omnicare.com/careers to apply directly.

(1/15/16) Pharmacy Technician Needed. Immediate opening at independent pharmacy in Marmaduke, Arkansas. Established pharmacy needing to hire a 32 hour per week Pharmacy Technician. Looking for someone who is responsible, personable, and organized. If you are interested, please email your resume to "eddingtonpharm@yahoo.com" (1/15/16) Independent Retail Pharmacy in Jonesboro, AR is seeking full-time pharmacist. Experience required, duties will include the normal staff pharmacist duties as well as helping with MTM consulting, immunizations, etc. Store hours are MondayFriday 9 am-6 pm and Saturday 9am-1pm. Send resume to pharmacist@exiee.com or fax 870-935-4027. (1/13/16)

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