March 2015 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association MAR. 2015

WOMEN IN PHARMACY The Official Publication Of The Florida Pharmacy Association JULY 2014

JULY 2005

Suzanne Kelley 2014-2015 FPA PRESIDENT

2005-06 FPA PRESIDENT

Kathy Petsos

A LOOK AT THE 7 WOMEN WHO HAVE LED THE FPA

A Pharmacist And A Lawyer Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN ◆ HEIMBERG, PLC

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FLORIDA PHARMACY ASSOCIATION 125TH ANNUAL MEETING AND CONVENTION Renaissance Resort at World Golf Village St. Augustine, Florida SAVE THE DATE: June 24-28, 2015

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Every day, pharmacies depend on PPSC to simplify purchasing, reduce costs and identify new revenue sources – making a significant impact on their bottom line. PPSC can help you: EXPAND use of high-profit generics CREATE effective store layout ENHANCE third-party profits CAPTuRE MTM revenue EsTAblisH new business niches INCREASE your overall margins

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 14 Campus Corner 18 Member Profile 25 Buyer’s Guide

VOL. 78 | NO. 3 MARCH 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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Volunteer Pharmacists and Pharmacy Students Visit Florida Capitol In Memoriam: Maita Post Singer

FPA News & Notes

MARCH 2015

Mission Statements:

FPA Calendar 2014-2015

APRIL 3

Good Friday, FPA Office Closed

6-8

Board of Pharmacy Meeting Tampa

18-19 FPA Regulatory and Law Conference - Tampa Airport Marriott Tampa 24

Last day to submit resolutions MAY

Legislative Session Ends

10-12 Pharmacist Mutual Leadership Conference Rockville, Maryland 12-13 NCPA Legislative Conference Arlington, VA 16-17 FPA Clinical Conference Jacksonville 25

Memorial Day, FPA Office Closed

JUNE 24-28 125th Annual Meeting and Convention St. Augustine JULY 3

Independence Day Observed, FPA Office Closed AUGUST

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32nd Annual Southeastern Education Gatherin’

14-16 45th Annual Southeastern Officers Conference 22-23 FPA Committees, Councils and Board of Director Meetings SEPTEMBER 7

Labor Day, FPA Office Closed

AphA Diabetes and Immunization Certificate Program

12-13 FPA Regulatory and Law Conference Ft. Lauderdale

For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.pharmview.com CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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FLORIDA PHARMACY TODAY

of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers THE HEALTH LAW FIRM.............................. 16 KAHAN HEIMBERG, PLC................................ 2 PHARMACISTS MUTUAL............................. 17 PHARMACY BROKERS.................................. 19 PPSC...................................................................... 2 Rx OWNERSHIP............................................... 26

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The President’s Viewpoint SUZANNE KELLEY, FPA PRESIDENT

This is the Year to Fight for Clarity on MAC Pricing

ould you build a house without knowing how much you would pay the contractor? Would you buy a car with the price unknown? Most of you would not! But how many of you have filled a prescription for a patient only to find out as they walk out the door that the amount you were paid by the third party was less than the cost of that medication? It seems that this is an unfair practice; however, it occurs numerous times a day. Can this be stopped? We have a chance, but you need to get passionate about this enough to get involved! So, how can you make a difference? Join the Florida Pharmacy Association, contribute to our Florida Pharmacist Political Committee and contact your legislators. You can even come to Tallahassee and visit them in person during this legislative session. So now, let’s get back to this unfair practice. Who operates in this “unknown” area? Believe it or not, every pharmacy experiences this. Currently, there are two bills that have been submitted on this issue: HB555, sponsored by Rep. Matt Gaetz, and SB 860, sponsored by Sen. Rene Garcia. Basically, these two bills are seeking “Clarity on MAC Pricing.” For those of you who are not quite sure what entities would dare to act in such a fashion, let me try to briefly explain. Do you know what MAC price you are paid for a drug? Often, this is an unknown variable in many third-party plans. PBMs (Pharmacy Benefits Managers) oversee most prescription insurance plans in the U.S. The managed care organizations created the first PBMs in the 1980s to help control cost, hence the “managed care” term was born. PBMs are primarily respon-

sible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims. Their goal is to save money, but do they? PBMs are getting bigger and richer while others are working hard to cut costs in health care. No one understands these PBMs and how they operate. It is all confidential information… Or is it? So now back to MAC pricing. What is MAC? It is the Maximum Allowable Cost and this is the method that the PBMs use to set pricing controls. These controls are mostly on the generic drugs (and some branded drugs) purchased and then dispensed by pharmacists to their patients. In many states, it is unknown to pharmacy businesses how the PBMs determine and set the MAC pricing. Since MAC pricing is considered proprietary information by the PBM, it is not provided to the pharmacy in most cases. There are states that have succeeded in passing MAC legislation, and there are a number that, currently, have pending legislation. Florida is one of those that has been fortunate to have some legislators who are concerned with MAC pricing as well as other PBM issues. Hopefully, if these bills are successful and become law, then there will be a bit of regulation to an “unregulated entity.” The bills are below for your information, but basically the end result will allow a pharmacy to be reimbursed enough to cover the cost of the actual medication and perhaps a bit of a dispensing fee. Over the last few years, there have been many drug shortages or medications discontinued by a man-

Suzanne Kelley 2014-2015 FPA President

ufacturer that have resulted in only a single-source product. This means there is now no competition and the price will more than likely increase exponentially. Unfortunately, the PBM does not adjust its MAC pricing to reflect the change. Another scenario is that a drug in one region of the U.S. may cost much less than what it costs here in Florida. Guess what? I am willing to bet that the PBM pays the lower cost medication since that is their MAC price. HB555 Regulation of MAC Pricing Provides requirements for contracts between pharmacy benefit managers and contracted pharmacies; requires pharmacy benefit manager to ensure that the prescription drug has met certain requirements to be placed on maximum allowable cost pricing list; requires pharmacy benefit manager to disclose certain information to MARCH 2015

2014 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Terry Gubbins.......................................................................... Chairman of the Board Suzanne Kelly...............................................................................................FPA President Tim Rogers................................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Bob Parrado................................................Speaker of the House of Delegates Jackie Donovan...........................Vice Speaker of the House of Delegates Jennifer Raquipo..............................................................Interim Director, Region 1 Michael Hebb........................................................................................ Director, Region 2 Stephen Grabowski........................................................................ Director, Region 3 Linda Lazuka........................................................................................ Director, Region 4 Jason Beattie...................................................................................... Director, Region 5 Luther Laite IV.................................................................................... Director, Region 6 Kimberly Jones................................................................Interim Director, Region 7 Humberto Martinez......................................................................., Director, Region 8 Mitchell Fingerhut......................................................... Interim Director, Region 9 Christine Gegeckas............................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair...........................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

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FLORIDA PHARMACY TODAY

plan sponsor; requires contract between pharmacy benefit manager and pharmacy to include appeal process. SB 860 Maximum Allowable Cost Prescription Pricing Providing requirements for contracts between pharmacy benefit managers and contracted pharmacies; requiring a pharmacy benefit manager to ensure that a prescription drug has met certain requirements to be placed on a maximum allowable cost pricing list; requiring the pharmacy benefit manager to disclose certain information to a plan sponsor, etc. We are asking for “transparency” between the PBMs, the pharmacies and consumers. Additionally, there should be a process for appealing, investigating and resolving disputes between the PBM and the pharmacy. Of course, this relates to MAC pricing. Additionally, the PBM should be required to provide the reason for the denial if the claim is denied. The only way that these bills will be passed is if you take an active role and contact your legislator. Get active and don’t just sit waiting on someone else to do this for you. Our voices can be heard but we have to be LOUDER than those of the PBMs and the insurance plans. We want transparency, we want a bit of regulation for them and we want to rein them in a bit. PBMs and the insurance plans do not want this transparency and they do not want regulation. There are many other practices that some question as being fair to the pharmacy. These can be found on the NCPA (National Community Pharmacists Association) website and others. It is only fair that when prices go up on a drug, the reimbursement should go up likewise. Stay involved! Speak loudly! Join the FPA and consider contributing to the Florida Pharmacists Political Committee. Don’t forget to contact your legislators and tell them to support these bills! For the talking points and other great emerging information, access the FPA website. Get passionate! FIND YOUR PHARMACY PASSION!!! n

Executive Insight MICHAEL JACKSON, RPH BY: DANELLA DIXON,BY 4TH PROFESSIONAL YEAR PHARMD CANDIDATE FPA ROTATION FEB. 2015. PRECEPTOR: MICHAEL JACKSON, EXECUTIVE VICE PRESIDENT/CEO

Women in Pharmacy

n what was once a male-dominated profession, females have become the face of the profession of pharmacy over the past 30 years. According to the American Association of Colleges of Pharmacy, female graduates outnumber males 62% to 38%. These women are also taking on management and leadership roles and are making tremendous strides in the profession. The Florida Pharmacy Association has had the pleasure of being led by seven women since its origin. These women and their contributions will be highlighted in this article. Betty Harris, 1991

Betty Harris was the first woman to be elected as president of the Florida Pharmacy Association in 1991. Dr. Harris embarked on her journey as president with the motto “Speak Up…We Are Listening.” She worked extremely hard to encourage pharmacists to take a stand on the issues that were affecting the practice of pharmacy in the state of Florida. She believed communication was a vital component to a successful organization and the keys to success were speaking up for what is important as well as listening to the concerns of others. Dr. Harris was an innovative thinker and believed pharmacists played a critical role in providing health care to the public. She reinvented what was known as the four P’s (Patient, Price, Product and Prescription) as she envisioned the future of the profession of pharmacy. She considered the new four P’s as Pharmaceutical Care, Pharmacoeconomics, Patient

Outcomes and Perception. Under her leadership, membership increased by 33.5% and volunteers worked tirelessly to approach the issues concerning pharmacy practice. The Adopt-A-Student campaign

Betty Harris was the first woman to be elected as president of Florida Pharmacy Association in 1991. was launched to increase student attendance at annual meetings as well as give members the opportunity to mentor and precept these individuals. This program would serve as an investment by the association by allowing students to participate and making them more familiar with the association and more likely to participate on behalf of the profession after graduation. The Academy of Pharmacy Practice also expanded with the addition of a hospital pharmacy section and all continuing-education programs incorporated practical patient communication skills. They were able to limit records that are open to investigation by Medicaid to only “Medicaid-related records,” whereas initial legislation as filed would have allowed Medicaid unrestrained discretion. Changes in the sanction section of the bill -- what con-

Danella Dixon

stitutes “evidence” of overpayment in a Medicaid audit and the amount the department is authorized to withhold -was negotiated. It was finalized with authorization of up to 10% rather than the 25% they were initially requesting. Dr. Harris and volunteers worked diligently during her term as president and were able to make adjustments in areas that would benefit the profession of pharmacy in Florida. Rebecca (Nichols) Poston, 1998 Rebecca (Nichols) Poston was the second woman to be elected as president of the Florida Pharmacy Association, serving in 1998. Ms. Poston took a strong stance on the importance of service and chalMARCH 2015 |

FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair.........................Jennifer Pytlarz, Herndon, Va. Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2015, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

lenged pharmacists to take charge of their profession. She encouraged them to “Stand up and be counted” in order to protect the future of the profession of pharmacy. She urged pharmacists to communicate more vocally with patients so as to display empathy, which she believed contributed to the healing process. She also informed pharmacists of the importance of continuous quality improvement programs and how essential they are to the progression of the profession. Guided by the profound leadership of Ms. Poston, volunteers worked extremely hard and were able to accomplish much during the 1999 legislative session. The term “other pharmaceutical services” was added to the definition of the profession of pharmacy in the state of Florida. This addition to the definition allowed pharmacists additional flexibility to monitor patients’ drug therapy as well as communicate with prescribers. Proposed changes to licensure by endorsement, not supported by the FPA, was also stopped although it had already made its way through the Senate. This proposal would have allowed pharmacists to transfer licenses from other states without the necessary Board review. Ms. Poston term ended on a positive note as many issues were addressed during the legislative session. Communication and understanding of the challenges faced by the profession were increased, and development of an investment policy was opened with the purpose of securing the future of the association. Joy Marcus, 2001

Joy Marcus had t he pleasu re of serving as president of the Florida Pharmacy Association in the years 2001-2002. She began her term of office by informing the members of the association about the importance of their participation. She reminded them that their voices were necessary to move the profession forward. Ms. Marcus took to the concerns of the pharmacists of the state of

Florida and, along with her leadership team, worked to ease the stress of the pharmacists’ workload by implementing a universal prescription drug card as well as a central filling system. It was thought that this would lessen the burden of insurance issues and overall workload of the pharmacists and allow for more time to provide care for the patient. Ms. Marcus supported the 2000 House of Delegates initiative for pharmacists to stand as a single entity rather than separately based on practice. By unifying as “One Voice” she believed they would be much stronger and more effective. Ms. Marcus also believed that pharmacists and pharmacy students should collaborate with the intent to make the legislative efforts a success. By doing so, the FPA conducted what became an annual Health Fair event in Tallahassee during the legislative session. This event gave pharmacists and pharmacy students from around the state the opportunity to showcase the services pharmacists are able to provide to patients. During her administration, both the House and Senate reviewed bills that addressed a universal prescription drug card. This bills were approved by the Legislature and signed into law by the governor. Senate Bill 604, which addressed centralized prescription processing was also found favorable by the House and Senate and signed into law by the governor. The rescheduling of Carisoprodol (Soma®) also took place during her time in office. This was addressed by the FPA House of Delegates twice and finally implemented in July 2002 when Governor Jeb Bush signed Senate Bill 351 making Carisoprodol a scheduled IV controlled substance. Ms. Marcus displayed great commitment during her time in office and was successful at reaching the goals she set for the association.

Theresa Tolle, 2003 Theresa Tolle set a goal for herself to become FPA president and 12 years later that goal became a reality. She served as president during the 20 03 -20 04 ter m. Her journey as president began by reminding her colleagues of the importance of unity and operating as a team. “Together Everyone Achieves More” was the slogan she chose to promote teamwork among all pharmacists in the state. She welcomed the thought of collaborating with other pharmacy or-

Theresa Tolle set a goal for herself to become FPA president and 12 years later that goal became a reality. She served as president during the 2003-2004 term. ganizations to advance the practice of pharmacy. Mrs. Tolle also stressed the importance of building healthy relationships with colleagues, the Legislature, co-workers and especially patients. She believed these relationships would be influential as they continued to advocate for the profession of pharmacy. Under her direction, the mission and vision statements were revised and a strategic plan was developed. With the help of volunteers, Mrs. Tolle worked extremely hard to tackle the issues that pharmacists were most passionate about. Senate Bill 2084, Requirements for Legible Prescriptions, was passed into law. This bill explained that a prescription must be legibly written or typed, making it easier for a pharmacist to read. It also defined what in-

formation must be present on a prescription in order for it to be valid in the state of Florida. The Association also partnered with Medicaid to pilot the Quality Related Events Program. The FPA collaborated with nursing associations in an effort to pass legislation on Senate Bill 1697, which would allow licensed pharmacists to provide immunizations. While this bill was objected to by the medical associations and ultimately did not pass, it did lay the groundwork for future successful campaigns on this issue. Senate Bill 1294, Automated Pharmacy Systems, was also passed during Mrs. Tolle’s leadership. While there were some issues in this bill on automation that were not supported by FPA, there were revisions to the bill that made it a violation for the use of certain pharmacy-related terms if a person is not licensed as a pharmacist. That language was supported by the FPA. Mrs. Tolle continued to urge volunteers to work as a TEAM going forward. Kathy Petsos, 2005 K at hy Pe t s o s wa s honored to serve as FPA president during the 2005-2006 term. She steered her presidenc y wit h t he Kathy Petsos theme “Focus on Your Future,” encouraging her colleagues to focus not only on their professional future but also the future of the profession of pharmacy. Under her leadership, there were several goals set for the 2006 legislative session and she, along with member and leadership volunteers, worked diligently to accomplish these goals. The No. 1 priority on the legislative agenda was regulation of Pharmacy Benefit Managers but, although volunteers worked tirelessly, the legislation failed to pass due to intense lobbying from a well-funded PBM industry. Two other issues that were important to Mrs. Petsos’s administration were to advance and protect the profession of pharmacy by allowing pharmacists to immunize and the regulation of pharJULY 2005

2005-06 FPA PRESIDENT

macy technicians. Although the debate was very lively, Senate Bill 570, Pharmacist Immunization Services, continued to be opposed by the medical associations and did not pass legislation. Senate Bill 1340, Pharmacist Technician Credentialing, was heavily opposed by the Florida Retail Federation and died in Senate committee. The association advocated against the proposed pharmacy common database law that would have created significant liability for pharmacists involved in load-leveling dispensing programs. This was successful due to the defeat of Senate Bill 1838. The association did however continue to work on compromise language. The association also argued successfully against House Bill 1167 (Sexual Predator Legislation) that would have required pharmacists to consult a sexual predator database prior to dispensing erectile dysfunction drugs. The association believed this was not within the scope of practice of the profession of pharmacy, and this bill not pass. Although some other pharmacy issues did not pass, Mrs. Petsos and her leadership team worked extremely hard fighting for and against challenging issues and had a successful year. The groundwork was laid for the ultimate passage of pharmacist immunization services the next year. Karen Whalen, 2009 Karen Whalen had the privilege to serve as FPA president during the 2009-2010 year. She launched her presidenc y wit h t he t heme “Collaboration is Key.” Dr. Whalen believed that in order for the association to experience continued success, members must collaborate as pharmacists and with other professional entities to make a difference in the profession of pharmacy. Directed by her leadership team, the mission and vision statements as well as the strategic plan of the association were revised. Dr. Whalen worked with volunteers to increase membership MARCH 2015

and retention of the association. Visiting different college campuses, she was able to register approximately 200 recent graduates. She even conducted student focus groups in order to gather ideas about how FPA could better meet the needs of student members. Dr. Whalen and her team were determined to address the issues that were considered most important during the legislative session, which included regulation of Pharmacy Benefit Managers, Medicaid appropriations and fundraising for pharmacy schools. Federal health care reform issues that were monitored by FPA included pharmacy benefit transparency in health exchanges. This would have leveled the playing field between mail order and community pharmacy by encouraging plans to hold PBMs accountable. Pharmacist-delivered Medication Therapy Management services was also monitored. This bill included a grant program that would help test new medication management strategies to reduce the budget associated with inappropriate therapy and non-compliance. House Bill 5001, General Appropriations Bill (Medicaid Mail Order), was passed which allowed chronically ill patients to receive prescriptions via mail. This issue was ultimately challenged by the FPA with a favorable outcome. House Bill 5201 was passed, which authorized a doctorate of pharmacy program at the University of South Florida. Dr. Whalen, with the collaboration of FPA leadership and other health care professions, made a positive impact on the profession of pharmacy. Suzanne Kelley, 2014 As I write this article, Pensacola pharmacist Suza n ne Kel ley i s Suzanne the seventh womKelley an to serve and is the current president of the Florida Pharmacy Association. Mrs. Kelley has been working diligently within the organization with plans to continue to expand the profession as president of FPA. Upon taking office she advised pharmacists, “It’s The Official Publication Of The Florida Pharmacy Association JULY 2014

2014-2015 FPA PRESIDENT

FLORIDA PHARMACY TODAY

time to be passionate about the profession of pharmacy.” She said the profession of pharmacy is changing regularly, and we want pharmacist to use these changes to improve their role in the health care system. Mrs. Kelley encouraged pharmacists to celebrate American Pharmacist Month by taking time to get involved so that others will understand how pharmacists do make a difference. Under her direction, the association’s main focus during the current legisla-

As I write this article, Pensacola pharmacist Suzanne Kelley is the seventh woman to serve and is the current president of the Florida Pharmacy Association. tive session is to obtain provider status and approve legislation allowing interns to immunize. She knows this cannot be accomplished alone, therefore she is urging all pharmacy professionals to take part in the movement of the profession of pharmacy by finding their passion. Whether it is volunteering to make phones calls to legislators, helping at the annual health fair or making a monetary donation it is going to take a collaborative effort to continue to improve the profession of pharmacy. Women have become a dominant force in the profession of pharmacy and they are continuously working to improve the image of pharmacists as health care providers. We are grateful for their untiring efforts to advance the profession of pharmacy in an everchanging health care system. n References

“AACP - AACP Resources.” AACP Discover, Learn, Care: Improve Health. N.p., n.d. Web. 2 Feb. 2015. Harris, Betty. “The State of the Florida

Pharmacy Association: The Choice is Yours.” Florida Pharmacy Today 54.12 (1991): 5, 24. Print. Jackson, Michael. “2005 FPA Advocacy Efforts.” Florida Pharmacy Today 68.7 (2005): 17-19. Print. Jackson, Michael. “2010 Another Important Session for Pharmacy.” Florida Pharmacy Today (2010): 7-8. Print. Jackson, Michael. “2010 Legislative and Regulatory Report of FPA.” Florida Pharmacy Today 73.6 (2010): 9-19. Print. Jackson, Michael. “Bold New Ideas and Reality.” Florida Pharmacy Today 62.6 (1999): 7-11. Print. Jackson, Michael. “How Pharmacy Fared in the 2006 Legislative Session.” Florida Pharmacy Today 69.6 (2006): 12-19. Print. Kelley, Suzanne. “American Pharmacist Month is Worth Celebrating.” Florida Pharmacy Today 77.9 (2014): 5-6. Print. Kelley, Suzanne. “It’s Time to be Passionate about the Profession of Pharmacy.” Florida Pharmacy Today 77.7 (2014): 5-6, 8. Print. Marcus, Joy. “The Calm Before the Storm.” Florida Pharmacy Today 64.8 (2001): 5, 8. Print. Marcus, Joy. “Unity and Persistence.” Florida Pharmacy Today 65.6 (2002): 5, 18. Print. Marcus, Joy. “You Mold This Ship.” Florida Pharmacy Today 64.7 (2001): 5-6. Print. Nichols, Becki. “An Exceptional Year.” Florida Pharmacy Today 62.6 (1999): 5, 33. Print. Nichols, Becki. “From the Grass Roots Up.” Florida Pharmacy Today 61.8 (1998): 5. Print. Nichols, Becki. “Health and Healing.” Florida Pharmacy Toda 61.10 (1998): 5. Print. Petsos, Kathy. “Focus on Your Future.” Florida Pharmacy Today 68.7 (2005): 5-6, 8. Print. Tolle, Theresa. “Are You Motivated Yet?” Florida Pharmacy Today 69.2 (2006): 5-6. Print. Whalen, Karen. “FPA-A Year in Review: Accomplishments Attained Through Collaboration.” Florida Pharmacy Today 73.7 (2010): 5-9. Print. Wisniewski, Ken. “Legislative Update: 2009-2010 Have You Heard?” Florida Pharmacy Today 72.10 (2010): 5-6, 22. Print.

FLORIDA PHARMACY FOUNDATION

FUNDRAISER 2015 Honda Fit WHEN: WHERE: TIME: COST:

*Picture for illustration purposes only.

June 27, 2015 Florida Pharmacy Association Annual Meeting Renaissance Resort at World Golf Village 500 Legacy Trail • St. Augustine, Florida 32092 7:00 PM - 10:00 PM $100.00 per ticket (You must be 18 years or older to purchase)

The proceeds will benefit the mission of the Florida Pharmacy Foundation, which provides scholarships and other resources to pharmacy students and pharmacists throughout the state.

PAYMENT INFORMATION 2015 Honda Fit: $100 Per Ticket Check enclosed for _____ tickets, in the amount of $_________, made payable to the Florida Pharmacy Foundation. Please charge my:  Visa  MasterCard

______ Tickets, in the amount of $_____________________

Card Number __________________________________________ Exp. Date ___________ Security Code _______ Signature ______________________________________________________________________________________ Signature Printed ________________________________________________________________________________ Name __________________________________________________________________________________________ Address ________________________________________________________________________________________ City ____________________________________________ State _______________ Zip _____________________ Email ___________________________________________ Fax ___________________________________________ Work Phone _____________________________________ Home Phone ___________________________________ This event is sponsored by the Florida Pharmacy Foundation to benefit the Florida Pharmacy Foundation. Picture for illustration purposes only. All tickets as described below will be entered into the drawing for the 2015 Honda Fit no later than 4:00 p.m. June 27, 2015 at Renaissance Resort at World Golf Village, 500 Legacy Trail, St. Augustine, FL 32092. All entrants must be 18 years of age or older. Entry ticket holders need not be present to win; a winner who is not present will be notified by mail, phone and/or email. The Florida Pharmacy Foundation will receive any contributions in excess of the wholesale cost of the Honda. All taxes are the responsibility of the prize winner. Odds of winning depend on the number of entries received. The winner will be selected at random from eligible ticket entries. The drawing is governed by Florida law. The Florida Pharmacy Foundation reserves the right to limit the number of tickets distributed to each drawing entrant. The drawing is not conditioned upon disbursing a minimum number of tickets or on receiving a minimum amount of contributions. Neither the Florida Pharmacy Foundation nor Proctor | Honda of Tallahassee has any responsibility for incorrect, incomplete or illegible information on tickets; if a winner cannot be readily identified or located (as determined by the Florida Pharmacy Foundation), an alternative entry ticket will be drawn within 30 days of the initial drawing. By accepting a prize, the winner consents to the publication of his or her name and likeness as the winner of the prize. Winner is responsible for all state and local fees including tax and title. According to federal law, the price of the entry ticket is not tax deductible. Applicable federal income tax must be paid in order to receive the prize. No substitutions allowed. Void where prohibited or restricted by law. No purchase or contribution is necessary to win; such tickets may be obtained by written request only, stating “No Contribution - Florida Pharmacy Foundation Fundraiser,” mailed along with a stamped, addressed, business sized return envelope to 610 North Adams Street, Tallahassee FL 32301, and limited to one ticket per person. The individual in whose name entry is to be made must make the request; requests by one individual for another for “no contribution” entries are not eligible. “No contribution” tickets must be completed and received before Entry Cutoff. “Entry Cutoff” is three (3) hours before the drawing on the day of the drawing. All entries must contain name, mailing address, and phone number and must meet the criteria described above to be valid. The prize has been derived, in part, from donations to the Florida Pharmacy Foundation. A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling 1-800-435-7352, toll-free within the State of Florida. Registration does not imply endorsement, Approval, or recommendation by the State of Florida.

Florida Pharmacy Foundation | 610 N. Adams St, Tallahassee, FL 32301 | (850) 222-2400 | Fax (850) 561-6758

Volunteer Pharmacists and Pharmacy Students Visit Over 400 pharmacy students and pharmacists from all over Florida visited the Capitol to participate in a health fair event and legislative day rally. Activities included visits into the House chamber and the old Capitol museum as well as attending hearings on three pharmacy bills scheduled on Tuesday. A briefing session took place on the campus of Florida A&M University where participants were welcomed by Dr. Thomas Fitzgerald, Professor and Interim Associate Dean for Academic Affairs for the College of Pharmacy. The FPA extends sincere thanks to the administration, faculty and staff of FAMU for hosting both the Pizza and Policy gathering and the legislative briefing sessions.

FLORIDA PHARMACY TODAY

t Florida Capitol

MARCH 2015

Campus Corner BY MICHAEL RPH BY MOHAMMED ABDULWAHHAB, PHARMD.JACKSON, CANDIDATE C/O 2015, FORMER FPA INTERN

Prescription Pain Medication Access Painful to Watch, Painful to Solve Many patients who are affected by pain can attest to the difficulty of obtaining pain medications and the hoops they have to go through. Pharmacists have responsibility to ensure the appropriateness of each prescription and assess the need for therapeutic interventions. However, some of our colleagues are not comfortable dealing with pain management issues for some patients. While some patients do exhibit drug-seeking behaviors, most are legitimate pain patients. It is unfair for those who are prescribed pain medications to suffer because our health system, enforcement agencies, prescribers and pharmacists are struggling to find ways to address this issue. Prescribers of these medications go through rigorous training to be able to adequately diagnose and prescribe medications for patients. As such, they should be held responsible when they prescribe drugs that are not medically indicated for patients. Some prescribers argue that they know the pharmacist will not fill the prescription, yet they prescribe it anyway. I personally encountered that during my internship at a pharmacy where the physician wrote a prescription for 180 count of oxycodone 10 mg. As per protocol, I called the physician to further verify the prescription as it seemed unconventional. The physician’s nurse stated that the prescriber knew that no pharmacy would fill it as written. The intention was to get the patient out of the clinic. Does this not break some form of ethics? The clinic charged the patient or his insurance an office visit fee, yet there was no medically necessary reason for the visit. Why must pharmacists be the

Prescribers of these medications go through rigorous training to be able to adequately diagnose and prescribe medications for patients. As such, they should be held responsible when they prescribe drugs that are not medically indicated for patients. 14

FLORIDA PHARMACY TODAY

regulator of prescribers’ medication choices? While it is not a common phenomenon, it does make the pharmacist’s job more difficult. A recent resolution passed in the American Medical Association (AMA) House of Delegates states that the AMA “deem[s] inappropriate inquiries from pharmacies to verify the medical rationale for prescriptions, diagnoses and treatment plans to be an interference with the practice of medicine and unwarranted.” The AMA also stated that it will “advocate for legislative and regulatory solutions to prohibit pharmacies and pharmacists from denying medically necessary and legitimate therapeutic treatments to patients.”1 Contrary to the AMA’s resolution, pharmacists are required to verify the legitimacy of each prescription to ensure safe and efficacious medication use and that the prescription meets the DEA criteria for use.2 Why would an organization change a system that was set to ensure checks and balances and ensure optimum patient care? Some prescribers ignore the fact that the best way to treat pain is by multimodal approach. Medications such as ibuprofen, acetaminophen and tramadol act on different aspects of pain and allow for decreased opioid use. Studies also have shown that yoga, meditation, acupuncture and other nonpharmacological methods help alleviate chronic pain for patients and are avenues that often go unexplored.3 It is an area in which pharmacists can play an enormous role in regard to optimizing pain management and assisting in exploring nonpharmacological treatment. Pharmacists rarely refuse to fill non-opioid prescriptions, even if they deem them to be medically unnecessary. Pharmacists sometimes try to avoid having to call the prescriber and wait for a response as it impacts workflow and resources stretched to maximum limits. Referral to another pharmacy to fill the opioid prescription in light of any doubt is the easiest approach for a pharmacy to take. By sending our patients from one pharmacy to the next, we make our patients agitated and leave their pain uncontrolled. Patients may be forced to travel to pharmacies that are far from their homes to fill their opioid prescription. The combination of distance and agitated behavior are considered signs of drug–seeking behavior, which may lead to the pharmacy refusing to treat the patient. Recently, a chain pharmacy came under fire after their opioid dispensing checklist was made available to the pub-

lic. This list attempted to standardize their opioid dispensing policy in response to a settlement with the DEA. Such measures were meant to decrease non-medically necessary opioid dispensing, but ended up decreasing access by patients who desperately needed these medications.4 Pharmacists are the most scrutinized healthcare profession by the regulatory agencies, thus pharmacists are more conscientious when filling opioid prescriptions. The problem is that a pharmacy accepts opioid prescriptions from multiple prescribers. Thus, when an investigator from a regulating agency examines the pharmacy records, they are likely to find at least one record error as grounds for an arm-twisting session. According to George F. Indest III, a lawyer at Health Law Firm in Orlando, investigators go as far as asking pharmacists and physicians to relinquish their license immediately, even prior to starting an investigation.5 They threaten pharmacists that if they do not comply, the investigator will recommend a federal investigation against them. His law firm has represented at least 10 pharmacists and physicians in Florida who have relinquished their DEA registration voluntarily under pressure. A $2 million inventory was seized from one pharmacy when they relinquished their DEA registration as the pharmacy could not have scheduled substances without a DEA number. Mr. Indest advises not to give your license or DEA registration, but rather to call a lawyer immediately. It is the prescriber and the pharmacist’s right to call a lawyer even though in many cases they inform you that you are not allowed to do so.6 Under Florida Statute 499.0121.15.B the number of scheduled opioid medication units that a pharmacy can order is limited to 5,000 per month; unless the supplier takes certain procedures to ensure that these medications are properly used.7 Suppliers may lean on the side of caution and refuse to ship more than 5,000 units monthly. A survey by the National Community Pharmacists Association (NCPA) showed that approximately 75% of pharmacies have experienced three or more delays in obtaining an opioid medication shipment and that 60% of these pharmacies had to turn patients away due to the delay. These delays, on average, impacted 55 patients per pharmacy.8 The DEA cited physicians and pharmacists for these shortages. “We’re not doctors. We’re regulators and enforcers of the law. If something is prescribed for a legitimate medical purpose, we’re certainly not going to get in the way,” DEA spokesman Rusty Payne told the National Pain Report. He also stated, “If a pharmacy chooses not to fill a prescription for someone, that’s their decision. It’s not the DEA’s decision.”9 A recent report from the Government Accountability Office (GAO) indicated that the DEA has contributed to a noticeable shortage of prescription drugs regarding controlled substance. They have done so by delaying the response to manufacturing quota processes. In this case, the manufacturers cannot increase the production of controlled substances to meet the increasing demand.10 Current regulations in Florida Statutes 499 require prescription drug suppliers to evaluate pharmacy businesses that exceed a certain threshold of dosage units that are ordered. This

...approximately 75% of pharmacies have experienced three or more delays in obtaining an opioid medication shipment and that 60% of these pharmacies had to turn patients away due to the delay. could create temporary shortages limiting quantities of opioid medications such that the supply may be scarce. The pharmacy usually has their own pre-established chronic pain patients. Thus, if a patient comes in with acute pain that requires treatment for a few weeks with frequent dosing, the pharmacist will not be able to fill that prescription. Pharmacies prefer to keep an adequate inventory of medications for patients who come in regularly to ensure the continuum of care. Although it is the duty of enforcement agencies to crack down on opioid drug misuse and abuse, they should also work with the provider community to improve access for legitimate pain patients. Enforcement agencies tend to focus on opioid script count and ratios rather than patient cases and the clinician’s professional judgment. The system must be restructured to help decrease abuse and help alleviate the burden of obtaining opioid medications for a legitimate diagnosis. Insurance companies also play a role in restricting patient access to opioid medications. Many of them charge high copays or do not cover long-acting opioid medications. Such policies force the pain management providers to prescribe immediate release medications. In clinical practice, pharmacists follow the mantra that immediate release opioid formulations increase the chances of addiction and do not provide sustained pain control.11 Requiring insurance companies to cover long-acting opioid agonists coupled with prescriber education would enhance access and improve patient pain control. It is much easier to obtain a prescription for an immediate release opioid to be used sparingly in supplement to a long-acting opioid medication that provides around-the-clock pain control. There are other ideas and policies that could positively impact the system and ensure that our patients who are in pain receive the best care that can be provided. Some within the presciber community may feel that a prescription issued is a prescription that should be filled with no questions asked. If this is the case, would the prescriber be comfortable with carrying 100% of the liability and responsibility or should that be shared with a pharmacist who is the last line of defense in patient care. This will ensure that each prescription is medically necessary rather than blame the pharmacist exclusively for filling them. Another idea is to include a diagnosis code on the prescription to allow the pharmacist to further evaluate the prescription. This would not break any HIPAA (Federal Health Insurance Portability and Accountability Act) laws. An alternative to a written diagnosis codes is to allow the pharmacist to remotely access patient records. This will allow MARCH 2015

for correct assessment of the patient for the right medication, regimen, dose, route and direction. This intervention will allow for verification in a timely manner. Instant verification is efficient, safe and does not break any state or federal HIPAA laws. During my time working in a homeless clinic, the community pharmacy had access to all patient records, leading to decreased call volume in verifying prescriptions and other medically related concerns. While scheduled substances were not prescribed at the clinic, it was still an innovative pilot program with great success. This idea is also supported by the former president of The American Society of Pain Medicine, Dr. Lynn Webster.12 Collaborative practice agreement between prescribers and pharmacists is an area that is underutilized. Collaborative practice positively impact patient outcomes and improve patient care. Collaborative agreements also allow the pharmacy to set practice protocol that holds the prescriber, the pharmacist and the patient equally accountable for the care provided. Such a model will give pharmacists autonomy and allow them to take ownership of their patient care. Collaborative practice doesn’t only protect the three entities, but also ensures that the patient knows that seeking other pain management doctors will result in dismissal from the program and possible legal repercussions. From a regulatory standpoint, all the enforcement agencies need to revamp their policies about addressing opioid access issues. They need to focus on drug diversion and suspected fraudulent activities, not questioning the judgment of health

Representing Health Care Professionals

• DOH Investigations • Licensure Discipline • Medicare/Medicaid Defense • Administrative Hearings • Contract Litigation George F. Indest III, J.D., M.P.A., LL.M.

1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com

FLORIDA PHARMACY TODAY

care professionals who hold doctorate degrees and are specialized in ensuring optimum patient care and disease state management. The solutions discussed in this article could possibly improve patient access, clinical outcomes, patient satisfaction, and ultimately decrease prescription opioid abuse. These ideas are not radical and have already been utilized in some settings such as the Unites States Public Health Service and the Veterans Affairs Health-System. The policies in place now are inhibiting the practice of medicine and are negatively affecting patient access. Absent a change in policy, access to medications and health care provider fear of sanction will not subside. We need to help our patients and ensure that they receive the care they most certainly deserve. References

1 Houck, L. (2013, 6 13). AMA Tells Pharmacists: “Don’t Call Us We’ll Call You.” Retrieved from FDA Law Blog: http://www. fdalawblog.net/fda_law_blog_hyman_phelps/2013/06/amatells-pharmacists-dont-call-us-well-call-you-.html 2 DEA. (2010, 3 31). tle 21 Code of Federal Regulations. Retrieved 3 16, 2015, from US Department of Justice Durg Enforecment Agency Office fo Diversion Control : http:// www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_05.htm 3 Pain Management Guidlines. (2005, 1 18). Retrieved from Agency For Healthcare Research and Quality: http://www. guideline.gov/content.aspx?id=9744 4 Anson, P. (2013, 9 25). Walgreens’ ‘Secret Checklist’ for Pain Meds. Retrieved from National Pain Report: http:// nationalpainreport.com/walgreens-secret-checklist-painmeds-8821775.html 5 George F. Indest III. (2015, 3 13). http://www. thehealthlawfirm.com/blog/posts/does-the-dea-useintimidation-tactics-to-force-doctors-and-pharmacists-to-giveup-their-dea-number.html. 6 George F. Indest III. (2015, 3 13).(M. Abdulwahhab, Interviewer) 7 The 2014 Florida Statutes. (2014). Retrieved from Online Sunshine: http://www.leg.state. fl.us/statutes/index.cfm?App_mode=Display_ Statute&URL=0400-0499/0499/0499.html 8 NCPA Controlled Substances Access Survey Results. (2014, 1). Retrieved from National Community Pharmacists Association: http://www.ncpanet.org/pdf/survey/2014/controlledsubstances-access-survey.pdf 9 Lowery, M. (2014, 2 3). DEA official blames pharmacists, doctors for pain-med denials. Retrieved from Modern Medicine Network: http://www.drugtopics.modernmedicine. com/drug-topics/content/tags/cardinal-health/dea-officialblames-pharmacists-doctors-pain-med-denials?page=full 10 Silverman, E. (2015, 3 11). DEA Contributes to Shortages of Drugs With Controlled Substances: Report. Retrieved from The Wall Street Journal: http://blogs.wsj.com/ pharmalot/2015/03/11/dea-contributes-to-shortages-ofdrugs-with-controlled-substances-report/ 11 Dipiro, J. (8th edition ). Pharmacotherapy. New York: McGraw HIll. 12 Webster, D. L. (2013). New Policing Role for Pharmacists Undermines. Retrieved from The American Academy of Pain Medicine: http://www.painmed.org/files/presidentsmessage-2013-volume14-11.pdf

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MARCH 2015

FPA Member Profile Jonathon M. Hickman

THE STATS Hometown: Tallahassee, Florida Employer: Walgreens What do you value most about your FPA Membership?

The ability to collaborate with other pharmacists across different practice settings, both as a mentor and as a person who is looking to be mentored. Also, serving on the GAC has given me a role of advocacy for the entire profession, and I have really enjoyed speaking for and representing my peers.

What are some thoughts you have on pharmacy as a profession right now?

I believe our profession has a unique challenge across all practice settings that is going on right now. It seems that as a profession we are faced with proving our collective value to the health care system. Pharmacists must unite to show/prove/explain our role and value to the future of health care in the United States. We must fight to protect and expand our services as practitioners. We must show our knowledge to third-party payers and demand fair and accurate reimbursement for all our goods and services. We need to educate and mentor the future pharmacists who are entering the job market on what the profession has been and what it â&#x20AC;&#x153;could beâ&#x20AC;? in the future. We need to continue to provide the best, most compassionate and accessible health care expertise to our patients so we can continue to be the most trusted profession in America.

What are you most excited about regarding the future of pharmacy?

Quite simply, it is the possibility that pharmacists may soon be associated with the health care expertise and value that we bring to our patients as well as the products we provide.

What do you wish everybody knew about pharmacy?

I wish they knew more about the intensive level of education and knowledge that pharmacists gain in school, practice experience and continued education in the workplace. Pharmacists contribute to all health care practice settings including: community practice, specialty health care, industry, sales, marketing, education, government, hospitals and research and development,

What got you interested in pharmacy in the first place?

I wanted the ability to be on the forefront of patient care in a respected health care profession and the unique flexibility for multiple opportunities in the workplace that our degree provides.

What do you think your patients would say about you and your practice?

They would say that Walgreens, and in particular our store, practices at the highest level of our profession. I am extremely proud that my pharmacy offers prescriptions, in-depth counseling, MTM services, travel health, immunizations, health testing, HIV expertise, Medicare and other third-party expertise. These services are provided 100% by pharmacists and offered 24 hours a day. It requires amazing pharmacists, great management, dedicated technicians and total buy-in by the entire team. All of these health care offerings are provided with the highest level of customer service and patient care.

What is the most humorous thing that has ever happened to you?

The Florida Relay Service is an amazing and compassionate tool for those patients in our state who are

FLORIDA PHARMACY TODAY

FPA Member Profile, continued

hearing impaired. It is designed to act as a third party go-between for health care practitioners and hearing-impaired patients. It works a little bit like this: a hearing-impaired patient connects via a computer to a Relay employee and types their message to the pharmacy. Then the Relay personal reads the message and actually speaks those typed words to the pharmacy on the phone. The pharmacy employee then speaks back to the Relay service and they type the message back to the hearing-impaired patient. This interaction continues back and forth until the call/message is complete. It usually takes a few minutes but tends to work well. I once had the distinct pleasure of being â&#x20AC;&#x153;blessed outâ&#x20AC;? by a patient via the Relay service. The patient had come to our attention from both our staff and their doctor as being a recognized drug seeker. As I struggled to explain to this patient we would not be refilling their cocktail of controlled medicines early, I was hit with a barrage of anger and semi-foul language all read dispassionately and professionally to me by the poor Relay operator who was stuck trying main-

In Memoriam: Maita Post Singer I regret to inform you that we have learned of the passing of FPA past treasurer Maita Post Singer of Tallahassee, Florida. Maita has been an active member of the Florida Pharmacy Association for many years and is a retired Winn Dixie pharmacist. She is a graduate of Florida A&M University. Below is information published in the New York Times. Singer--Maita Post Passed away on February 5. Born in Brooklyn in 1940, she was a respected pharmacist and beloved member of the Tallahassee community. She is survived by two children, Richard Singer and Bonni Etherton; three grandchildren, Joshua, Jonathan and Carson; her brother and sister-in-law, Martin and Amy Post; and her mother, Sarah Post. Donations may be made to Temple Israel, 2215 Mahan Drive, Tallahassee, FL, 32308.

tain some semblance of professional courtesy and still read the angry words coming across his screen. What made it even more hilarious is both the operator and myself could really sense the anger and venomous intent from the words the patient was pounding into his computer; however the sheer absurdity of the operator having to read it and then speak it to me had us both in stitches. We both began to laugh as the tirade continued to gain momentum from the patient, but neither of us could figure what to do to end the call. I could not find it in myself to get angry back because of the sheer craziness of the situation; even though the patient was getting pretty riled up and ugly. Eventually, the operator and I agreed to just hang up the call but not before we both were laughing so hard we were almost in tears. In my 16 years of being a pharmacist, that is the most creative dressing down I have ever received, and on the off-day when a patient may be giving me a hard time in person or on the phone, all I have to do is remember that conversation and I instantly smile and laugh inside.

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FPA News & Notes

Donovan Speaks at CFPA On March 17, Jackie Donovan made a presentation to the Central Florida Pharmacy Association and discussed the benefits of membership in our state Association, 2015 legislative updates, the importance of political giving and getting involved from a legislative standpoint, and offered an invitation to attend the Annual Convention. From left: CFPA Officers Cuca Rosado, Jennifer Weader, Erin St. Onge, Raul Correa, Jackie Donovan (guest speaker), Linda Lazuka and Sabrina Callahan.

Winner 2015 FPA Student Leadership Scholarship Matthew Schneller, pictured with FPA Chairman of the Board Terry Gubbins, receives the 2015 FPA Student Leadership Scholarship. This prestigious award recognizes Matt’s volunteer work with FPA, involvement in school and community activities and his demonstrated sense of passion to the profession.

FLORIDA PHARMACY TODAY

Matthew is a third year student pharmacist at the University of South Florida. Raised in Wisconsin, he moved to Tampa to attend pharmacy school and to live in a large city with an underserved population in health care. He regularly volunteers his time at Bridge, which is a free clinic, educating and counseling patients on drug-related issues. Matt plans to combine his passions for pharmacy and politics in the future and hopes to become a lobbyist where he can advocate for quality health care. University of Florida Pharmacy Students Win FPPC Challenge For the second year, students from our state’s pharmacy schools have been proactive in supporting the work of our polit ical committee. The Florida Pharmacist Political Committee Board of Directors include Mark Hobbs as Chair, Theresa Tolle as Treasurer, Kim Jones as Vice Chair, with board members Thomas Cuomo, Humberto Martinez, Preston McDonald, Ken Wisniewski and student member Ashley Huff. Last fall, each campus was challenged to help raise funds to build the FPA political committee war chest. Participating schools include PBA (2nd place), FAMU (3rd place), LECOM (4th place) and USF (5th place). This year’s winner are the student advocates from the University of Florida College of Pharmacy. Pictured is Jason Hoffmann accepting the award for UF.

CALL FOR ABSTRACTS FOR POSTER PRESENTATIONS For Florida Pharmacy Students

FLORIDA PHARMACY ASSOCIATION 125th ANNUAL MEETING AND CONVENTION

June 24-28, 2015 Renaissance World Golf Village Resort ♦ St. Augustine, Florida Poster Session: Friday, June 26, 2015 ♦ 11:00AM-1:00PM

The FPA Poster Presentations are open to PHARMACY STUDENTS ONLY. Complete and submit this COVERSHEET for each abstract submission. Submissions must be received no later than Friday, May 1, 2015. Abstracts will NOT be accepted after this date. Mail or E-mail this application along with the abstract submission to: Tian Merren Owens, MS, PharmD, Director of Continuing Education Florida Pharmacy Association 610 N. Adams Street Tallahassee, FL 32301 tmerren@pharmview.com

PLEASE TYPE

Contact Information: Presenter's Name (MUST BE A STUDENT):________________________________________________________________

□Entry Level Pharm.D. □ Post B.S. Pharm.D. Address: ________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________ Telephone No: _____________________E-Mail Address: _________________________________________________ Abstract Title: ____________________________________________________________________________________ Poster Type:

□Clinical Research □Basic Science Research □Translational Research (Basic Science and Clinical Research)

Primary Author: __________________________________________________________________________________ (Students must be listed first to be considered for the Award. Presenter will be notified by mail of acceptance). Co-Author(s): _________________________________________________________ Student

□YES □NO

Awards:

Posters will be eligible for 1st, 2nd, and 3rd place prizes to be presented at Convention. (Only one prize is given for each winning poster)

Free Registration:

Three entry level students from each Florida College of Pharmacy will be eligible for a complimentary Florida Pharmacy Association Convention Student registration. (Student Registration does not include CE or hotel accommodations) I am interested in being considered for this registration:

College:

□YES

□NO

_____________________________________________________________________________

ABSTRACT FORMAT The abstract form submitted should be the equivalent of one page. The abstract should include: Title (Include authors’ names and name of College of Pharmacy), Purpose, Methods, Results, and Conclusions. Abstracts will not be accepted if it is not in this format. Do not include figures or graphs.

Please direct all questions and concerns to:

Tian Merren Owens ♦ (850) 222-2400 ext. 120 ♦ tmerren@pharmview.com DEADLINE DATE: FRIDAY, MAY 1, 2015

S AV E

T H E D AT E â&#x20AC;&#x201D; J U N E

24-28, 2015

125th Annual Meeting and Convention of the Florida Pharmacy Association Renaissance World Golf Village Resort

500 South Legacy Trail St. Augustine, Florida 32092 For room reservations call (800) 468-3571

JUNE 24-28, 2015 Florida Pharmacy Association 610 North Adams Street Tallahassee, Florida 32301

Phone: (850) 222-2400 Fax: (561) 6758 www.pharmview.com

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NETWORK WITH COLLEAGUES

The Florida Pharmacy Association (FPA) is accredited by the Accreditation Council of Pharmacy Education as a provider of continuing education. The FPA is also a Florida Department of Health approved provider of continuing education and reports to CEBroker

Florida Pharmacy Association’s 125 ANNUAL MEETING AND CONVENTION Renaissance World Golf Village Resort, St. Augustine, FL June 24-28, 2015 th

Room Rates: $129 single/double occupancy for standard deluxe room. The room reservation deadline is Monday, June 1, 2015 or when room block is full. Thereafter, reservations may be taken on a space available or rate available basis. Please be sure to ask for the Florida Pharmacy Association group rate. All reservations must be accompanied by a first night room deposit or guaranteed with a major credit card. A deposit is refundable only if Hotel receives cancellation at least 72 hours prior to arrival. The check-in time is 4:00pm and the checkout time is 11:00 am. Room reservations can be made by calling (800) 266-9432. Guest self parking is complimentary. Valet parking is $10 per day/night.

Keynote Speaker:

JOHN H. ARMSTRONG, MD, FACS, was appointed by Governor Rick Scott as Surgeon General and Secretary of Health for the State of Florida on April 27, 2012. A graduate of Princeton University, the University of Virginia School of Medicine and the US Army Command and General Staff College, Dr. Armstrong believes that education and training are drivers for change. Dr. Armstrong came to the Florida Department of Health having previously served as the Chief Medical Officer of the USF Health Center for Advanced Medical Learning and Simulation in Tampa, where he worked to bring health care professionals together through hands-on team training. General Education Track Thursday - Sunday The general education track will offer courses designed to educate pharmacists on a wide variety of important topics pertaining to the profession of pharmacy practice. Specific courses being offered are Reducing Medication Errors, HIV/AIDS, and the always-popular offering of Florida Legislative Update. There will also be a New Drug Update course which focuses on the most recently FDA approved drugs introduced into the market. Consultant Education Track Thursday- Saturday The consultant education track will provide pharmacists with the most current information available on various topics that pharmacists encounter in the profession of pharmacy. The specific topics being offered include Nutrition, Pain Management and Autoimmune Disorders. There are 15 hours available for consultant pharmacists. Student and Technician Track Thursday – Sunday Students and Technicians will benefit from interacting with practicing pharmacists and attending student and technician focused continuing education programs. The technician track offers several hours of continuing education on a variety of topics, including the required courses for Florida registration and PTCB renewal: Medication Errors, Pharmacy Law and HIV/AIDS for initial renewal. The student track consists of several hours of fun and exciting continuing education, such as The Career Forum and the NASPA/NMA Game Show. Students will also have an opportunity to participate in the Patient Counseling Competition and showcase their Poster Presentations. Pre-Convention Education Wednesday Only Our traditional Wednesday program will focus on Pulmonary Disorders. Pulmonary disease affects all age groups. Pharmacists play a vital role in the management and patient education of pulmonary disorders. The hands on program will focus on the most current information evolving in the area of pulmonary disorders. The program will offer 7 hours of live continuing education credit. Register for this outstanding program and walk away with valuable knowledge for you and your patients with pulmonary disorders. A separate registration fee is required for the pre-convention program. Special Events Exhibits: Participate in our grand opening reception in the exhibit hall! Poster Presentations: Browse submissions from pharmacy students. Contact the FPA office for more information if you would like to submit a poster presentation. Awards Ceremony Reception: Honor outstanding practitioners during the awards presentation. President’s Breakfast: Attend the Sunday morning installation of new officers. Receptions: Enjoy catching up with your colleagues as the Universities entertain their alumni and friends, and as the FPA Foundation host its Speedway Tailgater. House of Delegates: Be a delegate or observer and see how important member participation is to the direction of the Association. Student Events: Participate in the Adopt-A-Student Mentor Social and Volleyball Tournament. Students will benefit from interacting with practicing pharmacists, attending student focused continuing education programs and learning first hand about the FPA and how involvement can improve their chosen profession. Call the FPA office and offer to mentor or sponsor a student. FPPC Reception: Attend this reception to support your Political Action Committee. 5K FUN RUN/WALK: Exercise is good for the soul. Incorporate health and fitness while at the FPA convention. FPA Golf Event: Join us Friday for the FPA Golf Event. Please register early to reserve your space.

FPA 125h ANNUAL MEETING & CONVENTION June 24-28, 2015 INFO (850) 222-2400 MARCH 2015

FPA 125th Annual Meeting and Convention June 24-28, 2015  St. Augustine, FL

5 Pre Convention -

Participant Participant Information Information

Name: _____________________________________________________ Name: _______________________________________________ Mailing Address: _____________________________________ Badge Name: _______________________________________________ City, State, Zip: _______________________________________ Mailing Address: ____________________________________________ Phone: (W)Zip: _____________________________________________ __(H)___________________ City, State, Email: _____________________________________________ (H)_______________________ Phone: (W) License: PS______________ PU _____________RPT_________ Fax: ______________________________________________________ NABP License:e-profile#____________________ PS________________ PU_________DOB Other(MM/DD)_______ State___________

Full____________________________________________________ Package Registration—Excludes Box 5 2Email: Full package registration includes Educational Programs (ThursExhibit Hall, Awards Reception and President’s Breakfast. 2 Sun), Handbooks are not included in full package registration.

Handouts will be available on our website, www.pharmview.com, the week of June 22, 2015. Before May 29 After May 29 Amount_ $_______

Wednesday, June 24, 2015

PULMONARY DISORDERS

Before May 29 � FPA Member with Full Registration $75 � FPA Member $140 � Non Member with Full Registration $100 � Non Member $190

After May 29 $95 $160 $120 $210

Pulmonary disease affects all age groups. Pharmacists play a vital role in the management and patient education of pulmonary disorders. The hands on program will focus on the most current information evolving in the area of pulmonary disorders. Total Amount: $__________

Special Events Registration

The events listed below must be purchased individually and are not included in any other registration packages.

House of Delegates

(Non-convention registrants)

Quantity

Price

Amount

_________

@ $25

$_______

Reception _________ Special Events Registration 6FPPC (Complimentary event, indicate if attending)

@ N/C

FPA Member

$320

$405

Non Member

$500

$585

$_______

The events listed below must be purchased individually and are not Golf Event in any other registration _________ $_______ included packages. @ $150

Pharmacist BEST Value

$515

$600

$_______

Christian RPh Breakfast

Quantity _________

Price @ $40

Amount $_______

Member Technician

$145

$180

$_______

PharmPACCE Luncheon Student Luncheon

_________

@@$60 $45

$_______ $_______

Non Member Technician

$165

$200

$_______

Technician BEST Value

$175

$210

$_______

Student

$135

$_______

Guest (no CE)

$150

$_______

$40

N/A

$_______

Guest Name: Handbooks

3(BEST Value includes Registration & Membership) indicate below which functions you will attend. These 3 Please functions are included in the Full Package. If no boxes are

selected, we will assume you will not attend any of the events listed below. Full registration package includes one ticket to each of these events. Please see box 7 for additional tickets.



House of Delegates (Thursday)



Exhibit Hall (Friday and/or Saturday)

Awards Reception (Saturday)



4

#_______

Before After President’s Breakfast (Sunday) June 27 June 27  I will not attend any of these functions. FPA Member $140 $150

# Amount

Non MemberEducation Daily

$_______

$195 $225 Registration

________

Total Amount: $

_____

Additional Tickets

The following events ARE included in the Full Registration Package. However, you must purchase additional tickets for guests who are NOT registered. Quantity Price Amount

Additional Tickets 7Exhibit Hall

@ $30 $_______ The following events ARE included in the Full Registration Package. Awards Ceremony @for $80 However, you must purchase additional tickets guests who$_______ are NOT registered.Breakfast President’s @ $50 $_______ Quantity Price A_______ Total Amount: $_______ _____

Contributions (Make

Foundation).

check payable to FL Pharmacy



Adopt-A-Student Program



Foundation

8 9

$_______

Daily registration include admittance$60 to functions or Member Technician does not $40 $_______ handbooks. Handouts will be posted on our website June 22. Non Member Technician $55 $75 $_______ Before After May 29 May 29 Amount Handouts $30 N/A $_______ Please select the day(s) you will attend: FPA Member $165 $185 $_______ Thursday Friday Saturday Sunday Non Member $220 $240 $_______

___________

Amount: $_______ Total Amount: $

Convention Polo Shirt (Deadline is May 29, 2015) Quantity



Yes

Price

______ @ $35

Payment  Payment Check (To: FPA)

Amount: $_______

 Discover

M/F

______

Size

______

Amount $_______

Total Enclosed: $______ Enclosed:$Visa Total MasterCard

 Check#(To: FPA)  MasterCard  Visa  AMEX  Discover Account _______________________________________________ Account # ________________________________________________ Security Code _________________ Expiration Date ______________

Member Technician

$85

$105

$_______

SecurityAddress Code _________________ Expiration Date _______________ Billing ___________________________________________

Non Member Technician

$100

$120

$_______

Billing Address _____________________________________________ Signature _______________________________________________

Handbooks

$40

N/A

$_______

Please select the day(s) you will attend: Friday Saturday Thursday

FLORIDA PHARMACY TODAY

Sunday

Four Ways to Register

Mail: FPA, 610 North Adams Street, Tallahassee, FL 32301 Phone: 850-222-2400 Fax: 850-561-6758 Web: www.pharmview.com

florida BUYER’S GUIDE PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law 561-392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029 Rx Relief (800) RXRELIEF

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. MARCH 2015

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