The Official Publication Of The Florida Pharmacy Association NOV. 2016
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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 29 Buyer’s Guide
VOL. 79 | NO. 11 NOVEMBER 2016 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION
Features
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Opportunity Knocking Promote Adult Immunizations
Zika Retroactive Fees Wreaking Havoc on Community Pharmacies
2017 Election Ballot Information
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Mission Statements:
FPA Calendar 2016-17
NOVEMBER 24-25 Thanksgiving - FPA Office Closed DECEMBER 3-4
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FPA Regulatory and Law Conference Sarasota APhA Diabetes Certificate Program
13-14 Florida Board of Pharmacy Meeting 23 - 26 Christmas Holiday FPA Office Closed JANUARY 2
New Year Holiday FPA Office Closed
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Forward Your Profession Through Leadership Orlando
28-29 Clinical Conference Destin 31
Last day to submit election ballots
FEBRUARY 7-8
Florida Board Meeting Gainesville
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Award Nominations Due MARCH
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Legislative Session Begins
11-12 FPA Committee and Council Meetings Orlando 14-15 Health Fair and Legislative Days at the Capitol Tallahassee 24-27 APhA Meeting San Francisco, CA APRIL 14
Good Friday - FPA Office Closed
22-23 FPA Law and Regulatory Conference Grand Hyatt Tampa Bay
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. There is a new 2 hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2017 or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by December 31, 2016. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com
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............................... 25 KAHAN HEIMBERG, PLC............................... 21 MCKESSON.......................................................... 2 PHARMACISTS MUTUAL.............................. 19 PHARMACY QUALITY COMMITMENT..... 10
CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 UF — Kristin Weitzel (352) 273-5114 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 is 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. 4 |
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E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com
The President’s Viewpoint SCOTT TOMERLIN, FPA PRESIDENT
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Thankfulness is Always in Season
hanksgiving is a great time for reflection on all the things we can be thankful for, both professionally and personally. Just recently, I had the opportunity to attend the National Community Pharmacists Association (NCPA) Annual Meeting, held in New Orleans. During that convention, I heard many noteworthy presentations, but one in particular really stood out. The keynote speaker of the opening general session was motivational speaker and thought leader Greg Bell, Ph.D., author of the critically acclaimed book, “Water the Bamboo.” During Bell’s presentation, he challenged each member of the audience to reflect on one thing that we were thankful for, and then share it with the person next to you. It was amazing to hear all of the different responses nearby, whether it be thankfulness for family, employment, health and so on. He further challenged the crowd to overlook the negativity that can become burdensome if allowed to impose on oneself, and he pressed the audience to take a simple moment out of each day to reflect on just one thing that we could be thankful for. It is very easy to succumb to the burdens and stresses that are ever present each and every day in our personal and professional lives. Pharmacists know this all too well. Whether it be job-related stress due to long working hours, continuous demands being placed on the pharmacist and pharmacy technicians by an overburdened system, or constant financial threats being thrown in every direction in the form of below cost reimbursement to pharmacy claims and DIR fees, we can find ourselves in a dark place very quickly and easily. I would hope that amidst all of this,
we can all stop for a moment and think of at least one thing in each of our lives that we are most thankful for. Please indulge me while I list a few of the things that I am most thankful for.
During Bell’s presentation, he challenged each member of the audience to reflect on one thing that we were thankful for, and then share it with the person next to you. I am appreciative and thankful for the wonderful staff at the Florida Pharmacy Association that serves our members and profession. Wanda Hall, Stacey Brooks, Chris Heil, Tian Merren-Owens and Michael Jackson are some of the hardest working folks I have ever had the opportunity to serve with, and I cannot tell you how thankful I am for all they do for us. We truly have a world-class staff that you should be very proud of.
Scott Tomerlin 2016-2017 FPA President
I am thankful for God, my wife Teresa, children – John, Nathan and Isabella – and my parents. I am grateful for a wife who understands my passion for serving our beloved profession and for my children being understanding of the many nights where I have been away and unable to spend time with them. I am thankful for the ability to serve my patients at Walgreens as a pharmacy manager and leader of my team. They are special folks, and I am especially thankful for the support they have shown me. I am thankful for pharmacy trailblazers such as Dan Buffington and DeAnn Mullins, just to name a few among many others. Dan and DeAnn, in particular, are living examples of those who are expanding the role of pharmacists in providing patient care services in our communities. DeAnn recently was inducted as the 2016-17 NCPA president, the first female from NOVEMBER 2016
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2016-17 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.
Tim Rogers............................................................................................................Board Chair Scott Tomerlin..............................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Suzy Wise ...................................................................................................President-Elect Carol Motycka............................................................................Speaker of the House David Mackarey............................................................Vice Speaker of the House Kathy Baldwin.......................................................................................... FSHP President Jennifer Chen........................................................................................ Region 1 Director Neil Barnett............................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director Paul Delisser.................................................................... Region 7 Director (Interim) Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director
Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer...............................Don Bergemann, don.bergemann@verizon.net Secretary................................................................... Stuart Ulrich, stuarx@aol.com Member.............................. Rebecca Poston, Rebecca.Poston@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.com Member................................................................Norman Tomaka, FLRX9@aol.com Member............................................Greta Pelegrin, gretapelegrin@yahoo.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
the state of Florida to hold this honor. I am also thankful for Norm Tomaka, Kathy Petsos and Theresa Tolle—my Brevard County Pharmacy Association family. They took me under their wing, and I could not be more blessed for their support. They are the definition of what mentors should be. And YOU – the membership of the Florida Pharmacy Association! You all are the lifeblood of pharmacy advocacy in the state of Florida. Thank you for allowing me to serve you this year and help to “Launch Your Profession Forward!” We are off to an outstanding start, and we have much more ahead in store. Let’s now begin to focus on the upcoming year. There will certainly always be the headwinds in our profession, but I challenge you to focus on the opportunities and look for ways to be involved. We have many opportunities for those who would like to do as much as they comfortably can. To start, please consider attending the 2017 Legislative Days and Health Fair at the Capitol being held on March 14-15, 2017. In addition, our 2017 FPA Annual Meeting will be here before we know it on July 13-16, 2017 in Orlando. Also, don’t forget our “Launching Your Profession Forward Through Leadership Conference” that is right around the corner on Saturday, Jan. 7, 2017, in Orlando. There are so many opportunities, and I hope to see you attend at least one of these events. You don’t want to miss out! n
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Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, B.PHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION
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The 2016 Election is Over. Now What?
hankfully, as we go to press with this month’s issue of Florida Pharmacy Today, the 2016 election season is over. It is an understatement to say that the process could be defined as “epic.” With over 20 years of advocacy under my belt, it is expected that I would have seen it all. Boy, was I wrong this year. In the discussions I had with our members leading up to the November 8 general election, most of the conversations dealt with who was not the desirable candidate. Some even suggested that voting this year would have been a waste of time and that there was no candidate worthy of supporting. My friends and colleagues, taking that position is both troublesome and dangerous. Troublesome, in that, a failure to actively engage in the electoral process means that you are transferring candidate selection out of your hands and into the hands of someone who could care less about what your needs are. It is dangerous, in that, you are empowering others to control what your future may be. For those of you who took the time to cast your vote, I thank you for being a part of American history. You did the right thing regardless of who you selected on the ballot. Voting in an election is the easy part of democracy. All it takes is the skill to bubble in a circle or respond to a touch screen. The hard part is what comes after. Now that you have elected a candidate (and I am referring to your local candidate), the work is just beginning. We cannot just send a state representative or senator to Tallahassee and expect them to behave themselves. The work that they do requires monitoring and guidance. It does not matter wheth-
er you voted for them or not. Whoever is elected is going to speak for you, the constituent, on health care issues. If they get elected on November 8, you should congratulate them on November 9 and then make an appointment to see them on November 10. An even better solution is to invite them to your phar-
Voting in an election is the easy part of democracy. All it takes is the skill to bubble in a circle or respond to a touch screen. The hard part is what comes after. macy so they can see what you do and learn about our industry. There is no shortage of issues on the table that they need to be aware of. There will be a lot of new faces in Tallahassee come opening session day on March 7, 2017. Now is a good time to educate them and get them ready for the decisions that they will be making on your behalf.
Michael Jackson, B.Pharm
Let’s review the state issues of importance for the next six months or so. Changes to the Pharmacy Practice Act Does the number F.S. 465 mean anything to you? It should, because it represents the laws that Florida licensed pharmacists and registered pharmacy technicians must comply with. It also means that no one has the authority to do what you do other than someone licensed under that statute. The pharmacy practice act was created, and modified through the years, to meet a very different type of pharmacy business model than what is needed today. The training and skill sets of pharmacists are light years ahead of what the current pharmacy practice act allows. Florida absolutely must make changes to statute 465 for a couple of reasons. With NOVEMBER 2016 |
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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................................Cristina Medina, Hollywood Treasurer...................Don Bergemann, Tarpon Springs Secretary.........................Stuart Ulrich, Boynton Beach Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala Member................................. Norman Tomaka, Melbourne Member..............................................Greta Pelegrin, Hialeah Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee
This is a peer-reviewed publication. ©2016, 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 Address: http://www.pharmview.com 8 |
FLORIDA PHARMACY TODAY
the growth of our population, it is clear that there will be a shortage of primary care providers. Pharmacists are uniquely qualified to step into a number of roles to support physician practices. However, our F. S. 465 is a barrier to patient access. As pharmacists, you have the most knowledge of prescription drug therapy. Your knowledge in laboratory normal values is strong. You also have the ability to make good clinical decisions on whether to initiate, modify or discontinue prescription drug therapy. The problem is, our current practice act does not give you clear authority to do that, and this needs to change. MAC Pricing Enforcement If you are not sure what maximum allowable cost (MAC) pricing is, and why it is a problem, then you have probably been a castaway on a deserted island for the past 20 years or so. You probably don’t even know that the Cubs won the World Series this year either. During the 2015 legislative session, the FPA was successful in advocating for the creation of a new law that defines a PBM and maximum allowable cost pricing. This was a big first step in recognizing a very large industry that is connected to the practice of pharmacy. The next step is to find a way to get these laws, which require MAC pricing to be updated regularly, enforced. For the moment, there is acknowledgement of these laws by state agencies, but none have plans to correct any bad behavior. PBM Transparency and Network Closures This issue is affecting a large number of pharmacy providers across our industry. Restriction of the pharmacy networks has been very disruptive for both patients and pharmacy providers. For example, many of our Florida pharmacy businesses are finding out through notices that they are being excluded from Medicaid networks. These pharmacies have cared for patients with Medicaid for many years and have managed the health of not only those patients, but their family members as well. These Florida-based
businesses are locally owned and operated and pay taxes and fees for the privilege of serving their communities. Taxes and fees paid by Florida-based pharmacy businesses and Florida licensed pharmacy personnel are used to fund the very health care entitlement programs to treat the indigent. It is disturbing that the language in Florida Statutes 409.975 gives managed care plans the authority to discriminate against these very same pharmacies, prohibiting them to care for citizens in their own communities. There is work to do on the federal level as well. If you have been reading our journals, Stat News, been watching information posted on Pharmview.com or been attending our FPA law conferences, you are fully briefed on the national efforts to get pharmacists recognized as health care providers. We will have a new Congress soon and it will be their responsibility to take up this issue. The FPA will continue to advocate with our national partners in support of this important legislation. We also have to address other issues such as direct and indirect remuneration (DIR) fees and see what happens with the Affordable Care Act under the new Congress. So, the answer to the title of this article, “Now What,” means that the election is over but the opportunities to educate are just beginning. The issues above will be on the table for your state legislator this year. Let them hear from you first, and then we will deliver the final message, and hopefully there will be a home run legislative report provided at the 2017 annual meeting and convention in Orlando next July. n
Opportunity Knocking—Promote Adult Immunizations By Beverly Schaefer, RPh Are you up‐to‐date on your adult immunizations? This simple, benign question can have a positive impact on your pharmacy practice, your patients’ health, and your bottom line. Adult vaccination rates in the United States are well below public health goals. Pharmacists are positioned to help improve those numbers. Vaccination is one of the 10 greatest public health achievements of the 21st century, according to the Centers for Disease Control and Prevention. Childhood vaccination rates in the United States remain at or near record levels, but many adults are not vaccinated as recommended. Many adults are unaware of what the recommendations are for adult immunization, and the topic is often overlooked at the doctor’s office. Pharmacist‐initiated conversations about immunization and pharmacist‐administered vaccinations are one way to help increase vaccination rates. Promoting wellness, health improvement, and disease prevention is part of the practice of pharmacy. Other daily activities in a pharmacy often crowd out this role, but practicing it daily is more professionally satisfying than most of those other activities. Additionally, patients trust their pharmacist. They are the most accessible source of reliable, unbiased information and advice regarding safe and appropriate use of medications, including immunizations. By asking about their immunization status, you are expressing an interest in keeping a patient healthy. They appreciate that and respond well to the idea of staying healthy. They trust a pharmacist’s recommendation about the need to be immunized. It is one of the few times pharmacists can initiate patient care. It is a role expansion of sorts, and it changes patients’ perception
of your role as a health care provider. Notifying the patient’s primary care physician of immunization also allows for the immunization to be noted in the patient’s permanent medical record, and it lets the doctor know where they can send patients needing immunizations. To promote the importance of vaccines, consider placing a small hand‐written sign on the pharmacy counter that asks “Are you up‐to‐date on adult immunizations?” and then list the four major target adult vaccines: TDap (tetanus, diphtheria and pertussis), shingles, pneumonia, and seasonal flu. It will get people thinking about immunizations and may generate questions about immunizations. This is opportunity knocking. Or, create a sign to hang on your front door that says “XYZ Pharmacy Offers Immunizations,” and then list all the vaccines that you offer in your pharmacy. Add a line to your recorded telephone message that says you are currently giving shingles and whooping cough shots. If you currently are offering flu shots, offering other adult immunizations can help build a year‐round immunization business. All Medicare Part D plans are mandated by federal law to cover all vaccines except flu, pneumonia, and some hepatitis B and tetanus. Medicare Part B covers flu and pneumonia for Medicare‐eligible patients. Many third‐party plans are now covering routine immunizations, including an administration fee. Consider this: if you increase your adult immunizations to at least one a week year‐round, you could add about $1,500 to your bottom line. So not only do immunizations improve patient health, they are good for the fiscal health of a pharmacy, too. Reprinted with permission from National Community Pharmacists Association in the June 2013 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.
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“I’M ALWAYS WATCHING OUT FOR MY PATIENTS, BUT WHO’S WATCHING OUT FOR ME?”
WE ARE. We are the Alliance for Patient Medication Safety (APMS), a federally listed Patient Safety Organization. Our Pharmacy Quality Commitment (PQC) program: • • • •
Helps you implement and maintain a continuous quality improvement program Offers federal protection for your patient safety data and your quality improvement work Assists with quality assurance requirements found in network contracts, Medicare Part D, and state regulations Provides tools, training and support to keep your pharmacy running efficiently and your patients safe
Call toll free (866) 365-7472 or visit www.pqc.net PQC IS BROUGHT TO YOU BY YOUR STATE PHARMACY ASSOCIATION
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ZIKA Hanh Do (Sophia), Palm Beach Atlantic University Pharm.D. Candidate 2017
Background: The Zika virus was first transmitted by Aedes mosquitoes through bites that infected rhesus monkeys in Uganda in 1947, and then infected humans in Uganda and the United Republic of Tanzania in 1952. ThroughHanh (Sophia) Do out the history of the disease, Zika has been detected in many Asian countries such as India, Malaysia, Pakistan as well as some African countries. Zika virus infection can cause microcephaly for newborn babies, sometimes resulting in severe brain damage for fetuses leading to eye defects, hearing loss and impaired growth of these infants. On Oct. 30, 2015, Brazil reported one newborn with microcephaly, and on Jan. 15, 2016, a newborn baby in Hawaii was reported to have microcephaly by the Hawaii State Department of Health. This baby’s mom was documented as having spent the first few months of her pregnancy in Brazil.1 A total of 3,936 new Zika cases were reported to the Centers for Disease Control and Prevention (CDC) on Oct. 12, 2016 in the continental United States and Hawaii.2 There are often little to no symptoms that patients experience when affected by the Zika virus, however, some symptoms may include fever, rash, joint pain, and conjunctivitis (red eyes).3 The Aedes mosquitos tend to be very aggressive biters during the day. After a mosquito bites an infected patient, the patient become a vector, spreading the virus to others. Urine and blood tests can be obtained to test for the Zika virus. After symptoms
AFTER SYMPTOMS HAVE APPEARED, THE VIRUS USUALLY STAYS IN THE BLOOD FOR ABOUT SEVEN DAYS FOR NORMAL PATIENTS OR 14 DAYS FOR PREGNANT PATIENTS.
ZIKA VIRUS
What is Zika?
Zika is a virus transmitted by the Aedes mosquito, which also transmits dengue and chikungunya.
Zika can cause:
Mild fever
Conjunctivitis
Headache and joint pain
Skin rash
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Skin rash
Headache and joint pain
have appeared, the virus usually stays in the blood for about seven days for normal patients or 14 days for pregnant patients. According to the CDC, in order to reduce the risk of Zika via sexual transmission, all couples should use condoms or abstain from having sexual intercourse because Zika can be transferred through different kinds of sexual activities such as vaginal, anal or oral sex, or even through the sharing of sex toys. On Oct. 13, 2016, the CDC announced new areas in Miami-Dade County, which were affected with the Zika virus: NW 79th St. to the North, NW 63rd St. to the South, NW 10th Ave. to the West and N. Miami Ave. to the East.3 The CDC has assigned colors to areas that have been affected by Zika, red signifying high intensity locations and yellow as an indicator of mild activity in in the continental United States and Hawaii (Figure 1).4 At the moment, there are no specific treatment options or vaccines indicated for Zika infection. However, several things can help relieve symptoms, including ample rest, hydration with plenty of fluids and acetaminophen for fever and pain. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDS) should be avoided or carefully considered due to bleeding risks.5
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Onset is usually 2-7 days after the mosquito bite
1 in 4 people with Zika infection develops symptoms
A very small number of people can develop complications after becoming ill with the virus
How is Zika infection prevented? To prevent mosquito bites that transmit Zika:
Cover skin with long-sleeve clothing, trousers and hats
Use insect repellent as recommended by health authorities
Sleep protected by mosquito nets
2. Why and how does Zika affect At least once a week, empty, clean, turn over, Florida the most? cover and/or dispose of containers that can hold water, such as tires, buckets and flower The Florida Department of Health (DOH) anpots, both inside and outside of dwellings nounced on July 29, 2016, that Florida is the first to eliminate mosquito breeding sites state in the U.S. where Zika has been detected.6 It was found to have affected a small area of Miami-Dade County, north of the downtown Use screens or mosquito nets in windows community. The first case in Florida was identiand doors to reduce contact with mosquitoes fied as having been related to travel in February 2016. After meeting several times with congressional leaders in Washington, D.C., to discuss how urgent the Zika situation is in Florida, Gov. Controlling the breeding sites of Aedes mosquitoes Rick Scott said on Sept. 22, 2016, “Today, I am reduces the likelihood of transmission of Zika, authorizing $25 million in state funds to supchikungunya, and dengue port research to help develop a vaccine against the Zika virus here in Florida.�7 An article published in Nature Journal on Oct. 31, 2016, described a study in which the Zika virus dam- of mosquito-borne diseases spreading. Florida experienced aged testis in mice.8 Though the results of the study were only Hurricane Matthew in October 2016, when it made landfall There is no vaccine or specific against thisthe virus. related to mice, future research in humans may be on the hojust north of Miami and drug travelled along east coast. There Only pain and fever can be treated. rizon in order to detect just how severe the risk is in males. have been many predictions about Zika possibly spreading to Florida residents and healthcare professionals should take the other parts of Florida even other states. According to BenjaPatients with symptoms ofor Zika infection should: transmission of Zika very seriously and contact the Zika homin Haynes, a spokesperson with the U.S. Centers for Disease tline at 1-855-622-6735 if they have any questions or concerns Control and Prevention, nuisance mosquitos are usually more related to the virus. prominent during tropical storms or hurricanes than mosquitos that transmit viruses, such as the Zika virus.9 Therefore, 3. Where is Zika expected to travel since hurricanes are actually very helpful in preventing Zika transHurricane Matthew landed in Florida? mission. However, the CDC is still closely monitoring Florida Hurricanes can either help decrease or increase the chance for any new cases related to Zika after the hurricane. At the
Is there a treatment?
Get plenty of bed rest
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Drink plenty of liquids
Take medicine to relieve fever and pain
PATIENTS RETURNING FROM AREAS THAT ARE ON HIGH ALERT FOR THE ZIKA VIRUS, OR THOSE WHO ARE EXPERIENCING MORE THAN TWO SYMPTOMS SHOULD ALSO OBTAIN A TEST FOR ZIKA. Cover skin with long-sleeve clothing, trousers and hats
Use insect repellent as recommended by health authorities
Sleep protected by mosquito nets
same time, people should protect themselves from being bitsymptoms such as red eyes, fever, joint pain and rashes, they ten by wearing long pants At and sleeves usingempty, insectclean, repel-turn should least onceand a week, over, schedule a Zika test. Furthermore, healthcare workers cover and/or dispose of containers lant. Moreover, residents should empty all water in gutters,that can should take proper precautions to prevent exposure to blood water, such as tires, buckets and flower kiddie pools and birdbathshold outside the house to prevent mosand bodily fluids when caring for Zika patients. Wounds pots, both inside and outside of dwellings quitos from developing. to eliminate mosquito breeding sites should be cleaned with soap and water and mucus membranes should be flushed. According to the CDC, caretakers 4. How should healthcare providers use caution of friends or family infected with the Zika virus should folwhen working with Zika patients? low these safety considerations: Use screens or mosquito nets in windows Healthcare providers should report any cases of Zika vi■■ Do not touch blood or body fluids, and surfaces contamiand doors to reduce contact with mosquitoes rus to the CDC to reduce the risk of transmission. Patients nated with these fluids, with exposed skin. are recommended to have a Zika test if they have lived in ■■ Wash hands with soap and water immediately after proor have travelled to Zika areas, or if they have had unproviding care to the patient. If hands are not visibly dirty, tected sex with a partner who has lived in or traveled to Controlling the breeding sites of Aedes mosquitoes an alcohol-based hand rub can be used instead of soap Zika areas. If men,the children and non-pregnant women have and water. reduces likelihood of transmission of Zika, ■■ Immediately remove and wash clothes if chikungunya, and dengue they get blood or body fluids on them. Use laundry detergent and the water temperature specified in the garment care instructions to wash clothes soiled with blood or body fluids. Using bleach is not necessary. There is no vaccine or specific drug against this virus. ■■ Immediately clean and disinfect surfaces Only pain and fever can be treated. that have blood or other body fluids on them, Patients with symptoms of Zika infection should: minimizing direct contact, using household detergent/disinfectant according to manufacturer’s instructions. The sick person’s immediate environment should be cleaned daily using household cleaners according to manufacturer’s instructions. 10
Is there a treatment?
Get plenty of bed rest
Drink plenty of liquids
Use mosquito nets when napping
Wear clothing that covers arms and legs
Take medicine to relieve fever and pain
If symptoms worsen or complications develop, see a doctor immediately
#zika #FightAedes #ZikaVirus www.paho.org/zikavirus
5. How do pharmacists play a role in combating Zika? Since the Zika virus is spread through travelling, pharmacists can serve as great resources to counsel patients who are visiting pharmacies to fill their prescriptions, getting vaccines or buying OTC products before leaving for trips. Pregnant women are at the highest risk for Zika, and ultrasounds can show the potential for microcephaly, so pharmacists should take due diligence to reach out to these patients. Patients returning from areas that are on high alert for the Zika virus, or those who are experiencing more than two symptoms should also obtain a test for Zika. All patients should visit their doctors right away if they have symptoms lasting several days. In addition, pharmacists should inform patients that, as of now, there are no vaccines or treatment options for the Zika virus, emphasizing supportive care. Prevention is a very important factor, so patients should be encouraged to wear clothing NOVEMBER 2016
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with long sleeves, apply insect repellant containing DEET, stay indoors and practice safe sexual intercourse with infected Zika partners. Parents should utilize mosquito nets for strollers, carriers and cribs and understand that insect repellant is considered safe for children two years and older. Pharmacists can truly be of great service to the community by providing quick answers to the questions that many may have regarding the Zika virus and by educating the public on how they can protect themselves both at home and abroad.
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References:
1 “The History of Zika.” World Health Organization. World Health Organization, n.d. Web. 05 Nov. 2016. 2 “CDC Working with Florida to Respond to New Active Zika Transmission Area in Miami-Dade County.” Centers for Disease Control 14
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and Prevention. Centers for Disease Control and Prevention, 2016. Web. 05 Nov. 2016. “Zika Symptoms.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2016. Web. 05 Nov. 2016. “Areas with Zika.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2016. Web. 05 Nov. 2016. “Zika Treatment.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2016. Web. 05 Nov. 2016. “Florida Governor Says Local Mosquitoes Have Transmitted Zika Virus.” NPR. NPR, n.d. Web. 05 Nov. 2016. “Gov. Scott Authorizes $25 Million in State Funds for Zika Virus Vaccine Research and Development.” Florida Governor Rick Scott. N.p., n.d. Web. 05 Nov. 2016. Govero, Jennifer, Prabagaran Esakky,
Suzanne M. Scheaffer, Estefania Fernandez, Andrea Drury, Derek J. Platt, Matthew J. Gorman, Justin M. Richner, Elizabeth A. Caine, Vanessa Salazar, Kelle H. Moley, and Michael S. Diamond. “Zika Virus Infection Damages the Testes in Mice.” Nature (2016): n. pag. Web. 9 Mack, Sammy. “Hurricane Matthew: Potentially Bad News For Fight Against Zika Mosquitoes.” N.p., 6 Oct. 2016. Web. 5 Nov. 2016. 10 “If you are caring for a person with Zika.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2016. Web. 05 Nov. 2016
Save the Date
127th Annual Meeting and Convention
July 13 – July 16, 2017 JW Marriot Orlando Grande Lakes 4040 Central Florida Parkway Orlando, Florida
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Retroactive Fees Wreaking Havoc on Community Pharmacies Anthony Benton, 4th year Pharm.D. candidate FAMU College of Pharmacy
Recently, the business of pharmacy has come under attack from Medicare Part D and Pharmacy Benefit Managers (PBMs) in the form of retroactive fees. These fees are often called direct and indirect remuneration (DIR) fees, but can also be referred to as network access fees, technical fees, service fees, administrative fees and credentialing fees. (1) But, why are DIR fees a problem? These retroactive fees are currently being used as a hidden revenue stream by the PBMs to recoup some of their costs at the detriment to the plan beneficiaries, the government, the taxpayers and the pharmacies. So, what exactly are these DIR fees? The Centers for Medicaid and Medicare Services (CMS) coined the term to describe price concessions, such as drug manufacturer rebates, that would impact the Medicare Part D gross prescription drug costs that were not being captured at the point of sale within the community pharmacy. Part D plans 16
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and PBMs are required to submit annual DIR reports to CMS, which is then used in conjunction with Prescription Drug Event (PDE) data to “true up” or adjust what CMS is paying to a Medicare Part D plan for a given plan year.(2) Currently, DIR fee is a broad term that is being used to describe three more specific types of fees. The first are network participation fees or “pay to play” fees. These are typically a flat-rate, per-claim fee or a flat percentage to be assessed at regular intervals. These fees are imposed on the pharmacy in order for the pharmacy to be included into the PBMs preferred network of pharmacies. The second type of fees is payment reconciliation fees. These are also called “trueup” fees, and they are used to describe the difference between a target reimbursement rate in a participating pharmacy agreement and the aggregated effective rate that is actually realized by the pharmacy as a contracted rate. The third and final type of fees are performance metric fees. These fees are imposed on pharmacies for non-compliance with quality measures that have been set in place by the PBM or are alternatively used as a payment method based upon the fulfillment of these quality measures. Some of the performance metrics that pharmacies are evaluated for are: refill rates, generic dispensing rates, preferred product dispensing rates, error rates and audit performances to name a few. Payments and fees are then determined based
upon how well the pharmacy performs or “measures up” when compared to other pharmacies in the plan’s network. (2)
Here is a hypothetical example of how a DIR fee may be assessed to the pharmacy. A community pharmacy submits a prescription claim to a Medicare Part D plan and the PBM reimburses the pharmacy in such a way as to provide a net profit of $30. Medicare officials only see the medication cost of $30, but they do not see that $5 must be remitted to the PBM as a condition of participation within the plans network, or that the pharmacy owner saw another $15 fee for this same prescription weeks after the prescription was dispensed. So, this prescription, which CMS saw as a pharmacy net profit of $30, was in reality only a net profit of $10. What are the solutions to the problems associated with DIR fees? There is currently bipartisan legislation that has been introduced into both the United States Senate and House of Representatives in an attempt to address these DIR fees. These two bills (S. 3308 and H.R. 5951) are being called the Improving Transparency and Accuracy in Medicare Part D Spending Act, which would prohibit the PBM/Medicare Part D plans, who are taking advantage of the pharmacies participating in their plans, from assessing these retroactive DIR fees. The Improving Transparency and Accuracy in Medicare Part D Spending Act
THERE IS CURRENTLY BIPARTISAN LEGISLATION THAT HAS BEEN INTRODUCED INTO BOTH THE UNITED STATES SENATE AND HOUSE OF REPRESENTATIVES IN AN ATTEMPT TO ADDRESS THESE DIR FEES.
would prohibit Medicare prescription drug plan (PDP) sponsors and Medicare Advantage prescription drug plan (MAPD) organizations from retroactively reducing payment on clean claims submitted by pharmacies. This is an amendment to Section 1860D-12(b)(4) (A) of the Social Security Act (42 U.S.C. 1295w-112(b)(4)(A)) and states: (3) “(iv) PROHIBITING RETROACTIVE REDUCTIONS IN PAYMENTS ON CLEAN CLAIMS.—Each contract entered into with a PDP sponsor under this part with respect to a prescription drug plan offered by such sponsor shall provide that after the date of receipt of a clean claim submitted by a pharmacy, the PDP sponsor (or an agent of the PDP sponsor) may not retroactively reduce payment on such claim directly or indirectly through aggregated effective rate or otherwise except in the case such
claim is found to not be a clean claim (such as in the case of a claim lacking required substantiating documentation) during the course of a routine audit as permitted pursuant to written agreement between the PDP sponsor (or such an agent) and such pharmacy. The previous sentence shall not prohibit any retroactive increase in payment to a pharmacy pursuant to a written agreement between a PDP sponsor (or an agent of such sponsor) and such pharmacy.” (3) This amendment to the Social Security Act would apply to contracts entered into effect on or after Jan. 1, 2017. Increased transparency around these DIR fees is desperately needed. There does not seem to be enough disclosure between the pharmacies and the PBMs in regards to how the DIR fees are being calculated or why they have been
assessed. At both the time of contract initiation and at the time that the fees are actually being assessed to the pharmacy, the amount of information being disclosed from the PBM is inadequate and the level of detail of the disclosure is being left entirely up to the discretion of the PBM. Due to this lack of information and the lag time of often several months, it has become difficult for community pharmacies to determine what their true reimbursement rate is at not only the time of dispensing prescriptions to patients, but also at the outset of the contract and the end of the contractual term. It is the position of the National Community Pharmacists Association (NCPA) that “all of these reported DIRs could be reasonably estimated at the point of sale and reflected in the adjudication process.” (2) S. 3308/H.R. 5951 will provide greatNOVEMBER 2016
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er transparency in drug pricing by eliminating the retroactive fees that are inflating drug pricing data shown on Medicare Plan Finder (CMS’ online insurance plan comparison tool), which will make this service more accurate and reliable for consumers, allowing beneficiaries to purchase the plan that best suits their specific needs and gauge the total cost of the plan. (4) S. 3308/H.R. 5951 will also lower the cost-sharing (copayments) for beneficiaries at the pharmacy counter. This is because the copayments that beneficiaries are responsible for are being calculated based on inflated drug costs that are directly related to the retroactive fees from the PBMs. According to an Avalere analysis published in March 2016, the average percentage of covered drugs facing coinsurance has risen from 35 percent in 2014 to 58 percent in 2016 among PDPs, which makes lowering the copayments of plan beneficiaries all the more important. (4) S. 3308/H.R. 5951 will also improve the integrity of the Medicare Part D program by ensuring that program costs are being reported in a correct and consistent manner. Currently, PBMs are reporting their DIR fees through different methods, which can skew the beneficiary responsible copayments, federal reinsurance, CMS payments to the plans, manufacturer coverage gap payment discounts and low income copayment subsidies. (4) There may be some people with concerns of negative repercussions associated with the Improving Transparency and Accuracy in Medicare Part D Spending Act, such as increased Medicare Part D costs or impeding the implementation of “pay for performance” programs associated with Part D plans/PBMs. However, plans that are currently reporting an increase in DIR fees are understating their bid, which in turn allows them to offer lower bids and lower premiums based upon how their costs are being reported to CMS. S. 3308/H.R. 5951 will not change the total costs to the Medicare Part D program; it will only increase the accuracy in which these costs are reported to CMS. In regards to the “pay for performance” programs, S. 3308/H.R. 5951 will allow for the implementation of appropriate pay-for-per18
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formance programs, aligned with current Medicare value-based programs, instead of the penalty-for-performance programs that community pharmacies are currently experiencing in the form of DIR fees. (4) Until the law is amended and PBMs are forced to become more transparent, what can be done as a pharmacy owner to alleviate the burden of DIR fees? The first and most important action is to ensure that any contract that is being signed is thoroughly read and comprehended. In addition, all of the different terms and conditions that the plan encompasses must be understood, including any network pharmacy manuals that may be included by reference into the contract.(2) Lastly, pharmacy owners should ensure that any and all available performance metrics set by the PBM are being met with satisfactory results (this may include ordering preferred products, dispensing the correct ratio of brand/generic prescription, etc.). One of the best courses of action right now is to tell congress to support the Improving Transparency and Accuracy in Medicare Part D Spending Act and to ban retroactive DIR fees (S. 3308/H.R. 5951). Urge your legislators to co-sponsor the legislation in both the United States Senate and the House of Representatives, which would explicitly prohibit PBMs from retroactively reducing the payment to pharmacies for clean claims and effectively eliminate DIR clawbacks by PBMs. References
1. Medicare’s Right to Tackle Part D Slush Fund for PBMs - Morning Consult. Morning Consult. 2014. Available at: https://morningconsult. com/opinions/medicares-right-tacklepart-d-slush-fund-pbms/. Accessed October 10, 2016. 2. Frequently Asked Questions (Faqs) About Pharmacy “DIR” Fees. 1st ed. Alexandria, VA 22314-2888: National Community Pharmacist Association; 2016. Available at: http://www.ncpa. co/pdf/FAQ-DIR-Fees.pdf. Accessed October 10, 2016. 3. Actions - H.R.5951 - 114th Congress (2015-2016): Improving Transparency and Accuracy in Medicare Part D Spending Act. Congressgov. 2016. Available at: https://www.congress. gov/bill/114th-congress/house-
bill/5951/actions. Accessed October 10, 2016. 4. Talking Points, September 2016, DIR Fees. 1st ed. Alexandria, VA 22314-2888: National Community Pharmacist Association; 2016. Available at: http://www.ncpa.co/pdf/ talkingpointsseptember2016-dir-feesmedicare.pdf. Accessed October 10, 2016. 5. DIR Fees. Ncpanet.org. 2016. Available at: http://www.ncpanet.org/ advocacy/dir-fees. Accessed October 10, 2016. 6. Two Bills Introduced to Combat Retroactive Fees on Pharmacies Participating in the Part D Program - Virginia Pharmacists Association. Virginiapharmacists. org. 2016. Available at: http:// www.virginiapharmacists.org/ news/307810/Two-Bills-Introducedto-Combat-Retroactive-Fees-onPharmacies-Participating-in-the-PartD-Program.htm. Accessed October 10, 2016. 7. Deninger MDeninger M. The DIR and the Pharmacy Rebate. The Thriving Pharmacist. 2015. Available at: http://www.thethrivingpharmacist. com/2015/09/16/the-dir-and-thepharmacy-rebate/. Accessed October 10, 2016. 8. Action Center. Ncpanet.org. 2016. Available at: http://www.ncpanet. org/advocacy/grassroots-resources/ action-center?vvsrc=%2fcampaigns%2 f47797%2frespond. Accessed October 10, 2016. 9. Medicare Part D Pharmacy “DIR” Fees Encourage CMS To Finalize Proposed Guidance On DIR And Pharmacy Price Concessions. 1st ed. Alexandria, VA 22314-2888: National Community Pharmacy Association; 2016. Available at: http://www.ncpa.co/pdf/dir-onepager-2016.pdf. Accessed October 10, 2016. 10. Pharmacies Face Financial Hardship with Rising DIR Fees. Pharmacy Times. 2016. Available at: http:// www.pharmacytimes.com/news/ pharmacies-face-financial-hardshipwith-rising-dir-fees. Accessed October 10, 2016. 11. Pharmacists Survey: Prescription Drug Costs Skewed by Fees on Pharmacies, Patients. Ncpanetorg. 2016. Available at: http:// www.ncpanet.org/newsroom/ news-releases/2016/06/28/ pharmacists-survey-prescription-drugcosts-skewed-by-fees-on-pharmaciespatients. Accessed October 10, 2016.
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2017 Election Ballot Information The election for FPA president elect, treasurer and regional directors will be done by computer again this year. A postcard containing instructions on how to cast your ballot will be mailed to FPA members in December. You will need to sign in with your username and password to cast your vote. If you live in regions 2, 4, 6 or 8 you will not be voting for a regional director. Those regions will have their election next year. You will, however, have an opportunity to select the next president elect and treasurer, as well as vote on a proposed constitution change. If you live in regions 1, 3, 5, 7 or 9, make your selection for your regional director. Remember that the system will allow you to vote only one time. The results will be tallied by the canvassing committee appointed by the president of the Florida Pharmacy Association in accordance with FPA bylaws. The last day to vote will be Jan. 31, 2017. Please visit www.pharmview.com after you receive the instructional postcard to cast your vote. Below is candidate information for you to review prior to voting.
CANDIDATE FOR FPA PRESIDENT ELECT Angela Garcia FPA Member Since 2004 Please allow me to introduce myself. My name is Angela Garcia, and I am running as a candidate for the FPA 2017-2018 President-elect position. As an active member since 2004, it has been my pleasure to serve and support the FPA Leadership in various positions. I consider myself blessed to have met some of the most amazing people and to have shared in our good fight for growth and change while ‘growing up FPA’. It is important to me to stay connected to what I love most about this profession, and more importantly, to have a pulse on pharmacy. I graduated from Nova Southeastern University College of Pharmacy, completed a Drug Information Residency and obtained my Master of Public Health. It has been rewarding to blend my education and training to prioritize the health of the community and address critical issues facing public health and pharmacy practice. Academic experiences I have held in graduate education programs include Florida Gulf Coast University in physical therapy, as well as several pharmacy programs including NSU College of Pharmacy, University of North Texas, and the University of Florida. Prior to my arrival at the University of South Florida College of Pharmacy, I was an Assistant Professor with Nova Southeastern University College of Osteopathic Medicine and Public Health Program. While at Nova Southeastern University, I had the humbling experience of serving as the co-coordinator for an international medical mission outreach program through Women of HOPE and the College of Osteopathic Medicine, working in an interprofessional capacity in Jamaica, West Indies, since 2008. In addition, I have worked 20
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in community pharmacy and spent my time building relationships that fostered initiatives resulting in improved outcomes for patients. Currently, I am serving as the Member-At-Large for the Florida Public Health Association, and formerly as a member of its Board of Directors. I served our pharmacy profession through local unit leadership as a former member of the Board of Directors with Broward County Pharmacy Association and currently with Pinellas County Pharmacy Association. My leadership experiences within the FPA includes serving as a Chair for both Public Affairs and Educational Affairs Councils, as well as the Ad Hoc Health Fair Committee Chair for seven years. I have also been active in advocacy and legislation to support the Florida Pharmacists’ Health Fair and Legislative Days. These experiences have prepared me to serve as your incoming President-elect. Some issues facing our profession that are of most concern to me include: ■■ Addressing our need for change to facilitate our ability to practice within interprofessional capacities at the height of our profession. ■■ Increasing active engagement and growth of the membership at all levels of the profession, including technicians, interns, and pharmacists. ■■ Enhancing critical practice areas related to public health and pharmacy (i.e. health literacy, adherence, disease prevention, health promotion, and population health initiatives). ■■ Community pharmacy as it relates to the impact of community health and the challenges experienced by those wanting to do more for patient care outcomes. It is my intention to serve the FPA leadership and membership with the highest levels of integrity and honesty. I do not have an agenda other than to listen to the needs of our members and our patients and try to foster what change I can while demonstrating absolute commitment to the pro-
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fession I love. I ask for your support and confirmation as we create new chapters and add to the story of us. William Napier FPA Member since 1981 I have been a member of the Florida Pharmacy Association since graduating from the University of Florida College of Pharmacy in 1981, though I have never held an elected office I have been pretty involved in the organization, attending conventions and continuing ed-
ucation meetings. I have also been involved in shaping legislation to protect our profession from the evil forces that seek to destroy it, or at least downgrade it. I have testified on behalf of our profession in Tallahassee several times, as well as Board of pharmacy meetings regarding the dispensing of opioid pain medications I remain passionate about the practice of pharmacy. For the past 25 years, I have been fortunate and proud to own an independent community pharmacy in Jacksonville, Fla. The pharmacy (Panama pharmacy) was founded in 1928 and I have been its guide and protector for the last quarter of a century. As a drug store owner, you must be like the turkey is to Thanksgiving, all in, it is a consuming life. All activities and thoughts must center on the success of the pharmacy and the patients you serve. Recently, I have passed to torch to a fine young pharmacist Kevin Duane, so now I feel I have the time to devote to becoming FPA president elect. I am also involved in APHA and NCPA as well as serving with my local Duval County Pharmacy Association for several years on the board of directors. I would appreciate your support of this office.
CANDIDATE FOR FPA TREASURER Ashley Huff FPA Member Since 2012 Ashley is a newly graduated pharmacist, earning her PharmD from the University of Florida in 2015. She is currently a pharmacy manager with Walgreens Pharmacy in Tampa, Fla., and an active participate in both her state association and with the local community, where she works with an organization call Pasco ASAP (Alliance for Substance Abuse and Prevention) focused on decreasing prescription drug abuse. She is a native Floridian and lives with her husband of four years in her home town
of Land O’Lakes, Fla. Through the association, she has served on the membership council for two years and served as both student and pharmacist chair of the Student Affairs Council. She has also held a student liaison position on the FPPC council and worked closely with all the schools of pharmacy in the state to run multiple programs to increase student involvement and membership. In addition, she has attended and helped coordinate Legislative Days from the school level for multiple years. As a pharmacist, she continues to devote her time and efforts to advancing the profession of pharmacy through the FPA. POSITION STATEMENT:
Greetings FPA Members, As many of you may know, I have a strong passion for my profession and have had extensive involvement in the Florida Pharmacy Association since my first year of pharmacy school. I have served on multiple councils, led efforts to increase student and pharmacist involvement within the association, participated extensively in our legislative efforts, and was the first recipient of the Terry Gubbins Student Leadership Scholarship. My latest efforts have centered on serving as the pharmacist chair of the Student Affairs Council. Our
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student members are the future of our profession and I truly believe they are capable of great things. As an active member, I want to continue to serve my association in an increased capacity. I have worked hard to develop myself within the association as a leader and mentor to others. I want to continue to learn and understand how the association operates in order to better help lead the association, with so many others, to the next level. The financial vitality of the association is a key part to this, and if elected, I would strive to maintain the progress of those that have come before me. It is a great honor to be considered a candidate for Treasurer, and it would be an even greater honor to serve in this position if elected. Thank you for your time and consideration. Allison Underwood FPA Member Since 2004 Allison graduated from the University of North Carolina at Chapel Hill receiving her pharmacy degree in 1994. She became a resident of Florida in 1995. Allison worked as a pharmacist in the U.S. Public Health Service retiring in 2013. The restraints of the Federal Government gave her great experience in managing a tight budget. She now works part time serving inmates in the Federal Bureau of Prisons. This unique practice gives her an expanded view of pharmacy beyond the norm. Allison served as President of the Leon County Pharmacy Association (LCPA) from 2004 until it was dissolved several years later. Her duties included informing the members about FPA news, introducing the speaker at monthly meetings and determining the local scholarship recipient each year. During this time from 2005 until 2008, she spent several years representing region 1 as a regional delegate (now regional director). This position was a wonderful way to observe and learn about the inner workings of the FPA. For the annual meeting in 2005, Allison served as a delegate representing LCPA. POSITION STATEMENT:
Since retirement I have looked for ways to become more involved in my community. I currently volunteer at St. Marks’s National Wildlife Refuge enjoying my love of the outdoors. Volunteering as treasurer of the Florida Pharmacy Association would allow me to gain more insight into this special organization. I would work closely with the staff and members to ensure the sustainability of the FPA for years to come. I’ve always loved to crunch numbers and would use this skill to help ensure the financial stability of the FPA. My experience managing a tight budget would come in handy if elected treasurer. I encourage all members to become more 22
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involved in their local and state pharmacy organizations. We need to be the voice of our profession so we are not left behind. I thank you for your support.
CANDIDATE FOR FPA REGION 1 (Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Bay, Jackson, Calhoun, Gulf, Gadsden, Liberty, Franklin, Leon, Wakulla, Jefferson, Madison, Taylor, Hamilton, Suwannee, Lafayette, Dixie, Gilchrist, Columbia, Baker, Union, Bradford, Alachua and Levy Counties) Joyanna L. Wright FPA Member Since 2009 Joy is the clinical pharmacy specialist for UF Health Shands Hospital Outpatient Pharmacy Department. She has been at Shands since 2005 and in this position since 2009. Before this, she worked as a satellite pharmacist, consultant pharmacist for University of Florida and community pharmacist for a small independent pharmacy. She graduated from the University of Toronto with her Bachelor’s of Science in Pharmacy and has 10 years of experience in Canada which gives her a unique crossborder perspective. While in Canada she sat on the Ontario Pharmacists Board of Directors for six years and participated in several committees during that time. She completed her Doctor of Pharmacy degree in 2001 from Shenandoah University in Virginia and became board certified in 2007. She has been involved in the Alachua County Association of Pharmacists as a Board member since moving to Florida in 2004, holding positions of director, vice president, president and chairman of the Board from 2010-2013 and is currently a director/parliamentarian. She has been a delegate representing ACAP at the FPA House of Delegates for several years including this past year. Joy has been actively serving on the FPA Professional Affairs committee for the past two years. She has been involved in local and state pharmacy associations for pharmacists and technicians for her entire career. She also is a preceptor for UF COP APPE ambulatory care students at Shands for up to two students per month, as well as a mentor to pharmacy students for both Universities of Florida and Toronto. POSITION STATEMENT
I am excited to get involved at the Board level to help support pharmacists and technicians at the state level. FPA has done a great job in recent years of monitoring legislation that will impact pharmacists and taking appropriate actions. I am looking forward to continuing to assist in that effort so that pharmacists and technicians will be supported by leg-
2017 FPA CANDIDATES
islation and association policies to keep us practicing at the top of our scopes of practice. Every pharmacist in every setting needs to be able to take the time they need to educate and empower patients to become knowledgeable about what they are taking, how to deal with adverse effects, improve health literacy, improve patient safety and reduce medication misadventures causing the spending of unnecessary health care dollars. Investigation into expanding new roles for pharmacists and technicians and the education, training and certification needed will be supported for pharmacists as the drug experts on the health care team and technicians as the preparation, dispensing and billing experts. Continued work to achieve national provider status and scope of practice to support billing for comprehensive medication management as well as disease state management by pharmacists is also a priority.
CANDIDATE FOR FPA REGION 3 (Citrus, Hernando, Pasco and Pinellas Counties) Dean Pedalino FPA Member Since 2004 Currently, I am Managing Partner of Integrity Partners, a diversified Pharmacy Consulting company and a Partner in Main St. Pharmacy of Safety Harbor, an independent community pharmacy. Dean brings more than 30 years of management experience in institutional pharmacy management and pharmacy consulting. Dean served as a CEO for Pharmetrics Specialty Rx, a non-sterile compounding company. He served as president of Pharmacy Matchmakers, Inc. and V.P. of Healthcare Consultants Business Solutions where the focus of business was brokering pharmacies, pharmacy acquisitions and new pharmacy startups. Dean served as C.O.O. for Executive Pharmacy Services, a multistate long-term care pharmacy serving 6,000 longterm care patients. Dean has been the consultant to two Fortune 500 companies. Dean is a graduate of St. John’s University College of Pharmacy. He is a past member of the American Society of Consultant Pharmacists (ASCP) and served for 8 years on government affairs councils Dean is currently the president of Pinellas Pharmacy Association. I am excited for the opportunity to serve my colleagues and profession. With a passion to preserve the neighborhood drugstore, this is still the first and most convenient access to
care for many of our patients. It also is their last line of defense. A pharmacist’s access is vital to a community. A mail order pharmacy and 800 number across the country is not the definition of patient “CARE.” Mandated PBM’s and monopolistic contracts cannot provide the proper assessment tools needed for good pharmaceutical care. The patient first model of pharmacy care and the unification of ALL pharmacists’ voices are my primary agenda. I thank you for your trust in me to help you in the service of your patients.
CANDIDATE FOR FPA REGION 5 (Hillsborough and Polk Counties) Melissa Ruble FPA Member Since 2013 Melissa is a current assistant professor in the Pharmacotherapeutics and Clinical Research Department at the University of South Florida College of Pharmacy. Her practice site is located at Florida Hospital Tampa where she practices in both the Emergency and Internal Medicine Departments. Prior to her role at USF she helped establish an emergency medicine pharmacist position at St. Anthony’s in St. Petersburg, Fla. During her three years at St. Anthony’s, she worked as an emergency medicine clinical pharmacist with an emphasis on medication reconciliation, discharge counseling, and acute care management (CODE blue, STEMI, Stroke alert, etc.). Melissa received her degree from Shenandoah University in Winchester, Va., in 2009 and went on to complete her PGY1 at Tampa General Hospital in Tampa, Fla. Since becoming a member of FPA, Melissa has shown her dedication towards the organization by serving as the advisor/liaison for the USF COP student chapter as well as being active through her volunteer efforts. She continues to volunteer at the annual meeting and conventions as a patient counseling and NASPA/NMA Student Pharmacist Self Care Championship judge, student mentor, and poster evaluator. She also participated in the Florida Pharmacists’ Health Fair at the Capitol Council, currently serves as a delegate for FPA, and is a member of the Legislative Days Committee. Melissa is also an active member of the American Society of Health-System Pharmacists, Florida Society of HealthSystem Pharmacists (Emergency Preparedness Committee member), the American College of Clinical Pharmacy (Chair and CODE Committee member), Kappa Epsilon student advisor and Phi Lambda Sigma (USF Alumni Coordinator). Melissa has spoken at multiple local and state FSHP meetings and continues to find opportunities to give back to the profession. NOVEMBER 2016
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POSITION STATEMENT
As an active FPA member, my enthusiasm and passion for this organization has shown through my volunteer efforts and insistence to make a difference through my participation in FPA. As an educator, I am always looking for ways to reach out and teach others how to be become more involved in such organizations and truly make a difference. If elected to the position of board of director, I will incorporate the ideas of the group to further promote pharmacy and encourage future and current pharmacists to become active in their profession. I continue to encourage my students to become involved in an organization not so that it looks good on paper but to move our profession forward and be proud of what we do. I believe that I can do this for our district, and given the chance, I can bring a refreshing and passionate leadership style that listens to its members and strives for excellence. It is an honor to be nominated for such a great district and I ask you to please vote for me and feel confident that we can make a difference together!
CANDIDATE FOR FPA REGION 7 (Hendry, Lee and Palm Beach Counties) Paul Delisser FPA Member Since 2010 I graduated in 1994 from Northeastern University Bouve College of Pharmacy and Health Sciences in Boston over 20 years ago. My wife and family moved to south Florida 22 years ago. I have been a Retail Department Pharmacy Manager with the Walgreens Company for over 18 years. In addition, I have had the experience of working in the Pharmacy Department of Wellington Regional Hospital. As a community Pharmacist, I have had the broad exposure of working in various communities that made me privy to diversified income groups and cultures. This experience has contributed to my growth as an individual, as well as a community Pharmacist. I have developed an insight with the elderly by recognizing their fears of the unknown as it relates to their health, and the advantage counseling contributes to their peace of mind. In dealing with our communities that are faced with economic challenges, I have found fulfillment in the way these communities rely on their neighborhood Pharmacists to educate and explain their prescriptions and their benefits with a fuller understanding to improve their health. As a certified immunizer, reaching out to our local schools, businesses, and churches immunizing their staff members is a way to bridge our profession with our community, resulting in a renewed appreciation for the ser24
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vice we provide. I am looking forward to working with our members to elevate the profession of pharmacy because it is a vital component of the health care profession. Our knowledge, experience and training significantly contribute to the health and wellness of our patients, and our community as a whole. My commitment to the pharmacy profession is quantified by the dedication I have made through mentoring our pharmacy students and pharmacy technicians. Our Pharmacy students from Nova Southeastern University, Palm Beach Atlantic University, and The University of Pittsburgh College of Pharmacy are part of our mentoring program. By sharing the knowledge of our profession and encouraging them to be members of their local and state Pharmacy Associations they will make a difference to the future of our profession. Serving on various posts of the Pharmacy Associations for the last 15 years, and as the current president of the Palm Beach County Pharmacy Association, further supports the dedication I have for our profession, and the improvement of our services. As the District 6 regional director, I will continue to energize our members through increased membership, dialogue and advocating for the pharmacy profession. I am currently seeking the post as the District 7 Regional Director, please give me your vote of support to continue working diligently in conjunction with our members to improve the quality of service to our community and the members of our association.
CANDIDATE FOR FPA REGION 9 (Broward County) Mitchell Fingerhut FPA Member Since 1976 Mitchell Fingerhut, Pharm.D., MSCIS, MBA-HA., is President and CEO of Clinical Rx, Inc., a pharmacy provider of Renal consulting services. He is also a Clinical Pharmacist with US Medical Supply, Inc. Much of his professional career has been split between hospital and independent pharmacy practice. He graduated Brooklyn College of Pharmacy and did a clinical internship at Maimomodies Hospital and Medical center in Brooklyn, N.Y. Later he attended the University of Miami and received an MBA in health care administration and a Master’s of Science in computer information systems. He also completed a health care Residency in healthcare administration where he successfully completed a Certificate of Need. He received his Pharm.D. from Nova Southeastern College of Pharmacy while attending part time while working full time as director of two local hospitals.
2017 FPA CANDIDATES
Mitchell has been on the board of Directors of Broward County Pharmacy association since 1986 and has been president and chairman of the board. He has held various positions with the Florida Pharmacy Association such as vice chairman and chairman of the Home Health Care Section of the Academy of Pharmacy Practice, Advisory Board of Pharmacy Provider Service Corporation, Legislative Committee and Board of Director of Region 10 and currently Region 9. He was appointed Legislative Committee of APHA 2009 to 2011. POSITION STATEMENT:
It is with great honor to be nominated as a candidate for Board of Directors of the Florida Pharmacy Association. I believe my prior positions with county, state and federal pharmacy associations will prepare me to better serve the pharmacists of Region 9. I believe that pharmacy should be of one united voice instead of community, hospital and institutional, that is why I have continuously supported Broward County Pharmacy Association, Florida Pharmacy Association, and the American Pharmacy Association. We need one voice when we deal with regulatory agencies, legislators and other healthcare providers. I believe that our patients need direction and input from
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.
Pharmacist so that they can optimize their medication therapies. That is why I helped pass pharmacist ordering labs when I was chairman of the Home Health Care section of the Academy of Pharmacy Practice. I also strongly support Pharmacy provider status with Medicare and other national health insurances. It will be my honor and privilege to serve Region 9 again, and that is why I ask for your vote. PROPOSED CHANGES TO THE FPA CONSTITUTION The FPA Constitution may be altered or amended provided that such proposal to alter or amend has been submitted to the chair of the Organizational Affairs Council in writing. The proposed alteration or amendment to the Constitution was presented and read at the 2016 Annual Meeting and Convention of the FPA in Fort Lauderdale, Fla. To proceed forward the majority of members attending the annual meeting must approve the proposed changes. Those members voting at the annual meeting have authorized the change to move forward to the next step, which is an order from the Board of Directors to have the executive vice president and CEO to publish this change to the constitution in the Journal and place it on this year’s election ballot. The proposed constitutional change was published in the November 2016 issue of Florida Pharmacy Today, and the election ballots will be issued in December. Final approval of the constitutional changes will require an affirmative vote of threefourths of the voting members who returned their ballots by the Jan. 31, 2017 deadline. Upon three-fourths of the members voting in favor of adoption of the amendment, it shall become a part of this Constitution. The proposed change is under Article III, Section 3, which is related to redefining a student member of the FPA to include those students in technician training programs. The change reads as follows: Article III, Section 3 - Student Members. Student members shall be those persons who otherwise qualify as members in good standing and are students in good standing, matriculated in a college or school of pharmacy or a Board of Pharmacy approved school or technician training program.
1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com
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C A L L
F O R
APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■ ■■ T recipient has not previously received the award. ■■ two on its award committee or an officer of the association other than in an ex officio capacity. ■■ has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years. Criteria: ■■ must be a Florida registered pharmacist and a member of the FPA. ■■ has rendered outstanding service to pharmacy within the past five years. Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career. Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.
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N O M I N A T I O N S ■■ Candidate must have demonstrated
contributions to the Florida Pharmacy Association and/or other pharmacy organizations. ■■ Candidate must have demonstrated commitment to community service. ■■ Candidate is not a past recipient of this award. R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida. Criteria: ■■ recipient must be a Florida registered pharmacist and a member of the FPA. ■■ has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida. Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.
F P A
Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine years or fewer. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.
A W A R D S
2 0 1 6 - 2 0 1 7
Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association.
Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association. Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applica-
tions will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse ■■ Involvement of other community groups in the planning and implementation of prevention programs ■■ Innovation and creativity in the creation and implementation of prevention activities ■■ Scope/magnitude of prescription drug abuse efforts ■■ Demonstrated impact of prescription drug abuse prevention efforts
DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2017 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:
NOMINATED BY:
Name:
Name:
Address:
Date Submitted: Signature:
FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2017) APhA Foundation and NASPA Bowl of Hygeia James H. Beal Award
Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)
R.Q. Richards Award Frank Toback/AZO Consultant Pharmacist Award DCPA Sydney Simkowitz Award Pharmacists Mutual Co. Distinguished Young Pharmacist Award IPA Roman Maximo Corrons Inspiration & Motivation Award The Jean Lamberti Mentorship Award Upsher Smith Excellence in Innovation Award Cardinal Generation Rx Award
MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2017
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CALL FOR RESOLUTIONS TO THE 2017 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2017 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is May 19, 2017! PLEASE NOTE THIS DEADLINE. The last day to submit items of new business is June 16, 2017. The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing. TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND
WHEREAS :
THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)
CONTACT NAME AND PHONE #: PROBLEM: INTENT:
Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758
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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 PPSC Retail Pharmacy Purchasing Program (888) 778-9909
LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law (561) 392-9000 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620
PHARMACEUTICAL WHOLESALER 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 http://floridapoisoncontrol.org/ NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 (703) 683-8200 (703) 683-3619 fax info@ncpanet.org
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.
RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”
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