2017 GEORGIA PHARMACY CONVENTION — JUNE 15-18
April/May 2017
THE NUMBERS ISSUE
SAVE THE DATE SUNDAY, APRIL 23, 2017
•
MACON MARRIOTT & CENTREPLEX
AIP SPRING MEETING CONTINENTAL BREAKFAST & LUNCH PROVIDED
Events and programs include: • Network with colleagues • Buffet lunch • Meet with Partners • CE opportunities Plus • Legislative Update
SHOW YOUR SUPPORT — ATTEND THIS YEAR’S AIP FALL MEETING Registration: Please fill out and fax back to (404) 237-8435 Member’s Name:
Nickname:
Pharmacy Name: Address: E-mail Address (please print): Will you be joining us for lunch (Noon – 1:00PM)? How many total will be attending? Names of Staff/Guests:
❑ Yes
❑ No
contents 12
COVER STORY: BY THE NUMBERS Our second annual numbers issue looks at some of the most interesting facts, figures, stats, and scales that affect your practice. From salaries (yours and others’), to whether Georgians are keeping healthy, to the (high?) cost of drugs (and more), you’ll find lots of interesting numbers to compare, contrast, and comment upon.
3
9 calendar Upcoming events and classes
10 legal injection 7
3 prescript
What actually falls under a Georgia pharmacist’s scope of practice... and what doesn’t?
You did this Only a small portion of the 4,405 bills in the legislature passed this year. Thanks to you, ours was one of them
17 convention preview Check out all the reasons you need to come to Amelia Island for the 2017 Georgia Pharmacy Convention (June 15 to 18).
4 news What’s happening in the Georgia pharmacy world Our major bill passes the legislature, DIY epi-pens, Neanderthal pharmacy, tinkering with evolution, and more
Georgia Pharmacy magazine is the official publication of the Georgia Pharmacy Association. Unless otherwise noted, the entire contents of this publication is licensed under a Creative Commons AttributionNonCommercial-ShareAlike 4.0 International license. Direct any questions to the editor at akantor@gpha.org.
4
5
16
President and Chair of the Board Lance Boles President-Elect Liza Chapman First Vice President Tim Short Immediate Past President Tommy Whitworth
21 PharmPAC Investors in the future of pharmacy in Georgia
Director of Communication & Editor Andrew Kantor akantor@gpha.org Art Director Carole Erger-Fass
Who does what at GPhA — and how to reach us
24 postscript Counting on us How the relationships you build can be more important to success than any numbers
SUBSCRIPTIONS Georgia Pharmacy is distributed as a regular membership service, paid for with membership dues. Non-members can subscribe for $50 per year domestic or $65 per year international. Single issues are $10 per issue domestic and $20 international. Practicing Georgia pharmacists who are not members of GPhA are not eligible for subscriptions.
POSTAL
ADVERTISING All advertising inquiries should be directed to Denis Mucha at dmucha@gpha.org or (404) 419-8120. Media kit and rates available upon request.
April/May 2017
23 contact us
Georgia Pharmacy (ISSN 1075-6965) is published bimonthly by the GPhA, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA, 30328. Periodicals postage paid at Atlanta, GA and at additional mailing offices. POSTMASTER: Send address changes to Georgia Pharmacy magazine, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA 30328.
Georgia Pharmacy
1
Dedicated to Our Members since 1909. phmic.com
800.247.5930 Our Mission To help our customers attain peace of mind through specialized insurance products, risk management solutions, and superior personal service.
prescript
You did this BY GREG REYBOLD
While numbers are not particularly my strong suit, in the spirit of GPhA’s annual numbers issue, I thought I would offer one of my own:
4,405 That’s the number of bills drafted this year at the Georgia Capitol as of March 9. Those bills look to address an almost unimaginable number of topics and subtopics — government, agriculture, transportation, healthcare, banking…. Only a portion of the bills that were drafted will be introduced, and far fewer will become law. Two of those 4,405 bills were yours. SB 103 and HB 247, introduced by Senator Mullis and Representative Knight respectively, had unprecedented support in the legislature. The bill is now on its way to Governor Deal for his signature. How strong was that support? The bills not only had dozens of sponsors (more than 30 for the senate version and more than 50 for the house version), it passed both chambers unanimously. Garnering that level of support (particularly when you consider the strength and resources of competing interests) is no small feat. We did it thanks to you, the care you provide, and the relationships you have. Representative Knight, as passionate an advocate as we could hope to have, became so in part because pharmacists in his district spent their time sharing the challenges they and their patients faced. Similarly, Senator Mullis’s desire to pick up the mantle and fight for Georgia’s pharmacists and patients came from hearing from pharmacists in his district how current industry practices were hurting patient care. The same holds true for most if not all of the cosponsors of these bills. I can’t tell you how many times legislators have told me, “Sounds like a great bill. Let me speak with my pharmacist and I’ll follow-up with you.” And sure enough, after speaking with their pharmacists they signed on. April/May 2017
And your work didn’t stop there. As our bills made their way through their respective committees and to the floor, GPhA sent out several calls to action. Pharmacists answered. At the same time, on an almost weekly basis, GPhA pharmacists and student pharmacists came to the Capitol and met with legislators on the rope line. As important as advocacy is, though, the support we’re enjoying this session isn’t just because of advocacy. It’s because of what you do and who
HE SPOKE ABOUT THE PHARMACISTS IN HIS DISTRICT. HE MENTIONED THEM BY NAME. you are. It’s easy to lose sight of that in the midst of a legislative session with all of the calls to action, advocacy events, committee meetings, and votes. But it is true. I was reminded of this as I sat in the senate balcony with several pharmacists awaiting the vote on SB 103 and listening to Senator Mullis address his fellow senators. He spoke about the pharmacists in his district, whom he mentioned by name, and those in other districts — and what an important job pharmacists do. Pharmacists take care of people, he said — our families and our constituents — and this bill will help them do that better. The vote was unanimous, and as this goes to print, the Pharmacy Patient Fair Practices Act is awaiting Governor Deal’s signature. The support these bills have received to date is because of you. So thank you for answering our call, and more importantly, thank you for taking care of the people of Georgia. Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
OPEN
GLOSS/GRADIENT
FLAT COLOR
1
Greg Reybold is GPhA’s vice president of public policy and our association counsel; he leads our lobbying team. Georgia Pharmacy
3
news
DID YOU KNOW YOU’RE HAPPIEST ON THURSDAY? Happy or Not, which conducts customer and employee satisfaction poll, found that — based on 5.2 million patient satisfaction “feedbacks” — patient satisfaction with pharmacists is highest on Thursday and lowest on Sunday. (Specifically, between 9:00 and 11:00 a.m. is the sweet spot.)
NEANDERTHAL PHARMACISTS Looking at DNA in dental plaque of Neanderthals,researchers found that they may have self-medicated with aspirin (from poplar bark) and penicillin (from mold). “Apparently, Neanderthals possessed a good knowledge of medicinal plants and their various anti-inflammatory and pain-relieving properties, and seem to be self-medicating.”
read more @ gphabuzz.com
4
Georgia Pharmacy
Pharmacist advocacy teams like this one brought our message face-to-face and ended up making a big difference.
Patient-protection bill passes legislature unanimously The Pharmacy Patient Fair Practices Act has passed the Georgia legislature and at press time is on the way to Governor Deal for, we hope, his signature. It’s one of the strongest patient protection bills in the country and a bill we are extremely proud of. The bill gives the commissioner of insurance the authority to create rules and regulations to enforce the provisions of the PBM chapter of the law. We can’t overstate how important this is. This provision alone would be a significant victory. But there’s much more in the bill. It would specifically prohibit several practices that have adversely impacted patients and pharmacies. PROHIBITED: Restricting pharmacies from providing patients with information about less costly prescription drugs (and selling them those less-costly drugs). PROHIBITED: Restricting pharmacies from offering directdelivery services to their patients as an ancillary service.
PROHIBITED: Charging patients copays that are higher than what the pharmacy is paid (i.e., copay clawbacks). PROHIBITED: Charging fees related to the adjudication of a claim (transaction fees). PROHIBITED: Recouping money from a pharmacy outside of the audit process, unless otherwise authorized or required by law. PROHIBITED: Penalizing or retaliating against a pharmacy for seeking to enforce its rights. PROHIBITED: Mandatory mail order under group, blanket, and individual accident and sickness policies. (There are several large swaths of the mail-order market that this bill will not affect due to federal law and other considerations.) Now, thanks to the support of Senator Mullis, Representative Knight, and the work of pharmacists who fought tirelessly for this bill, we are one signature away from seeing it become law. April/May 2017
Move the needle on chronic disease outcomes in Georgia We’ve re-upped our partnership with the Georgia Department of Public Health and already have some excellent programming in store for Georgia pharmacists. This year’s grant advances awareness of three areas: hypertension, diabetes education, and MTM. At the heart of our approach to all three focus areas is something we all know: Georgia pharmacists are uniquely positioned to counsel patients on managing chronic diseases. Accessing healthcare professionals, especially in medically underserved areas, can be difficult. (We talked some about the I-20 divide in last month’s cover story on DSME). Fortunately, we have you, Georgia pharmacists — the most accessible members of the healthcare team. So what are GPhA and DPH doing to help you help your patients? Lots, actually. This spring, we’ll offer three webinars, one on each subject area. We’re offering specific tie-in sessions at the 2017 Georgia Pharmacy Convention. And we’re promoting discussion and access to information through Facebook user groups and dedicated web pages. Your accessibility, combined with
HERE’S A RUNDOWN OF WHAT’S IN STORE: Free webinars
April 4: Basic Cents: Sustainable Models for Chronic Disease Management April 6: The Future of Hypertension Management May 11: DSME and You
SEE SPOT RUN. SEE SPOT GO TO THE VET. POOR SPOT.
2017 Georgia Pharmacy Convention sessions
Yikes, even Georgia’s pets aren’t all that healthy. The state ranks 44th out of 51 states (and DC), according to Care.com, which considered prevalence of illness, access to care, and other factors.
June 15: The Business of Diabetes: The Path to DSME Accreditation June 15: What’s New With Medication Therapy Management? Visit GPhAconvention.com your training as healthcare providers, means you are ready to help move the needle on chronic disease outcomes in our state. For more ideas on how to increase your impact, go to GPhA.org/ movetheneedle. There, you can register for any (or all) of the webinars, and find links to free resources to help you better reach patients. —Phil Ratliff
One Maine physician made her own, refillable, epinephrine injector Noting that the high cost of an EpiPen was in the injector, not the ingredient, she devised a system for her patients: Her own epinephrine injector, customized for each patient. “I found the right syringe,” she told The New York Times. “I put in the dose that I wanted. Whether it’s expired or used, people come back and refill it.” The cost? Fifty bucks for the device, and $2.50 for a refill. Wrote the Times, “[F]or customers with
April/May 2017
little money to spare, innovations like Dr. London’s might represent a path to more security.”
THANKS, REPRESENTATIVE COLLINS
Give your thanks to Georgia Rep. Doug Collins, who is championing the ‘generic transparency’ bill in Congress. (That’s just longhand for “MAC pricing.”) Hint: Send him a note through his website, dougcollins.house.gov or via Twitter at @RepDougCollins. Rep. Buddy Carter is, of course, also sponsoring the bill. But it would be great to get the entire Georgia congressional delegation on board, wouldn’t it? Georgia Pharmacy
5
news DRUG MAKERS SAY PBMS DEMAND HIGHER-PRICED MEDS
Representing pharmacists and pharmacies before the Georgia Pharmacy Board, GDNA and DEA. AREAS OF PRACTICE Professional Licensing Medicare and Medicaid Fraud and Reimbursement Criminal Defense Administrative Law Healthcare Law Legal Advice for Licensed Professionals
WWW.FRANCULLEN.COM (404) 806-6771 • admin@francullen.com
Gilead says it can’t cut the cost of its Solvaldi hep C cure because — get this — PBMs would refuse to cover it. Read that again. If Gilead lowers the price, it says PBMs won’t cover the drug. Why? Because PBMs’ rebates are based on a percentage of the cost. Lower cost, lower rebate, PBMs won’t buy it. “If we just lowered the cost of Sovaldi from $85,000 to $50,000, every payer would rip up our contract,” said Jim Meyers, executive vice president of [Gilead] worldwide commercial operations. PBMs responded by saying that wasn’t the case, and that the only thing causing high drug prices is… high drug prices.
Strategic Financial Advice
FOR PHARMACISTS & PHARMACY OWNERS
MEMBER SURVEY
(770) 353-6414 | mtarrant@inningroup.com 200 Ashford Center North, Suite 400 Atlanta, GA 30338 www.integrated-financial-group.com
MIKE TARRANT, CFP®
Securiies offered through LPL Financial, member FINRA/SIPC. Advisory Services offered through IFG Advisory, LLC, a registered investment advisor. Integrated Financial Group and IFG Advisory, LLC, are separate ennnes from LPL Financial. #1-527610 sepa
6
Georgia Pharmacy
Each year we ask our members what we’re doing right and what we can do better. The answers are important, and they help us plan for the future. The 2017 Member Survey will only take you about 10 minutes, tops. We look at every one, and your answers are critical for us. Please take those few minutes to fill it out — it’s at GPhA.org/2017survey. As an incentive, we’re giving away five $100 gift cards to random survey takers. Come and tell us what you think! April/May 2017
“TOUR ’N’ CURE”
REPORT: R&D DOESN’T JUSTIFY HIGH U.S. DRUG PRICES Pharma companies have said that a major reason for high drug prices is the cost of research and development. But now a new study published in Health Affairs finds that turns out not to be the case. Looking at the 15 drug companies that manufactured the 20 top-selling drugs in 2015, the researchers found that… • List prices of drugs in the U.S. were 144 percent higher than in
other developed countries. • Those higher prices earned drug makers $116 billion more (i.e., $166 billion more than if U.S. prices were on par with other countries’). • Those drug makers only spent $76 billion on R&D worldwide. Conclusion: the U.S. markup is well above and beyond the cost of researching and developing these drugs.
You are now free to move about the pharmacy After working with the Board of Pharmacy for more than a year, we are thrilled to announce this: The board has adopted a definition of “direct supervision” that allows pharmacists to provide care to patients in not only the prescription department, but also consultation rooms, vaccination rooms, and areas where over-the-counter drugs are sold — provided they’re available to provide assistance and direction to pharmacy personnel. In other words, pharmacists can come out from the prescription April/May 2017
If you can’t afford the $89,000 hepatitis C treatment in the U.S., an Egyptian company has a solution: Take a week-long vacation in Egypt, where you get the treatment — and sightsee — for only $6,000. It’s the brainchild of Egyptian drugmaker Pharco (get it?) and includes a physican visit, blood tests, three or six months’ worth of hepatitis C pills, and three days of sightseeing.
department to work with patients for up to five minutes at a time. It’s important to note that pharmacists will still be responsible for all activities performed by pharmacy personnel, and still need to document their final check of products before prescriptions are dispensed. In short, retail pharmacists no longer have to maintain a direct line of sight to pharmacy personnel; they are now free to leave the prescription counter to provide pharmacy care and interact with their patients.
JANSSEN SHEDS SOME LIGHT ON ITS PRICES Johnson & Johnson’s Janssen reported that, while the company’s list prices rose 8.5 percent in 2016, when you take into account rebates and discounts the net increase (i.e., what goes to the company’s bottom line) was only up 3.5 percent that year. What isn’t clear, though, is how much more insurance companies and individuals actually paid out of pocket and how much went to middlemen such as PBMs. (Which is something Janssen can’t provide, anyway.) Georgia Pharmacy
7
Georgia’s compounding pharmacies are experiencing closer scrutiny by state pharmacy regulators and the Food and Drug Administration.
news
Is your compounding pharmacy in compliance? Hasson Law Group has experience in: • regulatory compliance • licensing • government investigations • criminal proceedings • litigation
Hasson Law Group LLP
Among the products we offer: • standard operating procedures • training • compliance audits • licensing and registration • mock inspections • gap/risk assessment reports • government investigations • criminal liability negotiation • crisis management
www.hassonlawgroup.com 678-701-2869 | info@hassonlawgroup.com
8
Georgia Pharmacy
A BOLD EXPERIMENT TO COMBAT MALARIA IN WEST AFRICA Scientists working in Burkina Faso, West Africa, are considering a plan to eradicate a species of mosquito that has caused millions of deaths by malaria. But it’s a very different kind of experiment. You may have heard of the idea of tweaking the genes in male mosquitoes to make them infertile, thus reducing the population where they’re released; they outcompete the fertile males and reduce the population. This has been done successfully in South and Central America, and may even be used in the U.S. The Burkina Faso plan is a very different experiment. In this case, scientists would use a gene drive. (That’s a phrase you’ll want to know for the future.) A gene drive not only makes a change to an animal’s DNA, it also includes the mechanism to push that change into future generations. Normally a gene has a 50-50 chance of being passed on (you know, from either mom or dad). A gene drive essentially forces a gene to be passed on, skewing that 50-50 chance — and it passes that skewing mechanism on as well. The experiment being considered in Burkina Faso would create Anopheles gambiae mosquitoes that only produced male children... and whose children only produced male children. It has the potential to save untold millions of lives... but a gene drive has never been released in the wild, and its longterm effects aren’t known. April/May 2017
calendar
For details, registration, and more info visit GPhA.org/calendar.
June 15-18
April 11-20 GPhA’s Regional Legislative Briefings
June 3 GPhA’s Practical Skills Refresher Course
April 25 Controlled Substances Loss or Theft: What Steps Do I Take? (CPEasy)
July 6 Prescribing Guidelines, Quality Measures, and Care Practices to Improve Opioid Safety (CPEasy)
April 27 Physical Improvements for Enhancing Pharmacy Safety and Security (CPEasy)
July 13 Understanding Naloxone: Products, Protocols, and Georgia Law (CPEasy)
May 4 Preserving Personal, Staff, July 20 The Pharmacist’s Obligation and Customer Safety During a Pharmacy Robbery with Controlled Substances (CPEasy) July 22 GPhA’s Practical Skills May 7 Refresher Course MTM certification course, GPhA Headquarters, Sandy Springs
New GPhA Members GPhA welcomes our newest members (as of March 16, 2017). Pharmacists Robert Hall, Americus Clement Okpala, Fayetteville Lori Harvey, Griffin Christy Bivins, Clarkesville John Bird, Jonesboro Emily Lee, Calhoun Kristina Carter, Lithonia Karine Alleyne, College Park Thomas Rawls, Hixson, TN Mike Brinson, Wrightsville Jennifer Richardson, Canton Bridget Moore, Macon Ashley Gainey, Atlanta Vijay Patel, Macon
April/May 2017
Debra Toth, Peachtree Corners Kathy Huff, Augusta Kristi Schlacht, Cumming Eric Ridings, Boiling Springs, SC Joan Mangarelli, Fayetteville Jennifer Leavy, Saint Simons Island Tuyen Do, Decatur My Linh Ngo, Morrow Jennifer Proenza, Boca Raton, FL Nimisa Dave, Alpharetta Ann Tran, Hixson, TN Sylma Pagan, Jacksonville, FL Robin Elliott, Houston, TX Carol Henry, Tallahassee, FL Jiehyun Lee, Duluth
Emily Langlois, Milwaukee, WI Vijay Patel, Jacksonville, FL Megan Mills, Thomasville Leslie Holifield, Homewood, AL Tricia Francetich, Grayson Pharmacy Technicians Matt Brown, Statesboro Stacey Smith, Gray Melissa Cauley, Forsyth Monica Brady, Jackson Brittany Ellis, Warner Robins Trissi Philmon, Forsyth Kaylee Heape, Macon Marlana Smith, Douglas
Georgia Pharmacy
9
legal injection
A more perfect practice Greg Reybold, GPhA‘s vice president of public policy and association counsel, offers his perspective on issues specific to pharmacy. As a reminder, nothing in this column constitutes legal advice. If you have a legal issue or question, consult your own attorney. Can a pharmacist in Georgia administer a B12 injection? Yes — with a prescription. Specifically, the practice of pharmacy includes “drug administration.” However, GREG REYBOLD because a B12 injection is classified as a dangerous drug under Georgia law, a prescription is required. Can a pharmacist perform oral swab testing of patients? While the Pharmacy Practice Act specifically provides that performing capillary blood tests and interpreting the results falls within the practice of pharmacy (in connection with monitoring disease risk factors and patient education), the act makes no mention of oral swab or other types of testing. The Georgia Board of Pharmacy has consistently taken the position that, despite being less invasive than a capillary blood test, oral swab testing falls outside the practice of pharmacy. Can a pharmacist enter into a protocol agreement with a physician to perform services that fall outside the scope of practice of pharmacists in Georgia? Yes, but only in three circumstances. 1. P harmacists can enter into such a protocol agreement in connection with administer-
ing vaccines for influenza, pneumococcus, shingles, and meningitis — subject to very specific requirements. 2. A physician may delegate authority to a pharmacist to modify drug therapy through a protocol for a patient under the physician’s direct medical care and supervision. These protocols are subject to specific requirements: They must be patient-specific, there must be a physician diagnosis of disease, there must be procedures for the pharmacist to follow, and the date and length of time of agreement must be specified. (It can’t exceed two years.) The requirements are so specific that this protocol is, to my knowledge, rarely used. Note, this is distinct from substituting a generic for a brandname drug, which squarely falls within the practice of pharmacy. 3. Finally, hospital pharmacists can collaborate with members of the medical staff in an institution on drug therapy management pursuant to a protocol. This protocol is not nearly as restrictive as the protocol discussed above regarding drug therapy modification. What should I do if I have a question regarding whether an act falls within the practice of pharmacy in Georgia? Scope of practice questions are important and must be addressed with care as exceeding it can have serious ramifications and, in some circumstances, may constitute the unlicensed practice of medicine. As such, when in doubt I strongly recommend you consult qualified legal counsel and clear any practices in advance with the Georgia Board of Pharmacy.
DO YOU HAVE AN ISSUE YOU’D LIKE TO SEE ADDRESSED IN THIS COLUMN? LET US KNOW — SUBMIT IT TO GREG AT GREYBOLD@GPHA.ORG.
10 Georgia Pharmacy
April/May 2017
WHAT IS THE SCOPE OF PRACTICE FOR A PHARMACIST IN GEORGIA? such functions shall report the results obtained from such blood tests to the patient’s physician of choice; and the responsibility for compounding and labeling of drugs and devices.
In Georgia, the practice of pharmacy is defined by law in the Pharmacy Practice Act to mean: [ T]he interpretation, evaluation, or dispensing of prescription drug orders in the patient’s best interest; participation in drug and device selection, drug administration, drug regimen reviews, and drug or drug-related research; provision of patient counseling and the provision of those acts or services necessary to provide pharmacy care; performing capillary blood tests and interpreting the results as a means to screen for or monitor disease risk factors and facilitate patient education, and a pharmacist performing
Pharmacy care is also defined in the pharmacy practice act to mean: [ T]hose services related to the interpretation, evaluation, or dispensing of prescription drug orders, the participation in drug and device selection, drug administration, and drug regimen reviews, and the provision of patient counseling related thereto. Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
OPEN
GLOSS/GRADIENT
FLAT COLOR
1
Use of this article, or the information it contains, does not constitute any legal advice, does NOT establish any attorney-client relationship, and does NOT create any legal duty on the part of the author or the Georgia Pharmacy Association. When making a decision that may have legal consequences, readers should consult with qualified legal counsel.
We Deliver Solutions for a Healthier Bottom Line EPIC Pharmacies, Inc. provides more than 1,500 independent member pharmacies across the U.S. with the group buying power and managed care solutions essential to delivering quality patient care. Membership offers: • Group volume purchasing power • Aggressive wholesaler pricing programs • Successful rebate program - $60.8 million returned to members in 2016 • EPIC Pharmacy Network, Inc. (EPN) membership fee included at no cost – access to third-party contracts • Clinical services tools, including expert assistance from our in-house pharmacist and access to custom PrescribeWellness offerings and EQuIPP •
PUT THE POWER OF A NETWORK BEHIND YOU
800-965-EPIC | EPICRX.COM
•
TM
– free third-party claims reconciliation program and automated reimbursements below cost system – Web-based solution for pharmacy regulatory and compliance management
EPIC Half Page Ad - 7”W x 4.875”H, CMYK, 300dpi. Rev. 01.31.17 April/May 2017
Georgia Pharmacy 11
0
cover story
BY THE NUMBERS
E
ach year we like to take a break from our detailed feature stories — “words, words, words” to quote some Dane — and instead look at some of the numbers that affect your world. It would be nice to say that numbers don’t lie, but of course they can. You can always manipulate them, or cherry-pick them, or leave out the context. But we’ve tried not to do that here, mostly because we’re looking to inform you, not persuade you. This year’s collection is a lot about context — comparisons of money, time, and health (with
a few tidbits thrown in simply because they’re interesting). These numbers probably won’t change your life, but they may have you look at something in a different way: Your salary, for example, or your patients’ health. Maybe it will put into context some of the news you read, or show you a different angle. Maybe it will convince you that you’re not seeing things — prices really are going up that fast. Or maybe these next few pages will simply give you something interesting to talk about at the virtual water cooler. —Andrew Kantor
All ABOUT About YOU You ALL GPhA MEMBERSHIP STUDENT PHARMACISTS
PHARMACIST SALARIES GEORGIA PHARMACISTS earn a median salary of
$118,300 per year.
Georgia ranks #30 in the U.S. Highest, Alaska: $141,390 Lowest, Nebraska: $109,550 GEORGIA PHARMACY TECHNICIANS earn an average of
$30,572
per year Highest-paying region: Atlanta Lowest-paying region: Columbus Sources: Indeed, Drug Topics Salary Survey, U.S. Department of Labor
12 Georgia Pharmacy
5% 27%
PHARMACY TECHNICIANS 2.7%
ACADEMIC
RETIRED
2%
AFFILIATES
6.7%
0.5%
13.5% 16.9%
PHARMACY OWNERS
30.7%
PHARMACY EMPLOYEES (CLINICAL/ HEALTH-SYSTEM)*
PHARMACY EMPLOYEES (RETAIL)*
*approximate, based on member reporting
Are you using your skills? Surveyed pharmacists ranked “skill utilization” at
2.7
on a scale of 0 to 5. Source: Sokanu career advisors
April/May 2017
0
GEORGIANS’ HEALTH IMMUNIZATIONS ER VISITS
GEORGIANS OVER 65 RECEIVING THE PNEUMOCOCCAL VACCINE:
(2015)
TOTAL
3.85 million RURAL
807,300
URBAN/SUBURBAN
3,043,045
Counties with the highest rates of ER visits: • Polk • Troup • Ware • Spalding • Coffee Counties with the lowest rates of ER visits: • Tift • Catoosa • Forsyth • Fayette • Columbia Source: Georgia DPH
5.7%
of Georgians reported using tobacco during pregnancy
65.12%
2014
69.13%
2015 60
70
In July 2015 pharmacists first were allowed to provide the vaccine along with those for meningitis and shingles. Source: Department of Public Health
Georgia STDs: Good news and bad CHANGE IN GEORGIA’S HIV INFECTION RATE from 2008 to 2014:
-6%
LIKELIHOOD OF A GEORGIAN BEING DIAGNOSED WITH HIV in his or her lifetime:
1 in 51 RANKING OF GEORGIA AMONG STATES for overall HIV infections:
5th
• FOR SYPHILIS: 4TH • FOR GONORRHEA: 7TH • FOR CHLAMYDIA: 8TH
Source: Georgia DPH
April/May 2017
Georgia Pharmacy 13
OTHER PEOPLE’S MONEY The world’s largest pharmaceutical companies by revenue RANK/COMPANY
REVENUE
CEO PAY
10. Gilead Sciences
$24.5 billion
John Martin, CEO, $18.8 million
9. AstraZeneca
$26.09 billion
Pascal Soriot, CEO, $16.3 million
8. GlaxoSmithKline
$34.65 billion
Andrew Witty, CEO, $8.16 million
7. Sanofi S.A.
$36.73 billion
Olivier Brandicourt, CEO, $4.7 million
6. Merck & Co.
$42.2 billion
Kenneth Frazier, CEO, $19.89 million
5. Bayer
$45.84 billion
Werner Baumann, Chairman, $5.64 million
4. Roche Holding AG
$47.63 billion
Severin Schwan, CEO, $13.4 million
3. Pfizer
$49.61 billion
Ian Read, CEO, $18.0 million
2. Novartis
$57.99 billion
Joe Jimenez, CEO, $11.96 million
1. Johnson & Johnson
$74.3 billion
Alex Gorsky, CEO, $21.1 million
Revenue is based on 2014 filings. CEO pay is 2014 or 2015.
Source: Public filings
The other highest-paid pharma CEOs COMPANY
CEO
PAY
Valeant
J. Michael Pearson
$143.1 million
Regeneron
Leonard Schleifer, M.D., Ph.D
$47.5 million
Vertex
Jeffrey Leiden
$28.1 million
Alexion
Leonard Bell
$24.9 million
McKesson
John Hammergren
$24.8 million
Allergan
Brenton Saunders
$21.6 million
AbbVie
Richard Gonzalez
$20.8 million
Abbott Laboratories
Miles White
$19.4 million
Mylan
Heather Bresch
$18.9 million
Source: AFL-CIO
PBM CEOs’ compensation COMPANY
CEO
PAY
CVS Health
Larry Merlo
$28.9 million
Express Scripts
George Paz
$14.8 million
UnitedHealthcare
Stephen Hemsley
$66. 1 million
Includes salaries and bonuses, 2014 or 2015. 14 Georgia Pharmacy
Source: Public filings
April/May 2017
DRUGS
The United States spent about
$297.7 billion
PRICES: BRAND NAME
From 2006 to 2015 the average brand-name price rose...
on retail prescription drugs. (2014)
FDA DRUG APPROVAL PROCESS
2006 TO 2008 Brand-name drug prices
7.1%
Inflation
3.3%
2013 TO 2015 Brand-name drug prices
FDA MEDIAN DRUG-APPROVAL TIME
15.7%
Inflation
1993
1.1% 0
5
10
15
26.9 months
20
PRICES: GENERICS
10.1 months
2016
How prices changed depended on how old the drug was Generic drug prices OVERALL
-59%
0
ESTABLISHED generics
-9.8%
5
10
15
20
25
30
MEDIAN CANCER-DRUG APPROVAL RATES, 2003 TO 2016 FDA 183 days
European Medicines Agency 356 days
“Established:” on the market for all five years. New generics tend to have greater price drops soon after introduction.
Sources: FDA, Friends of Cancer Research
PRICE GOUGING? GENERIC PRICE INCREASES OF MORE THAN 100% FROM 2010 TO 2011: 45
FROM 2014 TO 2015: 103
Source: Government Accounting Office
April/May 2017
Georgia Pharmacy 15
Coverage You Need. Service You Deserve. A Price You Can Afford.
OMNI AMELIA ISLAND PLANTATION RESORT, JUNE 15-18, 2017
Why should you go? Tons of stress-reducing education
A great vacation for the family
More connections than Kevin Bacon
Yes, we know you like to wait until the last week before license renewal, but wouldn’t it be great to get a huge chunk of it out of the way now? We’ve worked hard to put together courses you’ll actually find interesting and useful; packed classrooms make us happy. Check out the list of courses and you’re bound to find more than a few that are worth your while. And this year every course is ACPE-approved for both pharmacists and technicians.
No matter how you split your time between work and pleasure, Amelia Island is a great place to do it. You’re on a resort after all — no matter what your family is into, they probably don’t even need to leave the property. Then there’s the rest of Amelia Island, all just a quick drive away. (Note to Atlanta residents: “Quick drive” means 10 or 15 minutes, not two hours.) And we picked June for a reason: The weather is likely to be perfect. And is it all tax-deductible? Maybe — that’s for you and your tax advisor to discuss.
Perhaps the biggest draw for the convention is the chance to meet other professionals: Your next hire, your next boss, your next mentor, or simply someone you wish you met a long time ago. Relationships aren’t built behind counters. They begin at events like these. In a lecture, at breakfast, on the Expo Hall floor, at the President’s Bash — there are plenty of chances to give your career and practice a boost by not just what you learn, but who you meet.
Info and registration at GPhAconvention.com
Grow, play, and connect on Amelia Island! MORE THAN 30 CPE SESSIONS THURSDAY Georgia DPH User Group: What’s New With Medication Therapy Management? Amanda Gaddy and Melanie DeFusco
2017 New Laws Update Greg Reybold
Empowering Your Pharmacy Team Workshop Tripp Logan Best Practices in Part B Billings Jonathan Marquess
FRIDAY Staying in the Loop: Making the Pharmacists’ Patient Care Process Relevant in Your Students’ Experiences Lindsey Welch and Kay Brooks
Treating Patients with Dementia: A Physician’s Perspective Dr. William Hu
How to Move In, Move Up, or Move On Mollie Durham
Preventing Medication Errors in the Retail Setting: What Pharmacists MUST Know, Do, and Say Michael Crooks, Jake Galdo, and Ashish Advani
Using Technology for Patient Engagement: Pros and Cons of the Latest Apps and Platforms Ashish Advani
What’s Changed? A Fast Review of Guideline Treatment Updates Jake Galdo
Making Progress with Senior Care: Opportunities for Improving Patient Care Steve Aldridge New Drug Update 2017: A Formulary Approach Rusty May Adverse Drug Events: A Legal Perspective Greg Reybold Technology in Care Transitions and Chronic Care Management: Pharmacy-EHR Integration and More Carlie Traylor Onboarding Your Techs: Tips from a Pharmacy Technician Educator Pedro Valentin
Info and registration at GPhAconvention.com
KEYNOTE SESSIONS THURSDAY JUNE 15 Millennials, GenXers, Boomers, and Beyond: How Not to Become Roadkill When Crossing the Generational Divide TERRY WATSON With his inimitable style and humor, Terry Watson will help separate myth from fact about generational differences in the workplace. His message: Approaching these differences with understanding and a sense of humor will help you reach your optimal levels as a manager, co-worker, and healthcare provider.
Compounding Procedure Review: The Basics of Quality Compounded Preparations Brenda Jensen Medication Errors and Adverse Drug Event Prevention: New Quality Measures on the Horizon for Medication Safety Michael Crooks SATURDAY Working in a Multi-Generational Workplace: Embracing Generational Differences Angela Clauson The SBIRT Approach: Improving Care for Patients with Substance Abuse Disorders Kay Brooks and Matt Perri
FRIDAY JUNE 16 Impacting Health Care Quality and Value with a High Performing Pharmacy Team TRIPP LOGAN, PHARM.D There’s a wealth of opportunity waiting for reimagining and re-orienting your pharmacy team toward new roles and better outcomes. Learn why pharmacy is changing and how pharmacists and pharmacy technicians can optimize their teams to succeed in the new pharmacy environment.
SATURDAY JUNE 17 Research Showcase: Innovations in Diabetes Treatment and More, from Georgia’s Schools of Pharmacy ASHISH ADVANI, PHARM.D Research conducted in Georgia’s four pharmacy schools is changing the way pharmacists everywhere will practice the profession. Do you know what going on in your own pharmacy research backyard? Join 2015 Generation Rx award winner Ashish Advani and guests from Mercer, PCOM, South University, and UGA for a look at some of the latest.
REGISTER TODAY! Federal Issues Update Marketing Your Pharmacy Services With Social Media Brian Donahue Improving Opioid Safety: Prescribing Guidelines, Quality Measures, and Care Coordination Practices Michael Crooks Improving Patient Outcomes with Med Sync and Other Adherence Programs Carlie Traylor
Cannabidiol: Updates in Pediatric Care Christopher Campbell Updates From the Georgia Board of Pharmacy and the GDNA SUNDAY Taking Your Immunization Program to the Next Level Jonathan Marquess Women’s Health Update Kendra Manigault and Kalen Manasco
Heath Literacy and Assessment: Tips for Using Patient Education and Counseling Resources Erin Dalton
Info and registration at GPhAconvention.com
CONGRATULATIONS TO THE 182 INDEPENDENT PHARMACIES THAT MADE THE SWITCH TO CPA® IN 2016,
especially the 25 from Georgia! 13
3
3 2
36
10
2
8 1
12
18
2
1
5
23 4
23
3
25
10 9
3 4
4
3 2
14% Annual CPA® Member Growth Rate
865
MEMBERS
2012
906
MEMBERS
2013
LET CPA® ADVOCATE FOR YOU. call 888.434.0308 visit compliantrx.com email sales@compliantrx.com
1127
MEMBERS
2014
1226
MEMBERS
2015
1
1408
MEMBERS
2016
MD 5 DE 1
INVESTING IN PHARMPAC IS INVESTING IN YOUR PRACTICE. 2017 PHARMPAC INVESTORS
The following pharmacists, pharmacy technicians, students, and others have joined GPhA’s PharmPAC for the 2017 calendar year. The contribution levels are based on investment through February 28, 2017. Diamond Investors ($4,800 or $400/month)
CHARLES BARNES Valdosta
MAC McCORD Atlanta
SCOTT MEEKS Douglas
FRED SHARPE Albany
Titanium Investors ($2,400 or $200/month)
RALPH BALCHIN Fayetteville
DAVID GRAVES Macon
JEFF SIKES Valdosta
LON LEWIS St. Simons Island
BRANDALL LOVVORN Bremen
DEAN STONE Metter
David Graves, Macon, PharmPAC chairman April/May 2017
Georgia Pharmacy 21
2017 PHARMPAC INVESTORS Platinum Investors ($1,200 or $100/month) BRUCE BROADRICK THOMAS BRYAN, JR. WILLIAM CAGLE HUGH CHANCY KEITH CHAPMAN WES CHAPMAN DALE COKER BILLY CONLEY BEN CRAVEY BLAKE DANIEL AL DIXON JACK DUNN ROBERT HATTON CASSIE HAYES MARSHA KAPILOFF IRA KATZ
Gold Investors ($600 or $50/month)
JEFF LUREY DREW MILLER LAIRD MILLER WALLACE PARTRIDGE HOUSTON ROGERS JOHN SANDLIN TIM SHORT TERESA SMITH CARL STANLEY DENNIS STRICKLAND CHRIS THURMOND DANNY TOTH ALEX TUCKER TOMMY WHITWORTH
JAMES BARTLING LANCE BOLES WILLIAM BREWSTER LIZA CHAPMAN BARON CURTIS MARSHALL CURTIS MAHLON DAVIDSON SHARON DEASON ED DOZIER KEVIN FLORENCE KERRY GRIFFIN MICHAEL ITEOGU STEPHANIE KIRKLAND GEORGE LAUNIUS MACK LOWREY EUGENE MCDONALD
Bronze Investors
Silver Investors
($300 or $25/month)
Michael Adeleye Nelson Anglin Michael Azzolin James Carpenter Gregory Drake Marshall Frost Joe Holt Susan Kane Willie Latch Tracie Lunde Hillary Jack Mbadugha
(CONTINUED)
Bill McLeer Donald Piela, Jr Jonathan Sinyard Renee Smith Austin Tull
BOBBY MOODY SUJAL PATEL GREG REYBOLD DARYL REYNOLDS BRIAN RICKARD ANDY ROGERS JAMES THOMAS WILLIAM TURNER CHUCK WILSON H.D. WILSON III INTEGRATGED FINANCIAL GROUP MERCER UNIVERSITY STUDENTS
Member Investors
($150 or $12.50/month)
(up to $150)
Phil Barfield Bryce Carter Mathew Crist Michael Crooks Larry Harkleroad Hannah Head Phillip James Brenton Lake Micheal Lewis Terry Shaw Amanda Stankiewicz
Marla Banks Chandler Conner Tricia Francetich Josh Greeson Lori Harvey Iris Ivey Mike Martin Kathy McLeod Mi-Deok Park Donnie Payne Alex Pinkston Thomas Rawls Jennifer Richardson
HELP US REACH OUR GOAL FOR 2017! PharmPAC funds help elect legislators who are friendly to pharmacy. As of February 28, 2017, we still had a long way to $130,000, our goal for the year.
Goal: $130,000
$20,599
0
130,000
Thank you to all our PharmPAC investors for their contributions to the future of pharmacy in Georgia. Visit GPhA.org/PharmPAC to find out more.
22 Georgia Pharmacy
April/May 2017
contact OPEN
Keep in touch
REACH US AT 404.231.5074 OR GPhA.ORG
FLAT COLOR
GPhA LEADERSHIP President & Chair of the Board LANCE BOLES, Hartwell lanceboles@hotmail.com President-Elect LIZA CHAPMAN, Dawsonville liza.chapman@kroger.com First Vice President TIM SHORT, Cumming garph9@aol.com Immediate Past President TOMMY WHITWORTH, LaGrange twhitworth@corleydrug.com Directors MICHAEL AZZOLIN, Bishop azzolinm@pharmdondemand.com SHARON DEASON, Newnan sdeason99@hotmail.com AMY MILLER, Gainesville amylulapharmacy@gmail.com FRED SHARPE, Albany fsharpe@u-save-it.com JONATHAN SINYARD, Cordele sinyardj@gmail.com RENEE SMITH, Columbus rdapharmd1995@gmail.com CHRIS THURMOND, Athens vildrug@bellsouth.net
1
For membership questions Mary Ritchie Director of Membership Operations (404) 419-8115 mritchie@gpha.org For questions about our magazine, blog, websites, or social media Andrew Kantor Director of Communication akantor@gpha.org For questions about our educational offerings Phillip Ratliff Education Consultant pratliff@gpha.org For questions about any of our insurance products Denis Mucha Manager — Member Services (404) 419-8120 dmucha@gpha.org For questions about governmental affairs Greg Reybold Vice President of Public Policy greybold@gpha.org For questions about the Board of Directors or GPhA governance policies Ruth Ann McGehee Executive Assistant and Governance Manager (404) 419-8173 rmcgehee@gpha.org
For operational or accounting questions: Dianne Jones Vice President of Finance & Administration (404) 419-8129 djones@gpha.org Patricia Aguilar Accounting Coordinator (404) 419-8124 paguilar@gpha.org
For assistance with independent-pharmacy issues Jeff Lurey, R.Ph. VP of Independent Pharmacy (404) 419-8103 jlurey@gpha.org For questions about your AIP membership Verouschka “V” Betancourt-Whigham Manager of AIP Member Services (404) 419-8102 vbwhigham@gpha.org AIP Member Service Representatives Rhonda Bonner (229) 854-2797 rbonner@gpha.org Charles Boone (478) 955-7789 cboone@gpha.org
GPhA’S MEMBER SERVICE PARTNERS InfiniTrak infinitrak.us Track and trace compliance software (844) 464-4641 Pharmacy Quality Commitment pqc.net Quality assurance compliance resources (866) 365-7472 Pharmacy Technician Certification Board ptcb.org (800) 363-8012 SoFi sofi.com/gpha Student-loan refinancing (855) 456-7634
Got a concern about a GPhA program or service? Want to compliment or complain? Drop a note to info@gpha.org.
Melissa Metheny (678) 485-6126 mmetheny@gpha.org Gene Smith (423) 667-7949 gsmith@gpha.org
Georgia Pharmacy A S S O C I AT I O N
April/May 2017
Georgia Pharmacy 23
postscript
Counting on us Pharmacy practice and operations increasingly utilize numerical data on a daily basis in order to continually look for ways to improve outcomes and performance. We use laboratory values, LANCE BOLES Hemoglobin A1c reports, and blood pressure readings to assess the health status of a patient. Adherence scores, Star Ratings, and performance measures are the instruments prescription plans use to evaluate our quality. Prescription counts, sales data, and margins are useful in determining the financial health of a pharmacy. While these numbers allow us to make more informed decisions, it is important to not neglect the fact that the role of the pharmacist is built around relationships. I would like to highlight a few relationships that a pharmacist must develop and cultivate in order to be successful in delivering excellent care and positive outcomes. Pharmacist — Patient The patient is the core focus of what we do and the reason behind why we do it. Our role as pharmacists is quite simply to care for our patients. A key tenet to providing the best care for our patients is developing relationships with our patients. It’s important that we not only review their medication profiles, but that we have an understanding of patients’ healthcare literacy, activity level, social support system, and the resources available to correct any deficiencies. We owe it to our patients to use every encounter to strengthen this relationship by finding a small way to positively impact their health. Pharmacist — Prescriber Prescribers are facing many of the same challenges that pharmacists see daily in the healthcare system. Pharmacists are highly trained 24 Georgia Pharmacy
medication experts, and we should position ourselves as such in our daily practice. We must communicate with prescribers that we are capable and ready to assist as a critical part of the healthcare team. By offering solutions that improve quality, reduce inefficiencies, and drive positive outcomes, pharmacists will demonstrate their value. Pharmacist — Professional Association Professional associations like GPhA work to give a voice to our profession and accomplish goals for the membership — goals each of us could not achieve alone. Membership and involvement in organizations like GPhA give us the benefit of learning best practices from colleagues, access to high-quality educational programming, and the opportunity to network with peers. When pharmacists collaborate and utilize the resources of associations like GPhA, we can achieve far more together than we can as individuals. Pharmacist — Policy Makers Pharmacists are active members of the communities we serve. As such, we have the ability to develop relationships with our local, state, and federal elected leaders. It is critical that pharmacists interact with and foster relationships with these policy makers so that the importance of the services that pharmacists provide is well understood at all levels of government. We depend on the relationships forged with our elected leaders to both protect and expand our ability to practice pharmacy in today’s constantly changing healthcare system. As pharmacists, each of these relationships are critical to our professional success. I challenge you to work on fostering these relationships in your own practice and community. Georgia Pharmacy A S S O C I AT I O N
BLACK & WHITE
OPEN
GLOSS/GRADIENT
FLAT COLOR
1
Lance Boles is GPhA’s 2016-2017 president and owner of independent pharmacies in Harwell, Ga., and Iva, S.C. April/May 2017
0.125% rate discount1 when you refinance student loans with SoFi. The cure to student debt? Refinancing, thanks to SoFi and the Georgia Pharmacy Association. Pharmacists save an average of $408 a month2 by refinancing student loans with SoFi.
Apply at SoFi.com/GPHA Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. Current as of 3.1.17. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet SoFi’s underwriting requirements. SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offerws such as Income Based Repayment or Income Contingent Repayment or PAYE. See eligibility requirements at sofi.com/legal. Licensed by the Department of Business Oversight under the California Finance Lender Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. 1 See SoFi.com/GPHA for important terms and conditions for rate discount eligibility. 2 See sofi.com/disclaimer1.
Georgia Pharmacy A S S O C I AT I O N
GEORGIA PHARMACY FOUNDATION, INC. 6065 Barfield Road NE | Suite 100 Sandy Springs, GA 30328
BLACK & WHITE
OPEN
GET UPDATED AND GET FED: GPhA’S SPRING REGIONAL LEGISLATIVE BRIEFINGS AND DINNERS
GLOSS/GRADIENT
REGISTER NOW FLAT COLOR
for your region’s meeting1 and dinner, and get updated on the issues we’re working on during this legislative session.
SEATING WILL BE LIMITED! Registration is open! Get thee to GPhA.org/briefings
YOU MUST REGISTER TO ATTEND Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region 10 Region 11 Region 12
April 18 Statesboro April 20 Valdosta April 12 Columbus April 18 Peachtree City April 11 Sandy Springs April 18 Macon April 19 Acworth April 13 Waycross April 19 Jasper April 12 Athens May 2 Gainesville April 13 Augusta April 20 Dublin