GPhA Journal - November 2013 by Georgia Pharmacy Association

November 2013 VOLUME 35, Issue 11

The Pros & Cons

Is the Passage of the Drug Quality and Security Act Good for the Profession?

November 2013 Editor: Jim Bracewell jbracewell@gpha.org

The Georgia Pharmacy Journal® (GPJ) is the official publication of the Georgia Pharmacy Association, Inc. (GPhA). Copyright © 2012, Georgia Pharmacy Association, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording or information storage retrieval systems, without prior written permission from the publisher and managing editor. All views expressed in bylined articles are the opinions of the author and do not necessarily express the views or policies of the editors, officers or members of the Georgia Pharmacy Association.

Contents Message from Pamala Marquess ................... Welcome New Members................................... Message from Jim Bracewell ...........................

Is Passage of the Drug Quality and Security Act Good for the Profession?

Articles and Artwork Those interested in writing for this publication are encouraged to request the official “GPJ Guidelines for Writers.” Artists or photographers wishing to submit artwork for use on the cover should call, write or email jbracewell@gpha.org. Subscriptions and Change of Address The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is distributed as a regular membership service, paid for through allocation of membership dues. Subscription rate for non-members is $50.00 per year domestic and $10.00 per single copy; international rates $65.00 per year and $20.00 single copy. Subscriptions are not available for non-GPhA member pharmacists licensed and practicing in Georgia. The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is published monthly by the GPhA, 50 Lenox Pointe, NE, Atlanta, GA 30324. Periodicals postage paid at Atlanta, GA and additional offices. POSTMASTER: Send address changes to The Georgia Pharmacy Journal®, 50 Lenox Pointe, NE, Atlanta, GA 30324. Advertising Advertising copy deadline and rates are available upon request. All advertising and production orders should be sent to the GPhA headquarters at jbracewell@gpha.org.

GPhA Headquarters 50 Lenox Pointe, NE Atlanta, Georgia 30324 t 404-231-5074 f 404-237-8435

2 3 4

The Pros & Cons

When It Isn’t Alzheimer’s

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All Dementias Are Not Created Equal ...................

Long Term Care

What Do YOU Need to Know? ............................... PharmPAC ..................................................... Continuing Education ................................

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gpha.org

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MESSAGE

from Pamala Marquess

Making the Grade: Improving Medication Adherence

ou don’t see bumper stickers stating “My Child is a ‘C’ Student.” While good grades aren’t everything, when it comes to medication adherence, anything less than an A deserves Pamala Marquess attention. Unfortunately, recent research has revealed that Americans with chronic disease GPhA President earn a troubling C+ when it comes to taking their medications correctly. This lackluster grade translates to an estimated $105 Billion annually in avoidable health care costs in the United States. Results from a number of studies indicated that increased medication adherence improves health outcomes in patients while reducing their use of health care ser“Non-adherence vices, such as hospitals, which leads to a lower overall cost of care. In contrast, has become a non-adherence to medication has been found to increase overall health care large part of spending. Non-adherence has become a large part of the health care discussion and the health care how pharmacy is stepping in to offer solutions to this nationwide epidemic. discussion and Through technology advances, pharmacists now have more tools than ever to how pharmacy assist patients in taking their medications. Pharmacists also have programs such as MTM, motivational interviewing and synchronization to educate and is stepping in to improve adherence. Patients face barriers such as high co-pay’s, limited access offer solutions to to drugs due to preferred formularies, and complex treatment regimens. Despite these barriers, intervention programs led by pharmacists have this nationwide been shown to improve adherence among patients. Many studies have shown epidemic.” that face-to-face meetings with pharmacists had higher adherence levels than patients who had no interaction with pharmacists. Other studies have indicated the importance of medication therapy management (MTM) and comprehensive medication reviews(CMRs) on patients’ medication adherence levels. The results of a recent study of Medicare patients diagnosed with chronic diseases found that patients who received MTM services were more likely to be adherent than those who did not. Patients who also received a CMR had the greatest improvements in medication adherence. We know that increased pharmacist patient interaction and education lead to increase medication adherence will in turn improve health outcomes and decrease overall health care cost. What programs are you using to improve medication adherence in your practice? Thanks for all you do for GPhA,

Pam Pam

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WELCOME New Members Stephanie Lionbarger

Canton, GA - 9/27/2013

Kerrie Glass

Your Voice in Pharmacy

Woodstock, GA - 9/27/2013

The Georgia Pharmacy Association strives to be the leading voice for pharmacy in the state of Georgia. We aggressively advocate for the profession by shaping public policy and scope of practice to enhance the value of pharmacy. We take pride in our prestigious history and value our membership for its diversity in all practice settings as well as its dedication to health care.

Ball Ground, GA - 10/03/2013

GPhA provides its members with the resources and support needed to advance our profession. As healthcare changes, so do job responsibilities and career tracks may be refocused. GPhA is your career development partner as you address your future in pharmacy. Professional networking, skills training and continuing pharmacy education are key benefits of your GPhA membership. Whether you are a recent Pharmacy school grad or an established pharmacist, there is a place for your voice at GPhA.

Jeff Richardson Susan Thomas

Smyrna, GA - 9/27/2013

Stella Okpala

Fayetteville, GA - 10/01/2013

Tim Williams

Marietta, GA - 9/06/2013

Robert Peek

Augusta, GA- 9/13/2013

Susan Villaume

Auburn, AL- 10/20/2013

Marianne Crowe

Statesboro, GA - 10/30/2013

Jane Perlman

Atlanta, GA - 11/01/2013

Have you considered GPhAâ&#x20AC;&#x2122;s new Sustaining Membership? ..........only $14.58 per month Never get another renewal notice! Visit gpha.org and sign up today!

THE GEORGIA PHARMACY ASSOCIATION 50 Lenox Pointe, NE, Atlanta, GA 30324 | tf: 888.871.5590 | ph: 404.231.5074 | f: 404.237.8435 | www.gpha.org

A Year of Transition GPhA Names 2013-14 Executive Vice President Transition Committee Jim Bracewell Executive Vice President

he Associationâ&#x20AC;&#x2122;s current four year professional employment contract with Executive Vice President Jim Bracewell will conclude at the end of August in 2014. Therefore at its August 2013 Meeting the GPhA Board adopted a Transition Policy to address this issue and the following members have been elected to serve on the committee. Lance Boles, GPhA Second Vice President, will serve as Chairman of the Committee. Drew Miller, Chairman of the Academy of Independent Pharmacy, will represent the six GPhA Academies. Renee Adamson, President of Region 3, will represent the twelve GPhA Region Presidents. Eddie Madden, current Member at Large, will represent the seven At Large GPhA Board Members. Robert Bowles, Sharon Sherrer, and Bill Dunaway will represent the former Presidents of GPhA. The seven member committee will begin its work immediately and sincerely welcomes your input and advice as they plan for the best future for the Georgia Pharmacy Association. It has been my pleasure to serve the members of the Georgia Pharmacy Association and your profession.

Jim

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December 2013 Events THE GEORGIA PHARMACY ASSOCIATION SUNDAY

TUESDAY

MONDAY

SATURDAY

WEDNESDAY

THURSDAY

11 EC Holiday Dinner

FRIDAY

Executive Committee Meeting GA Board of Pharmacy Meeting

GPhA Closed

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GPhA Closed

Is Passage of the Drug Quality and Security Act Good for the Profession?

The Pros & Cons The U.S. House of Representatives passed the Drug Quality and Security Act on Saturday, September 28. The legislation addresses pharmaceutical compounding and the prescription drug supply chain. This bill would:

• Distinguish compounders engaged in traditional pharmacy practice from those making large volumes of compounded drugs without individual prescriptions. • Define the Food and Drug Administration’s role in oversight of outsourcing facilities. • Offer providers and patients more information about compounded drugs. • Clarify current federal law regarding pharmacy compounding. • Develop a workable pathway to unit-level tracking. • Strengthen licensure requirements for wholesale distributors and third-party logistics providers. • Establish nationwide drug serial numbers.

Read the Full Bill at: http://beta.congress.gov/bill/113th/house-bill/3204/text Track the Bill at: http://www.govtrack.us/congress/bills/113/hr3204 6

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A View from a Pharmacist Dale Coker, RPh, FIACP

ur greatest fear is FDA’s “enforce- pharmacies to cGMP standards, even ment discretion” of FDCA 503(A), though they have no authority to do so. The passage of this law has the real powhich was left intact, save the advertising language which led to split decisions in tential to lead to further litigation. PerFederal Court Districts. There is no pro- haps the most troubling aspect of this vision for office use compounding or an- bill is that an outsourcing facility does not have to be a pharmaticipatory compounding cy. Guess who will be in except for the proposed “Guess who line to become outsourcnew section, 503(B). ing facilities? Certainly Based on their past hiswill be in line not community comtory, we have no reason to become pounding pharmacies. to believe that FDA will This should be very not arbitrarily use their outsourcing troubling to state Boards enforcement discretion facilities?” of Pharmacy as they will to take action against a have no jurisdiction over Pharmacy engaged in ofthese facilities. With fice compounding, even if it is allowed in that State. In the past outsourcing facilities having the ability several months, FDA has used their en- to fill individual prescriptions as well forcement discretion to hold certain as “outsourcing,” it will be a matter of

time before community pharmacy compounding will be phased out. This bill was sold on the premise that becoming an outsourcing facility is voluntary, when in fact, the only pharmacies that could afford to become such a facility are the so-called manu-compounders, one of which caused the problem in the first place. This bill does nothing to protect the public’s health as the bill was intended to do, but opens up a golden opportunity for those non-pharmacy entities looking to cash in on the opportunity. Dale Coker, RPh, FIACP is with Cherokee Custom Script Pharmacy, the first PCAB accredited Pharmacy in Georgia.

National Community Pharmacists Association

NCPA’s Analysis - Facts & Myths T

he Drug Quality and Security Act (HR 3204) addresses pharmaceutical compounding and the prescription drug supply chain. This analysis will review Title I of the Act, which addresses pharmaceutical compounding of human drugs, and distinguish between myth and fact.

MYTH #1: The Drug Quality and Se-

curity Act replaces current Food, Drug, and Cosmetic Act (FDCA) Section 503(a). FACT: The Drug Quality and Security Act preserves FDCA Section 503(a) as current law over pharmaceutical compounding. The only section within HR 3204 that alters FDCA Section 503(a) is found on page 30, beginning on line 17 regarding striking the prohibition on marketing provisions that were pre-

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viously found to be unconstitional by the United States Supreme Court (more thorough analysis of this marketing provision below). Notwithstanding that provision, the Drug Quality and Security Act leaves FDCA Section 503(a) untouched as it is today and reinstates that pharmaceutical compounding will in fact be governed by FDCA Section 503(a) and by state Boards of Pharmacy. While the Drug Quality and Security Act does nothing to replace current FDCA Section 503(a), the Act adds an additional section to the FDCA as Section 503(b). Section 503(b) would allow entities compounding sterile to voluntarily register with the FDA to fall under FDA’s purview and to comply with all the requirements found within the Drug Quality and Security Act. In addition, there are no changes to FDCA Section 704 for tra-

ditional pharmacy compounding, which states that FDA does not have access to records of compounding pharmacies.

MYTH #2: The registration with the FDA found within the Drug Quality and Security Act is a mandate. FACT: NCPA was instrumental in making the registration found within the Drug Quality and Security Act voluntary. Specifically, on page 3, line 7 of the Act, language has been added to state “that elects to register as an outsourcing facility.” In addition, on page 9, line 24, the wording “upon electing” was added and on page 19, line 9, the definition of what is an outsourcing facility was altered to read a facility that “has elected to register as an outsourcing facility.” Thus, registration under this Act is 7

voluntary and if a pharmacy does not voluntarily register with the FDA under this Act, that pharmacy will instead remain under current law FDCA Section 503(a) and under the oversight of the state Boards of Pharmacy. If a pharmacy does choose to voluntarily register with the FDA, then that pharmacy must comply with all provisions found within the Drug Quality and Security Act.

MYTH #3: The Drug Quality and Security Act prohibits advertising and promoting of compounding medications. FACT: The Drug Quality and Security Act does not prohibit the advertising and promoting of compounding medications. To the contrary, the only section within the Drug Quality and Security Act that impacts current law FDCA Section 503(a) can be found on page 30 beginning on line 17 regarding the marketing and promoting provisions within current 503(a). Current 503(a) prohibited advertising and promoting of compounded medications and this provision was previously struck down by the US Supreme Court. The Drug Quality and Security Act addresses this prohibition by removing it from current 503(a). By striking this subsection from current law 503(a), the Drug Quality and Security Act makes clear that advertising and promotion of compounded medications is allowed and legal under current 503(a). MYTH #4: Anticipatory compounding,

office use, and “do not compound” lists change from current law. FACT: The Drug Quality and Security Act preserves current 503(a) including the current practice of anticipatory compounding in limited amounts. HR 3204 also preserves the “do not compound” lists currently found in 503(a) including a “do not compound” list for demonstrably difficult to compound drugs as well as the right for states to enter into a memorandum with the FDA regarding the amount of compounded medications that can be shipped interstate. The exact language found within current 503(a) that is preserved is found below. In addition, while currently FDA has

not attempted to exercise its authority over office use, office use is not addressed within current 503(a). A drug product may be compounded under subsection (a) only if— (A) such drug product is not a drug product identified by the Secretary by regulation as a drug product that presents demonstrable difficulties for compounding that reasonably demonstrate an adverse effect on the safety or effectiveness of that drug product; and (B) such drug product is compounded in a State— (i) that has entered into a memorandum of understanding with the Secretary which addresses the distribution of inordinate amounts of compounded drug products interstate and provides for appropriate investigation by a State agency of complaints relating to compounded drug products distributed outside such State; or (ii) that has not entered into the memorandum of understanding described in clause (i) and the licensed pharmacist, licensed pharmacy, or licensed physician distributes (or causes to be distributed) compounded drug products out of the State in which they are compounded in quantities that do not exceed 5 percent

of the total prescription orders dispensed or distributed by such pharmacy or physician.

MYTH #5: The legislation does not include incentives for state Boards of Pharmacy to communicate with the FDA in order to prevent another NECC. FACT: One of the main elements of HR 3204 is that it increases communication between the state Boards of Pharmacy and the FDA. Beginning on page 29, line 3 and continuing to page 30 line 16, HR 3204 develops an enhanced communication system that allows state Boards of Pharmacy to submit actions taken against compounding pharmacies and concerns that a compounding pharmacy is acting outside of current 503(a). After receiving a submission from the state Boards of Pharmacy or making a determination that a pharmacy is in fact acting outside of current 503(a), FDA must immediately notify state Boards of Pharmacy. Please note that current 503(a) can be found at http://www.gpo.gov/fdsys/pkg/ USCODE-2010-title21/html/USCODE2010-title21-chap9-subchapV-partA-sec353a.htm.

National Association of Chain Drug Stores

NACDS Supports Congressional Agreement T

he National Association of Chain guarantee patient safety through a more Drug Stores (NACDS) endorsed the secure supply chain and appropriate and agreement reached by improved oversight of the U.S. Senate and U.S. compounding activities,” House of Representatives NACDS stated in the let“Bill to help on comprehensive supply ter. “We believe that the guarantee chain and compounding reforms contained withlegislation. In a letter to patient safety” in the legislation meet congressional leaders, the overarching goal of NACDS said the agreeprotecting patients while ment makes strong efforts to ensure the allowing chain pharmacies to operate health and safety of the American public. effectively and efficiently in dispensing “We believe [the agreement] will help needed medications.”

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Specifically, NACDS noted that the bill establishes one national standard for supply chain regulation as opposed to an unworkable patchwork of state laws and regulations. “Chain pharmacy has made significant investments to ensure that the U.S. pharmaceutical distribution system is one of the safest in the world and your legislation will only improve and strengthen

the process for all stakeholders,” the letter stated. In addition, NACDS cited the agreement’s clarification and call for an additional regulatory track for sterile compounding to help safeguard patient safety. “This is a large step in helping avoid tragedies such as last year’s national meningitis outbreak. At the same time, we appreciate the agreement’s protection

of traditional compounding practices largely performed by retail pharmacists,” NACDS stated in the letter. “As the House and Senate debate on the agreement, NACDS will continue to urge lawmakers to pass this legislation so it can be signed into law to improve protections for patients,” NACDS stated.

International Association of Compounding Pharmacists

What Does It Say? What Does It Mean? What Happens Now? H

R 3204 – also known as The Drug Quality and Security Act -- as currently worded does two things which directly impacts compounding pharmacy practitioners. It creates a new type of FDA regulated business called an “outsourcing facility” and it retains and clarifies the existing section 503(a) of the Food Drug and Cosmetic Act which governs pharmacy compounding.

Outsourcing Facilities

The legislation provides for the creation of a new regulated entity called an “outsourcing facility” which is subject to FDA oversight. An “outsourcing facility” is technically a voluntary registration. Outsourcing facilities: • Must be overseen and supervised by a pharmacist. • May compound using APIs if those APIs appear on a list generated by the Secretary of Health and Human Services or • May compound using APIs if those APIs have a USP or NF monograph and • The APIs are produced in an FDA registered facility and • A certificate of analysis is available for each API. May not compound a preparation that: • Appears on a list of medications that have been deemed to be unsafe or inef-

fective. • Are “demonstrably diﬃcult” to compound as determined by the Secretary and appear on a list of specific drugs or classes of drugs that fall in the category. • Is essentially a duplicate of an FDA approved drug. • If a medication is within a REMS program unless the facility fully complies with the requirements of the specific REMS program including labeling provisions. Compounds prepared by an outsourcing facility may not be resold or transferred by the pharmacy or entity that acquires those preparations. They may only be dispensed or administered to a patient subsequent to a valid prescription. Outsourcing facilities must register with the FDA, pay a fee for such registration, submit an annual report to the FDA, and also comply with new labeling requirements. The FDA may inspect these facilities as provided for in current law; however, if a pharmacy chooses to register as an outsourcing facility, it may not claim the exemption provided for in law under section 704(a)(2).

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IACP breaks down the compounding section of this Act and highlights several sections that raise concern for them.

The FDA will have full authority to inspect all records, prescriptions, invoices, formulas, and other such paperwork without exception. All outsourcing facilities must participate in the FDA’s adverse event reporting program (AERS). An outsourcing facility may be a pharmacy. It may also fi ll individual patient prescriptions as part of their business. It does not have to be a pharmacy and therefore there may be outsourcing facilities which are not subject to oversight or laws/ regulations p romulgated by state Boards of Pharmacy. There are also new penalties associated with the existence of “ outsourcing facilities.” The bill specifies that it is illegal to: • Resell any compounded preparation prepared by an outsourcing facility. • Dispense a compounded preparation based upon a falsified prescription (e.g., “fake” patient names) . This appears to also apply to pharmacies as well as the outsourcing facilities. • Advertise a compounded prepara-

IACP breaks down the compounding section of this Act and highlights several sections that raise concern for them.

tion with false or misleading advertising; such advertising will be deemed misbranding under the Food Drug and Cosmetic Act. Section 503(a) remains essentially intact save for the removal of the prohibition on advertising which was struck down by the Supreme Court in Western States, et.al. v. Thompson . Section 503(a) speaks to the compounding of preparations for an identified individual patient. Section 503(a) currently permits anticipatory compounding.

What Does This All Mean?

For the past year, IACP has worked tirelessly to eliminate the uncertainty under which every compounding pharmacy has practiced each and every time it prepares a medication for “office-use”compounding? Which authority takes precedence – state or federal? This is an unknown and one of the reasons why IACP opposed HR 3204. Section 503(a) permits anticipatory compounding based upon historical prescriptions received for identified individual patients. Does that mean any anticipatory compounding for office - use is not permitted? Does that mean that anticipatory compounding may only be for the preparation of medications to be used by the same patients at a future date? By leaving 503(a)’s section on anticipatory compounding unchanged, the same uncertainty of whether or not the compounding of “office-use” medications may be prepared in anticipation remains. This is an other unknown and an additional reason why IACP opposed HR 3204. Based upon IACP’s review, including by our counsel who is an expert in FDCA law, leaving 503(a) unchanged could lead to the following scenario: ABC Pharmacy regularly prepares a topical anesthetic gel for a local dentist. While permitted by the state’s pharmacy practice act to do so, federal law only permits the compounding for an “identified individual patient.” The FDA determines that the “office-use” anesthetic gel is illegal under

503(a) because it is not for an individual. It therefore takes action against the pharmacy for: a) introducing an unapproved drug into the market without complying with the requirements to file an NDA; b) deems that preparation “misbranded” because it is not approved; c) is adulterated because the medication was not prepared in accordance with cGMP standards; and, d) has violated the FDCA by not being an outsourcing facility duly registered as required by HR 320 4. In short, the professional and business decision to provide of “office-use”compounding services may lead to one of two choices. One, either the pharmacy ceases “office-use” compounding or registers as an outsourcing facility.

Two, because of the continued ambiguity within the existing languag e of section 503(a), the FDA will continue to conduct inspections and take actions against compounding pharmacies that clearly demonstrate their intention to place pharmacies engaged in “office-use” dispensing and distribution is an untenable situation. IACP believes that given the current circumstances in a post-NECC world and especially in an environment with aggressive action by the FDA against compounders, believing that it is better to continue with the uncertainty of 503(a) as it is currently worded ignores the risk associated with vague language open to interpretation and “enforcement discretion.”

Professional Compounding Centers of America

PCCA Issues a Neutral Response A

bipartisan, bicameral agreement on compounding has been linked to the track-and-trace bill, known as the “Drug Quality and Security Act” (HR 3204). Leaders from the House Energy & Commerce Committee and Senate Health, Education, Labor & Pensions Committee made the announcement September 25, and released bill language late that night. Revisions to the bill were made the following day. Proponents in the House are trying to pass the bill under “suspension of the rules,” meaning they need two-thirds of the House to support the track and trace/ compounding compromise. We expect this could happen as soon as Saturday, September 28.

In conversations with key legislators, PCCA was able to get clarification in the bill which allows compounding pharmacies to elect to become “outsourcing facilities” on a voluntary basis. This is an important change as the first draft of the bill was ambiguous on this point. With the voluntary election provision, the bill paints a clear picture as to why a pharmacy may elect to become an outsourcing facility and, more importantly, shows that the FDA cannot force a pharmacy to become an outsourcing facility because of some arbitrary rule the FDA would feel it could enforce. There are some additional improvements made to this bill over the Senate

“We also believe opposing or delaying the bill would give other interests the opportunity to negatively influence the bill even further.”

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Bill 959. HR 3204 does not provide exemptions for certain types of pharmacy practice nor does it require pharmacies practicing under 503(A) to report their compound activities to the FDA when compounding for drug shortages. PCCA would have hoped for additional revisions to 503(A) to modernize a 15-yearold piece of legislation to reflect the current state of pharmacy compounding. If the current legislation is signed into law,

we will continue discussions with our legislators about this issue. After carefully reviewing the legislative options, we believe the bill could still have unintended consequences; however, we also believe opposing or delaying the bill would give other interests the opportunity to negatively influence the bill even further. Therefore, PCCA has decided to be neutral regarding the “Drug Quality and Security Act.”

PCCA is committed to remaining an active participant in legislative issues and continuing to represent our members and their patients to ensure access to compounded medications. Visit http://click.mail-pccarx. com/?qs=be7fd1db9556f7fc5d0821770ea5df3edc7d7560e0b36c1c195832501eacf117 for the latest news.

Committee Leaders Applaud Passage Energy and Commerce Committee: United States House of Representatives Chairman: Fred Upton WASHINGTON, DC – The House of Representatives today passed H.R. 3204, the Drug Quality and Security Act, by a voice vote. The legislation, sponsored by Energy and Commerce Committee Chairman Fred Upton (R-MI), is the product of a thoughtful, bipartisan, bicameral effort to improve drug safety and help prevent a future public health crisis like the 2012 deadly meningitis outbreak tied to the New England Compounding Center (NECC). Energy and Commerce Committee leaders voiced their support of this legislation. Upton worked closely with committee Ranking Member Rep. Henry A. Waxman (D-CA), and Senate HELP Committee Chairman Sen. Tom Harkin (D-IA) and Ranking Member Sen. Lamar Alexander (R-TN) in achieving the agreement. “I am proud to say that this piece of legislation is a product of true bipartisan and bicameral work. The Senate and the House, Republicans and Democrats came together to produce a bill that will protect American patients by ensuring

they receive safe drugs,” said Chairman Upton. “It is because of our collaborative and tireless efforts that we are near the resolution of last year’s deadly outbreak. To all the families who have lost loved ones and to those who are still suffering today, with this bill we say ‘never again.’” “This past year, a meningitis outbreak claimed 16 lives in Tennessee and 64 lives across the nation, and plagued hundreds of Americans,” said Energy and Commerce Committee Vice Chairman Marsha Blackburn (R-TN). “The cases stemmed from contaminated compounded drugs manufactured in some cases without the consent of the FDA. Traditional compounding is critical for patient needs and this legislation ensures millions of our most vulnerable relatives, friends, and neighbors continue to have safe access to essential and lifesaving medication. As a result of our investigation at Energy and Commerce, the bipartisan passage of H.R. 3204 will ensure necessary steps are identified to prevent a tragic outbreak

“I am proud to say that this piece of legislation is a product of true bipartisan and bicameral work.”

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from happening again.” “The Drug Quality and Security Act is a first step at clarifying current law,” said Rep. Morgan Griffith (R-VA). “It eliminates perceived confusion that existed as a result of court decisions on advertising related to compounding drugs and adopts the notification provisions that were in the Griffith-Green-DeGette Compounding Clarity Act. The Drug Quality and Security Act leaves a large portion of existing law intact. It also leaves many areas of practice where clarification may still be needed, particularly as it relates to office use, repackaging, and nuclear pharmacies. Along with my colleagues, I will continue working to oversee the FDA’s interpretation and implementation of this law.” “I applaud Chairman Upton for his work on this bill, and I’m very pleased to see that H.R. 1919, a bill that I introduced to strengthen and secure our nation’s pharmaceutical distribution supply chain, was included in this overall legislative package,” said Rep. Bob Latta (R-OH). “I am proud to support H.R. 3204, which makes improvements to the current supply chain and ensures greater patient safety for all Americans.” “This legislation would address two important issues affecting the quality

and security of America’s drug supply,” said Health Subcommittee Chairman Joe Pitts (R-PA). “First, the bill would protect traditional pharmacies and clarify laws related to human drug compounding in response to last year’s nationwide meningitis outbreak – one of the largest public health crises in recent memory. Second, the bill would strengthen the prescription drug supply chain in order to protect American families against counterfeit drugs.” “With the passage of this bill, the FDA will have the authority it needs, but we have to also make sure that they have the fortitude to take action on any compounding pharmacy that they see not up to the high level of standards the FDA sets, that all citizens expect,” said Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA). “The Drug Quality and Security Act will end these problems, we hope, end these inspection holidays, and reassure the American public that these medications, wherever they are manufactured,

and most by compounding pharmacies, who do a superb job of maintaining sterile conditions, but in all cases the FDA will have the authority to make sure they have the inspections and they have the team that can go in there and take solid action when these centers do not adhere to those high standards.” “Since over 60 American lives were lost, and the excellent investigative work of the Subcommittee on Oversight and Investigations, I have been disturbed that not one person at FDA has been held accountable for their failure to use existing authorities or informing the State of what they knew,” said Vice Chairman of the Health and Oversight and Investigations Subcommittees Michael C. Burgess, M.D. (R-TX). “I hope the passage of the Drug Quality and Security Act will usher in a new day of accountability.” Dozens of leading national health and

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patient organizations have also voiced their support for this breakthrough agreement to improve drug safety. H.R. 3204 would protect traditional pharmacies and clarify FDA’s authority over the compounding of human drugs while requiring the agency to engage and coordinate with states to ensure the safety of compounded drugs. To date, the CDC has linked 64 deaths and 750 cases in 20 states to contaminated drugs from NECC. This legislation would also create a uniform national standard for drug supply chain security to protect Americans against counterfeit drugs while eliminating needless government red tape. It would help prevent increases in drug prices, avoid additional drug shortages and eliminate hundreds of millions of dollars worth of duplicative government regulations.

“The bill would protect traditional pharmacies and clarify laws.”

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SAVE PHIL THE TURKEY

Phil the Turkey has been taken hostage by GPHA Executive Vice President Jim Bracewell. (Jim is on the left.) Jim is planning to release Phil during the Christmas Season if the generous members of GPHA donate at least $6,000 to the Georgia Pharmacy Foundation Annual Fund, supporting Pharmacy Student Scholarships and the New Practitioner Leadership Conference. Any GPHA member who makes a ďŹ nancial donation will be entered in a drawing and Phil will be delivered to the lucky winner as a Holiday Feast, or if you prefer, Phil will be released back into the wild.

Help SAVE PHIL from his hostage situation. Give a tax deductible donation to the Georgia Pharmacy Foundation today.

Georgia Pharmacy Foundation

To make a donation and enter the drawing visit www.ghpa.org Scroll down to the Foundation Logo, click on the Logo and click on Donate.

When It Isn’t Alzheimer’s All Dementias Are Not Created Equal.

ne form, Lewy body dementia rate diagnosis of LBD is of critical impor(LBD), features visual hallucinations and tance. People with LBD respond as well unfortunately also the possibility of severe as (or possibly more favorably) to chosensitivity to the very medications pre- linesterase inhibitors than people with scribed to treat hallucinations. LBD is a Alzheimer’s, allowing for early treatment that may improve their common, relentless brain disease that affects think- The Georgia Pharmacy quality of life. Also, many ing, movement, behavior Association commends people with LBD respond poorly to a) certain medand sleep. We invite you and congratulates ications for behavior than to spread the word in your pharmacy by posting our Robert Bowles on his people with Alzheimer’s and b) medications for LBD Awareness flyer in a initiative to bring movement than people prominent location. awareness and with Parkinson’s, someApproximately 1.3 miltimes with dangerous or lion Americans have LBD, improved outcomes permanent side effects. but it is frequently misdito the treatment of The Lewy Body Demenagnosed as Alzheimer’s this disease. tia Association (LBDA) disease. Early and accu-

Key Medication Concerns for People With LBD • Anticholinergics and some antiparkinsonsonian medications (like dopamine agonists) can worsen certain LBD symptoms. • Typical antipsychotics (such as haloperidol) should be avoided due to the risk of neuroleptic malignant syndrome, parkinsonism, somnolence and orthostatic hypotension. • Atypical antipsychotic medications (such as quetiepine and clozapine) should be used sparingly and under close monitoring. is a 501(c)(3) nonprofit organization dedicated to raising awareness of the Lewy body dementias (LBD), supporting people with LBD, their families and caregivers, and promoting scientific advances. Through outreach, education and research, LBDA supports those affected by Lewy body dementias. To learn more about LBD and LBDA please visit www. lbda.org. Twitter: People with Lewy body dementia have severe sensitivities to antipsychotic medications. #LBDAwareness www.lbda.org

Governor Nathan Deal signs proclamation designating October as Lewy Body Dementia (LBD ) month in Georgia. Pictured with the Governor is GPhA former President Robert Bowles and his wife Judy.

Facebook: Did you know that not all dementia is Alzheimer’s disease? Lewy body dementia (LBD) is a common, progressive brain disease that affects thinking, movement, behavior and sleep. Approximately 1.3 million Americans have LBD, and it is frequently misdiagnosed as Alzheimer’s disease. Some people with LBD can have severe medication sensitivities, and it is therefore very important to have an early and accurate diagnosis. We invite you to spread the word! www.lbda.org

The Georgia Pharmacy Journal

October Lewy Body Dementia Lewyis Body Dementia (LBD) Awareness Month (LBD) Awareness Lewy body dementia is a progressive brain disorder in older adults. LBD is not a rare disease. It accounts for up to 20% of dementia cases & affects an estimated 1.3 million families in the U.S. alone. LBD is challenging to diagnose, because symptom onset & combinations vary. Early and accurate diagnosis is important, because people with LBD often have extreme sensitivity to certain prescription & over-the-counter medications.

Tell your doctor if you experience changes in: Thinking & Behavior

Movement

 Dementia is the primary symptom

 Parkinson’s-like symptoms include

 Acting out dreams, sometimes

 Repeated falls attributed to

 Severe sensitivity to neuroleptics

and includes problems with memory, problem solving, planning, and abstract or analytical thinking.

 Cognitive fluctuations involve

unpredictable changes in concentration and attention from day to day.

 Hallucinations are seeing or

hearing things that are not really present

 Other mood disorders and

psychiatric symptoms such as depression, delusions (false beliefs), or hallucinations in other senses, like touch or smell.

rigidity or stiffness, shuffling gait, tremor & slowness of movement.

dizziness, fainting, or the effects of parkinsonism on posture & balance.

 Previous diagnosis of Parkinson’s

disease, followed a year or more later by a decline in cognitive abilities that interfere with every day living. (Parkinson’s disease dementia is one clinical presentation of Lewy body dementia.)

Help is available! Visit lbda.org to learn more.

Sleep & Other Systems violently. May appear years before any changes in cognition. (also known as antipsychotics), which are medications used to treat hallucinations or other serious mental disorders.

 Excessive daytime sleepiness or

transient loss of consciousness.

 Significant changes in the

autonomic nervous system, such as dizziness, fainting, sensitivity to heat & cold, sexual dysfunction, early urinary incontinence, or constipation.

What Do YOU Need to Know?

Long Term Care

You process the prescriptions for Long Term Care related matters, what do YOU as the pharmacist need to know about Long Term Care after you have been effectively educated?

fter your Long Term Care education, the next 2 steps are to further understand underwriting and funding. Step 2: Understanding Underwriting and the Underwriting Process: After Understanding the risks of Long Term Care and being educated, it is important to fully understand underwriting and what the carriers are looking for and reviewing in terms of your medical history. The carriers will likely want to review the following in your medical history after reviewing your application: • 10 Year Medical History • 10 Year Surgical History • Prescriptions that you have taken or are taking Our firm has successfully developed an algorithm that will assist greatly in finding you potential Long Term Care carriers; and since we work with all of the major Long Term Care carriers that traditionally broker their products, we will explore the market fully on your behalf and bring those findings to you and your families and companies. Many times, the LTC carrier that is chosen for clients is a direct result of how they present medically with the 3 factors shown above. Step 3: Understanding Funding: There are multiple ways to fund your Long Term Care and otherwise define your payment. Many times, there can be an accompanying payment strategy that is highlighted not only by how you pay but by how often. There are generally 3 ways available that relate to how you pay: • Single Premium Payment

• Defined Premium PayGenerally, the followment (For example, 10 year ing factors are charged for premium payment) Long Term Care Premium • Lifetime Payment payments that are more Generally means you pay frequent that annual: until you collect benefits or (Can vary by state and by until your passing. carrier) There are 4 relevant mat• Semi-Annual ters to consider that relate to Ruth Ann McGehee Generally carriers can Manager of Insurance how often you pay, which is charge 2%--3% Services, GPHA applicable to Defined Pre• Quarterly mium Payment and Lifetime Payment Generally carriers can charge 4% Strategies: • Monthly • Annual Payment Generally carriers can charge up to 8% • Semi-Annual Payment Please give RuthAnn McGehee a call •.Quarterly Payment at 404-419-8173 to set up a no-obligation • Monthly Payment Long Term Care consult. We will look It is important to consider that the forward to helping you however we can more often you pay, the more premium with our area of expertise or email at you will pay. rmcgehee@gpha.org

What Do YOU Need to Know?

Insurance Exchanges

The Health Insurance Marketplace, commonly called insurance exchanges, are marketplaces laid out in the Affordable Care Act for Americans to buy health insurance or face tax penalties.

pen enrollment began on October 1, 2013. Coverage begins as early as January 1, 2014. During the initial enrollment period from October 1, 2013 to March 31, 2014, seven million people are expected to sign up for health insurance.

All plans offered through the insurance exchanges must cover ten essential benefits, including prescription drugs. States had the opportunity to run their own state-based exchanges (16 states and the District of Columbia), par-

The Georgia Pharmacy Journal

ticipate in a shared responsibility federal-state partnership (7 states), or default to the federal-facilitated exchange (27 states). The Kaiser Family Foundation has information on each state’s exchange decision: kff.org/state-health-exchangeprofi les. Individuals and families will fi ll out one application in the Marketplace, available at Healthcare.gov. The application automatically determines if the applicant is eligible for Medicaid, Children’s Health Insurance Program, government subsidies, or cost-sharing. Approximately 90% of uninsured Americans will receive some financial assistance to purchase health insurance. Community pharmacists have the flexibility to take an active role in helping patients find the best plan for the patient’s needs in most states. Pharmacists looking to capture new business and foster goodwill should consider hosting an insurance enrollment event in their store. To find consumer assisters, visit localhelp.healthcare.gov. The Affordable Care Act created a small business marketplace known as Small Business Health Options Program (SHOP). The SHOP Marketplace opens November 1, 2013 with coverage beginning as early as January 1, 2014 for small businesses. The employer mandate requiring businesses with 50 or more employees to offer employee health insurance or pay tax penalties has been pushed back until 2015. Tax credits are available for some small employers. The definition of a full-time employee differs depending on the size of the business. Visit business.usa.gov/healthcare to learn how the Affordable Care Act will affect small businesses. Visit Marketplace.CMS.gov for more information and resources to aid in assisting patients. Consumer information on how the exchanges operate, available plans, and general information can be found at Healthcare.gov. This information has been excerpted from the NCPA’s insurance exchanges resource center located under the Members-Only section of NCPAnet.org. This comprehensive webpage features a Read-

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iness List designed to prepare NCPA members for the implementation of the Affordable Care Act as well as exclusive

marketing materials to present the pharmacy as an educational source on the Health Insurance Marketplace.

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1117 Perimeter Center West, Suite N-307 Atlanta, GA 30338 • 770-350-2455 mike@fnaplanners.com www.fnaplanners.com Securities, certain advisory services and insurance products are offered through INVEST Financial Corporation (INVEST), member FINRA/SIPC, a federally registered Investment Adviser, and affiliated insurance agencies. INVEST is not affiliated with Financial Network Associates, Inc. Other advisory services may be offered through Financial Network Associates, Inc., a registered investment adviser.

SAVE THIS DATE ON YOUR CALENDAR Thursday, February 27, 2014

VIP DAY Voice In Pharmacy At The State Capitol

No cost to you to participate. Huge cost to your career not to be there. THE GEORGIA PHARMACY ASSOCIATION

January 17-19, 2014 Omni Grove Park Inn Asheville, NC Partnering State Associations: Georgia ● Kentucky Mississippi ● North Carolina Tennessee ● Virginia Gather your friends for a weekend of fun, facts and facials! Full registration includes 12 hours of CE programming, breakfast on Saturday and Sunday, a dinner reception on Friday, an event t-shirt and gift bag! The Southeastern “Girls of Pharmacy” Leadership Weekend was developed originally for the growing female demographic. With pharmacy schools becoming predominately female, we felt it was important to develop a program specifically tailored to the needs of female professionals. Thus, the Southeastern “Girls of Pharmacy” Leadership Weekend was born! We hope to see you there!

Visit www.scrx.org for more information and specific event details! Need to book your hotel room? Call 800.438.5800 by December 17 to take advantage of our group rate of $152 per night! Want first choice of the Spa treatments? We have blocked off various appointment times for all of your favorite spa services. Call 800.438.5800 today to get your first choice of times and services! DON’T FORGET! Spa appointments are 20% off for guests of this event and are available on a first come, first serve basis. In order to receive this discount, you must tell the Spa that you are with the SE Girls of Pharmacy Leadership Weekend! Back by popular demand! After the reception, you can join us for a Paint and Mingle networking experience! At this optional event, you will paint a piece of artwork while getting to know fellow attendees. Take home your art to remember the weekend. No artistic ability required. Register today at www.scrx.org or return the completed registration form (attached) with payment to SCPhA.

Mail: 1350 Browning Rd., Columbia, SC 29210

Fax: 803.354.9207

Email: laura@scrx.org

Questions? Contact SCPhA at 803.354.9977 or email Laura Reid, Director of Events, at laura@scrx.org.

FALL NEWSLETTER A message from the Chairman - Sharon Zerillo

We hear a lot about it but what does it really mean? Webster defines satisfaction as contentment or gratification. Do you feel content or even gratified at the end of the day? Are you excited every morning as you go to work? People say it takes thirty days to change a bad habit or create a new one. What new habits can you create that will improve your job satisfaction? •Do you need to start an MTM program for your patients? •Can you begin a diabetes nutritional class? •How about increasing the immunizations you administer (maybe adding tetanus or shingles)? •Have you looked into compounding for the dermatologists in your area? These are just some of the opportunities available to increase your job satisfaction. The GPhA has many programs that will help you to advance your pharmacy career. I encourage you to join AEP and begin to make those new habits a reality. Mark your calendar for the AEP February networking dinner where you can meet old friends, make new ones, learn how to improve your practice and ultimately, your pride in being the best pharmacist possible! I challenge you to try just one new idea in your pharmacy this year. Take a step out of your comfort zone and expand your role as a pharmacist. The GPhA and AEP are always there to help you in any way we can. Join us today! If you missed the GPhA convention this year in Amelia Island you missed a great time! Plenty of CE, tennis, golf, pool and beach time during the day and seeing old friends and meeting new ones at night. This year our emphasis is on increasing membership in GPhA and the academy of your choice. We have academies for retail pharmacists, independents, consultants, hospital pharmacists and even technicians. There is a place for everyone at GPhA. Upcoming opportunities The Georgia Prescription Drug Monitoring Program, (PDMP) is now live online and can be used by pharmacists and prescribers who are registered users. This program allows the user to view any CII-CV prescriptions that a patient has had filled within the last year. This is to be used as a tool to help decide whether or not to fill a prescription for a controlled substance. In order to register, go to www.hidinc.com/gapdmp. To register, click on “registration site” under the practitioner/pharmacist link. Once you submit your registration form it will be verified against your license information with the GA BOP. Once verified, you will receive an email with instructions on how to log in to the PDMP. According to the law that makes the PDMP possible: 1. Only prescribers are allowed to print patient records from the PDMP 2. You are only to search for anyone who is currently your patient or for those seeking to fill a prescription from you – and a log is kept of every query that is made under your account on the PDMP.

for involvement: • Fall regional meetings in November 2013 • AEP spring networking dinner in February 2014 • Very Involved Pharmacists day at the capitol February 27th 2014 • Convention in Panama City on June 26th through June 29th Our association is only as strong as you make it—join today! Is this the year you get involved in YOUR profession?

3. You are not to share information that you see on the PDMP to anyone, not even your partner pharmacist or your technicians. Don’t add notes to patient profiles from anything you see on the PDMP. Even if a patient is doctor/pharmacy hopping, a pharmacist cannot call the physicians or other pharmacies to alert them. Please share this information with your fellow pharmacists and with your physicians in order to help decrease drug diversion and drug abuse in our state. AEP Member|Amanda Westbrooks

EVENTS

NOVEMBER 2013

JOB SATISFACTION?

WELCOME TO AEP

UPCOMING Join us on February 27th, 2014 at the capitol for Very Involved Pharmacist day. Invite your senator and representative to breakfast at the Train Depot with pharmacists and students from around the state. Show your solidarity by wearing your white coat. There is power in numbers—let our legislators see how involved we can be in our profession! AEP Member|Mary Meredith

Region Meetings for Regions 3, 5 & 12 are on Tuesday, November 12th. Please visit the event calendar at gpha.org to register for your region meeting. Region meetings provide a great opportunity for networking with local pharmacists and technicians in your area. Receive legislative law updates & agenda, and find out what GPhA and its Executive Committee have in store this year. I encourage you to invite a pharmacist that is not a member to attend to learn about our organization. Check the GPhA website for details on exact times and locations and to RSVP for your meeting. See you there! AEP Member|Ashley London

AEP BOARD MEMBERS Sharon Zerillo · Chairman Tracie Lunde · ViceChairman Laura Greene· Secretary

AEP MEMBERS Catherine Bourg Johnathan Hamrick Ashley London Mona Majmudar Mary Meredith Natalie Nielsen Amanda Westbrooks

The Georgia Pharmacy Journal

• Pharmacists Mutual Insurance Company • Pharmacists Life Insurance Company • Pro Advantage Services®, Inc.

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Now more than ever, pharmacists are learning just how important it is to have not only proper insurance coverage, but the right amount of insurance. We understand the risks involved in operating a pharmacy practice and have coverage designed to ensure that you and your business are protected. We even provide policies specifically designed for practices that offer specialty services such as compounding or home medical equipment. Trust the experts - our representatives can help you determine the right coverage for you. We offer products to meet all your needs; everything from business and personal insurance to life and investments. We’re proud to be your single source for insurance protection.

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Thanks to All Our Supporters Diamond Level

$4,800 minimum pledge *Scott Meeks, R.Ph. *Fred Sharpe, R.Ph

Titanium Level

$2,400 minimum pledge *Ralph Balchin, R.Ph. T.M. Bridges, R.Ph. 12/12 *Ben Cravey, R.Ph. *Michael Farmer, R.Ph. *David Graves, R.Ph. *Raymond Hickman, R.Ph. Ted Hunt, R.Ph. 1/13 *Robert Ledbetter, R.Ph. *Brandall Lovvorn, Pharm.D. *Marvin McCord, R.Ph. Loren Pierce, R.Ph. 12/12 *Jeff Sikes, R.Ph. *Danny Smith, R.Ph. *Dean Stone, R.Ph. *Tommy Whitworth, R.Ph.

Platinum Level

$1,200 minimum pledge *Larry Braden, R.Ph. *William Cagle, R.Ph. *Hugh Chancy, R.Ph. *Keith Chapman, R.Ph. *Dale Coker, R.Ph. *Billy Conley, R.Ph. *Al Dixon Jr., R.Ph. *Ashley Dukes, R.Ph. *Jack Dunn Jr., R.Ph. *Neal Florence, R.Ph. *Andy Freeman 22

*Robert Hatton, Pharm.D. *Ira Katz, R.Ph. Thomas Lindsay, R.Ph. 5/13 *Eddie Madden, R.Ph. *Jonathan Marquess, Pharm.D. *Pam Marquess, Pharm.D. *Kenneth McCarthy, R.Ph. *Ivey McCurdy, Pharm. D *Drew Miller, R.Ph. *Laird Miller, R.Ph. *Jay Mosley, R.Ph. *Sujal Patel, Pharm D *Mark Parris, Pharm.D. *Allen Partridge, R.Ph. Jeff Lurey, R.Ph. 4/13 *Houston Rogers, Pharm.D. Tim Short, R.Ph. 10/13 *Benjamin Stanley, Pharm.D. *Danny Toth, R.Ph. *Christopher Thurmond, Pharm.D. *Alex Tucker, Pharm.D. Lindsay Walker, R.Ph. 6/13 Henry Wilson, Pharm.D. 11/13

*Michael Iteogu, R.Ph. Ed Kalvelage, R.Ph. 11/13 John Kalvelage, R.Ph. 11/13 Steve Kalvelage, R.Ph. 11/13 *Joshua Kinsey, Pharm.D. *Don Kiser, R.Ph. *Allison Layne, C.Ph.T Lance LoRusso 6/14 *Sheila Miller, Pharm.D. *Robert Moody, R.Ph. *Sherri Moody, Pharm.D. *William Moye, R.Ph. *Anthony Ray, R.Ph. *Jeffrey Richardson, R.Ph. *Andy Rogers, R.Ph. Daniel Royal Jr., R.Ph. 3/13 John Sherrer, R.Ph. 11/13 Sharon Sherrer, Pharm.D. 11/13 *Michael Tarrant *James Thomas, R.Ph. Zach Tomberlin, Pharm.D. 4/13 *Mark White, R.Ph. *Charles Wilson Jr., R.Ph.

Gold Level

Silver Level

$600 minimum pledge James Bartling, Pharm.D. 6/13 *William Brewster, R.Ph. *Liza Chapman, Pharm.D. Carter Clements, Pharm. D. 7/13 *Mahlon Davidson, R.Ph. *Angela DeLay, R.Ph. *Benjamin Dupree, Sr., R.Ph *Stewart Flanagin, R.Ph. *Kevin Florence, Pharm.D. *Kerry Griffin, R.Ph.

$300 minimum pledge *Renee Adamson, Pharm.D. Larry Batten, R. Ph. 11/13 Lance Boles, R.Ph. 8/13 Laura Coker, Pharm D 6/13 Patrick Cook, Pharm.D. 1/13 *Ed Dozier, R.Ph. *Greg Drake, R. Ph. *Terry Dunn, R.Ph. *Marshall Frost, Pharm.D. *Amanda Gaddy, R. Ph. The Georgia Pharmacy Journal

*Denotes a monthly sustaining PAC member. (Month/Year) Denotes most recent contribution. Highlight denotes new and increased contributors.

*Johnathan Hamrick, Pharm.D. *Willie Latch, R.Ph *Hilary Mbadugha, Pharm.D. *Kalen Manasco, Pharm.D. *William McLeer, R.Ph. *Sheri Mills, C.Ph.T. Albert Nichols, R.Ph. 2/13 *Richard Noell, R.Ph. *Cynthia Piela *Donald Piela, Jr. Pharm.D. Bill Prather, R.Ph. 6/14 *Kristy Pucylowski, Pharm.D. *Edward Reynolds, R.Ph. *Ashley Rickard, Pharm D. *Brian Rickard, Pharm D. Flynn Warren, R.Ph. 6/14 Steve Wilson, Pharm.D. 7/14 *William Wolfe, R.Ph. *Sharon Zerillo, R.Ph.

Bronze Level

$150 minimum pledge Monica Ali-Warren, R.Ph. 6/13 *Shane Bentley *Robert Bowles, R. Ph. *Rabun Deckle, R. Ph. Ashley Faulk, Pharm.D. 4/13 James Fetterman, Jr., Pharm.D. 4/13 Charles Gass, R.Ph. 1/13 *Larry Harkleroad, R.Ph. Winton Harris Jr., R.Ph. 6/13 *Amy Grimsley, Pharm. D *Thomas Jeter, R.Ph. *Brenton Lake, R.Ph. *Tracie Lunde, Pharm.D. *Michael Lewis, Pharm.D. The Georgia Pharmacy Journal

Max Mason, R.Ph. 6/14 *Susan McLeer, R.Ph. Judson Mullican, R.Ph. 11/13 *Natalie Nielsen, R.Ph. *Mark Niday, R. Ph. *Don Richie, R.Ph. *Amanda Paisley, Pharm.D. *Alex Pinkston IV, R.Ph Don Richie, R.Ph. 11/13 *Corey Rieck *Laurence Ryan, Pharm.D. *Olivia Santoso, Pharm. D. *Dana Strickland, R.Ph. G.H. Thurmond, R.Ph. 11/13 *Tommy Tolbert, R. Ph. William Turner, R.Ph 1/13 *Austin Tull, Pharm.D.

Members

No minimum pledge Claude Bates, R.Ph 6/13 Winston Brock, R.Ph. 6/13 David Carver, R.Ph. 6/13 Marshall Curtis, R.Ph. 6/13 John Drew, R.Ph. 6/13 James England, R.Ph. 6/13 Martin Grizzard, R.Ph. 6/13 Christopher Gurley, R. Ph 6/13 Marsha Kapiloff, R.Ph. 6/13 Charles Kovarik, R. Ph. 6/13 Carroll Lowery, R.Ph. 6/13 Ralph Marett, R.Ph. 6/13 Kenneth McCarthy, R.Ph. 6/13 Whitney Pickett, R.Ph. 11/13 Michael Reagan, R. Ph 6/13 Ola Reffell, R.Ph. 6/13

Leonard Reynolds, R.Ph. 6/13 Victor Serafy, R.Ph. 6/13 Terry Shaw, Pharm.D. 5/13 Harry Shurley, R.Ph 6/13 Amanda Stankiewicz, Student 6/13 Benjamin Stanley, R.Ph 6/13 Krista Stone, R.Ph 6/13 John Thomas, R.Ph. 11/13 William Thompson, R.Ph. 6/13 Carey Vaughan, Pharm.D. 6/13 Jonathon Williams R.Ph 8/13

NOTICE:

Contact Andy Freeman, GPhA Director of Government Affairs, to update your support or if any information is incorrect. afreeman@gpha.org 404-419-8119

139th GPhA Convention Wyndham Bay Point Resort Panama City Beach, FL Schedule of Events June 26-29, 2014

Wednesday, June 25, 2014

Certificate Program 2013-2014 Board of Directors Meeting Council of President’s Reception

Thursday, June 26, 2014

CPE Programs General Session Exhibit Hall featuring Student/Sponsor VIP Lounge Alumni Dinners

Friday, June 27, 2014

Golf / Tennis CPE Programs General Session Exhibit Hall PharmPAC Reception

Saturday, June 28, 2014

Georgia Pharmacy Coalition Meeting CPE Programs General Session Academy Luncheons Election Closes Tellers Committee Resolutions Committee President’s Reception & Banquet

Sunday, June 29, 2014

Sunrise Service Annual Meeting 2014-2015 Board of Directors Meeting

Book Your Room Today!

Room Rate: Run of House (1 King Bed OR 2 Double Beds) $189/night + tax with no resort fee Reservation Line: (866) 269-9165 Visit gpha.org for more information!

The Georgia Pharmacy Journal

Georgia Pharmacy Association

2013-2014 BOARD OF DIRECTORS Name

Position

Robert M. Hatton Pamala S. Marquess Robert B. Moody Thomas H. Whitworth Lance P. Boles Liza Chapman Terry Forshee David Graves Joshua D. Kinsey Eddie Madden Laird Miller Chris Thurmond Krista Stone Ed S. Dozier Renee D. Adamson Nicholas O. Bland Shelby Biagi Sherri S. Moody Tyler Mayotte Michael Lewis Amanda Westbrooks Flynn Warren Kalen Manasco Ken Von Eiland Ted Hunt Sharon B. Zerillo John Drew Drew Miller Michelle Hunt Leah Stowers John T. Sherrer Michael E. Farmer Al McConnell Megan Freeman Amy C. Grimsley Rusty Fetterman Lindsey Welch Tyler Bryant Tiffany Galloway Jessica Kupstas Jim Bracewell

Chair of the Board President President-Elect First Vice President Second Vice President State At Large State At Large State At Large State At Large State At Large State At Large State At Large 1st Region President 2nd Region President 3rd Region President 4th Region President 5th Region President 6th Region President 7th Region President 8th Region President 9th Region President 10th Region President 11th Region President 12th Region President ACP Chair AEP Chair AHP Chair AIP Chair APT Chair ASA Chair Foundation Chair Insurance Trust Chair Board of Pharmacy Chair GSHP President Mercer Faculty Representative South Faculty Representative UGA Faculty Representative ASP, Mercer University ASP, South University ASP, UGA Executive Vice President

Melvin M. Goldstein, P.C. AT T O R N E___ Y AT L AW 248 Roswell Street Marietta, Georgia 30060 Telephone 770/427-7004 Fax 770/426-9584 www.melvinmgoldstein.com

n Private practitioner with an emphasis on representing healthcare professionals in administrative cases as well as other legal matters n Former Assistant Attorney General for the State of Georgia and Counsel for professional licensing boards including the Georgia Board of Pharmacy and the Georgia Drugs and Narcotics Agency n Former Administrative Law Judge for the Office of State Administrative Hearings

Keeping Independents Independent Dear Jeff, Jennie and I want to thank you for your recent intervention to help us retire and to keep our pharmacy independent. When we made our decision to sell Warwick Drugs, you were our first contact. You

Is it time to sell your pharmacy?

acted quickly and professionally to find a buyer in 5 days! We joined AIP at its inception. We

Do you want to own your own pharmacy or buy another pharmacy?

have participated in its programs, utilized the extensive information network and treasured our relationships with exceptional people, like you. We wish the best for all of you and the role you all play in our healthcare future. If we can ever be of assistance, please call on us. Thanks again; our best regards to all. Sincerely yours, Cliff Hilliard, RPH, PHD

Call Jeff Lurey, R.Ph. AIP Director 404-419-8103 jlurey@gpha.org

Georgia Pharmacy Association

50 Lenox Point NE Atlanta, GA 30324

It’s more than just investing. We’re pleased to partner with GPhA to bring our comprehensive services to members as the endorsed wealth management provider for the association. Through the UBS/Georgia Pharmacy relationship, GPhA members have exclusive access to financial services resources through the Wile Consulting Group. This group relationship enables members to leverage the vast scale of products and services at UBS. We distinguish ourselves with a robust service model, comprehensive benefits, diligent research, quality performance and competitive pricing.

Member benefits include – Complimentary financial planning (a $5k–$10k value)

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– Brand new 401(k) retirement savings plan designed exclusively for GPhA members at a group discount rate

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– Advisory and investment program offered at group discount rate – Retirement planning guidance, including a retirement income replacement system – Lending capabilities with competitive interest rates – Free access to UBS global investment research

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Chartered Retirement Plans SpecialistSM and CRPS® are registered service marks of the College for Financial Planning®. Neither UBS Financial Services Inc. nor any of its employees provides legal or tax advice. You should consult with your personal legal or tax advisor regarding your personal circumstances. As a firm providing wealth management services to clients, we offer both investment advisory and brokerage services. These services are separate and distinct, differ in material ways and are governed by different laws and separate contracts. For more information on the distinctions between our brokerage and investment advisory services, please speak with your Financial Advisor, the Wile Consulting Group, or visit our website at ubs.com/workingwithus. Financial Planning services are provided in our capacity as a registered investment adviser. As a firm providing wealth management services to clients in the U.S., we offer both investment advisory and brokerage services. These services are separate and distinct, differ in material ways and are governed by different laws and separate contracts. ©UBS 2013. All rights reserved. UBS Financial Services Inc. is a subsidiary of UBS AG. Member SIPC. 7.00_8.5x8_AX0313_WilE 0313150 exp3/22/15