Pharmacy Edge by APPA

Pharmacy Edge Magazin

Issue

HOW TO GUIDE FOR

SALES SUCCESS

IN SPECIALTY PHARMACY HOW TO MARKET YOUR PHARMACY:

PUBLIC RELATIONS

PHARMACIST RESUME TRENDS FOR

interview with

eleven

January/2017

UNITED STATES OF ALLERGIC DISEASE The Impact of Unsafe Injection Practices:

Just the Tip of the Iceberg for Payers

SO THEY

SAY

Brian Nightengale

SUBSCRIBE TO OUR MAGAZINE.

Table of Contents Issue 11 / January, 2017

Presidents Message

interview with Brian Nightengale

PHARMACIST RESUME TRENDS FOR 2017

UNITED STATES OF ALLERGIC DISEASE By Robyn O’Brien

PBMs: WHY THEY’VE BECOME THE MAFIA OF THE PHARMACEUTICAL WORLD

HOW TO GUIDE FOR SALES SUCCESS IN SPECIALTY PHARMACY - part 2

STEVEN H. COLLIS, CEO OF THE YEAR IN THE 2016 INDUSTRY AWARDS.

HOW TO MARKET YOUR PHARMACY: PUBLIC RELATIONS

SO THEY SAY

LEARNING MORE ABOUT THE LARGEST PHARMACEUTICAL GPO’S IN THE COUNTRY

NICOLLE MCCLURE ANNOUNCED AS NEW PRESIDENT OF GRX MARKETING

The Impact of Unsafe Injection Practices: Just the Tip of the Iceberg for Payers

President’s message Joshua Pirestani Happy New Year! Pharmacy Edge Magazine is excited to start the new year by sharing some inspiring stories with our readers. This first issue of the year will highlight motivating stories and biographies from key personalities in the pharmaceutical industry.

New Year’s being a time for new beginnings and learning experiences we encourage you to start the month with the right choice by subscribing to our Pharmacy Edge Magazine at: http://joinappa.com/ pharmacy-edge-magazine/ For more information, contact info@ joinappa.com if you have any questions!

We will also highlight pharmacist resume trends for 2017, a guide to sales success in specialty pharmacy, how to market your pharmacy, plus many other interesting stories.

May this New Year bring you a peace filled life, warmth and togetherness in your family and much prosperity! Happy New Year!

This year, APPA will continue to help the community grow professionally through our service offering, such as education and access to other industry experts.

Joshua Pirestani President.

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Brian Nightengale 6 pharmacy edge

What was your journey like to get where you are? I graduated from the University of Oklahoma College of Pharmacy in 1990, but my connectivity to independent pharmacy began well before that. In fact, a family friend and local independent pharmacist completely changed my career path. I grew up in a very small farming community and always wanted to be a veterinarian. After three years of college, however, I became a bit apprehensive about the possibility of spending every day with primarily cows and pigs. So, I reached out to Rick Hill, a pharmacist at Scheffe’s Pharmacy in Enid, Oklahoma. After shadowing him for a day--and what, to me, was a transformational dinner discussion--I changed my major the next week. Over the next 10 years, I worked for three outstanding independent pharmacists who taught me the importance of putting patients first, being innovative and embracing an entrepreneurial spirit. It is that entrepreneurial spirit that led me to AmerisourceBergen. For the past 20 years, I have been at Xcenda, the consulting arm of AmerisourceBergen. Xcenda is a group of exceptional professionals who design, develop and deliver solutions that help our customers succeed in an ever more complex global health care market. When the opportunity for Xcenda to join AmerisourceBergen was presented, I realized that ABC was the perfect home for both Xcenda, and for me, because of the deep entrepreneurial culture of excellence, customer focus, teamwork, and innovation. That experience working for and with independent pharmacists for so many years has provided me such a unique perspective and deep appreciation for the role the independent pharmacist plays in healthcare, and I’m excited now to

bring that to bear as President of Good Neighbor Pharmacy. How do you see the company changing in two years, and how do you see yourself creating that change? The health care environment is rapidly changing. From health care reform on Capitol Hill to payment models shifting from feefor-service to outcomes-based reimbursement, to an evolving patient experience, there are myriad changes happening that will affect independent pharmacists and those they serve. For independent community pharmacies to compete and grow in this dynamic environment, they will need to innovate, diversify their businesses and enhance their clinical services. Our goal is to make the independent pharmacy a destination for health and wellness in the community. AmerisourceBergen and Good Neighbor Pharmacy are innovating with independent pharmacists to position them to be valued, differentiated and vital members of the healthcare team. We are doing that by investing in technology that will simplify their interactions with the distributor, including developing an intuitive ordering system – ABC Order – and making significant investments into our distribution center network. We’re also investing in data, reporting and personnel that will help independent pharmacists make smarter decisions in real-time with

the help of our team of dedicated experts including business coaches, retail merchandising specialists and sales associates. Can you share a time when you have had to expand a core product set through innovation? At Good Neighbor Pharmacy, we developed Advanced Features for Elevate Provider Network, our PSAO. Elevate Provider Network is designed to support independent pharmacists’ operational efficiency and profitability through everything from: pre- and post-edit services with data capture, reconciliation services, and a patient engagement center, helping our members improve quality and adherence measures while offering other unique patient-centered services. Prior to taking the helm at Good Neighbor Pharmacy, my team at Xcenda developed industry-leading innovations, like an outcomes analyzer and deploying field reimbursement managers, who generated actionable data at the specific customer level to change their business and enhance patient care. These core offerings allowed our customers to demonstrate the value of pharmaceutical products while improving patient access to medications. How do you see the landscape of the independent pharmacy changing in the next few years with all the consolidation happening? As I mentioned, the healthcare industry is rapidly changing and will only continue to do so. Inde-

At Good Neighbor Pharmacy, we developed Advanced Features for Elevate Provider Network, our PSAO.

pharmacy edge

pendent pharmacists will need to innovate and differentiate to continue to operate as pillars of their communities. To remain independent, pharmacists will need to have a very clear and unique value proposition to patients, physicians, hospitals, payers and manufacturers. Each of these key partners will play a crucial role in supporting independent pharmacists. For example, patients need to understand the benefits of going to a dedicated, local independent pharmacist. Not only is there a personalization and intimacy with the experience, but studies also show that care delivered at the community level is more cost-effective. Physicians and hospitals need to view the pharmacist as a partner in

er hospitalizations and the overall cost of care for their patients. And, manufacturers need to see the viability of the independent retail channel for specialty medications and why limiting distribution will not benefit high quality, holistic patient care. With several consolidations occurring industry wide, how are you helping your customers to compete in today’s marketplace? AmerisourceBergen and Good Neighbor Pharmacy have developed several products and services that combine business differentiation, data and analytics and advocacy work to communicate the importance of the independent pharmacist to each of those key audiences – patients, physicians, payers and manufacturers.

My family provides a constant sense of support, encouragement, and humor that gets me through those very busy and stressful times.

care, advancing outcomes through adherence, immunizations, preventative screenings and specialty programs designed for various disease states. Independent pharmacists can have a big impact on keeping patients out of the hospital or from returning to the hospital, which is beneficial if a provider is involved in outcomes-based contracting. Payers need to know the benefits of keeping independent pharmacists in network, and pharmacists will need to communicate the value of their services that go “beyond the pill” – the clinical, cognitive and enhanced services that can low-

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Through Elevate Provider Network, our PSAO, we are delivering creative solutions that maximize profitability from prescriptions and drive smarter decisions for the pharmacy. Since launching Elevate last year, more than 2,500 of our members have taken full advantage of all the features of our network, driving growth and improving outcomes in their pharmacies. Additionally, our member pharmacies outperformed the overall market with year-on-year prescription growth of +3.4% compared to +1.9%. Elevate is also a collective contracting voice for more than 4,500 pharmacies to ensure that,

despite payer consolidation, our pharmacies can serve their patients and are in-network or have a contract with payers. Simultaneously, we have spearheaded advocacy on Capitol Hill and in the pharmacist community. We are encouraging our customers to share their own voices on the regulatory issues that matter most. Through the launch of our new advocacy website, www.OurIndependentVoice.com, independent pharmacists are provided with the latest updates and resources to amplify their collective voice among government officials and shape the delivery of pharmacy services. With the many changes occurring in the industry how do you think it will impact Medicare and Medicaid reimbursements for your customers? Our customers are feeling a tremendous amount of downward pressure on reimbursement and that will likely continue. The DIR fees that many pharmacy benefit managers (PBMs) are implementing for Medicare programs are particularly troublesome on many fronts. However, we are working with independent pharmacists to effectively communicate their value propositions, diversify and innovate their businesses and advocate on their behalf. Explain what AmerisourceBergen does. AmerisourceBergen is one of the largest global pharmaceutical sourcing and distribution services companies, helping both healthcare providers as well as pharmaceutical and biotech manufacturers improve patient access to products and enhance patient care. With services ranging from drug distribution and niche premium logistics to reimbursement and pharmaceutical consulting services, AmerisourceBergen delivers innovative programs and solutions across the

pharmaceutical supply channel in human and animal health. Would you explain a little bit about the Good Neighbor Pharmacy program for those interested in starting a franchise? As part of AmerisourceBergen, Good Neighbor Pharmacy provides the knowledge, reach and partnership independent pharmacies need to be the preferred healthcare destination in their local communities. Good Neighbor Pharmacy has unsurpassed expertise in the latest industry and policy changes; a robust supply chain enabling product access; and a philosophy of partnering to find opportunity in the changes in healthcare delivery to ensure pharmacies have the tools they need to transform and not only build a better business but also improve patient lives. If some of our readers are interested in joining the Good Neighbor Pharmacy program, how should they reach out? We welcome all independent pharmacies to our program and would be happy to share more about how to join. Interested pharmacies should get in touch with Lara Knudsen, our director of membership and onboarding, at LKnudsen@ amerisourcebergen.com or 610727-7000. Think back and share a story about a personal life experience that defines who you are today. What was the value/lesson? I was a small fish in a big pond growing up. As I grew older, I moved to a small town and considered myself a new fish in a little pond. There, I took full advantage of the many leadership and sports opportunities afforded to those in a small community. Once I got to college, I grew out of my shell and knew I could succeed if I worked hard enough and pursued the right opportunities for leadership and work experience. The confidence that I gained in a

small town community served me well as I progressed through undergraduate, pharmacy and graduate school. All of these experiences collectively served as the launching pad for a successful 30-year career. Through all of those progressive steps in life, what I have learned is that your environment does not define you – take chances; try new things, be uncomfortable and allow yourself to fail. In failure, you are able to grow. Those moments of growth will help you expand beyond your environment to reach your goals and find success. And, when you find that success, redefine it. How do you allow ideas to flow through the chain of command? I believe open and honest communication is key. It fosters ideas and innovation that help people, teams and companies grow. It is important to empower your team to communicate openly, present ideas and make decisions without fear of failure. But, what I’m most passionate about is engagement, and for me, ensuring my teams are engaged in their work starts by helping them connect a sense of personal purpose to their professional purpose. Once you have teams that are engaged and empowered, unleash! Get out of their way, and let them succeed. What Are Your 3 Biggest Accomplishments? From a personal standpoint, my biggest accomplishment is raising my four incredible and amazing children with my wife of 20 years, Jennifer. My children are growing to be amazing young adults who I believe will have a very positive impact on their communities and those around them. My family provides a constant sense of support, encouragement, and humor that gets me through those very busy and stressful times.

Prior to my role at Good Neighbor Pharmacy, I was president of Xcenda, AmerisourceBergen’s strategic consultancy. There, my team and I created a culture of excellence and teamwork, consistently scoring at the top of our peer group in associate engagement – a driver of growth and financial success. We built a significant record of accomplishment of high double-digit growth coupled with low employee turnover and were twice recognized as a top place to work. Finally, I was once recognized by an industry publication as one of the top 100 most inspiring leaders in healthcare. While this was an individual honor, I view it as a collective honor representing the excellent accomplishments and culture created by the entire Xcenda team. What other CEOs do you look up to? I certainly look up to our current CEO, Steve Collis. I admire and am inspired by any CEO who puts his or her associates and customers first, and does so with integrity and compassion. I think Steve embodies those ideals. Yes, he is CEO of a very large corporation, but he has remained true to the values he developed as an entrepreneur conceptualizing a business at his kitchen table. He is approachable, incredibly engaged in our associates’ well-being, and is driven to truly shape health care through innovation and partnership. Any concluding thoughts or closing message you want to tell our readers? A) Independents are a critically important part of the health care system; B) They need to continue to innovate to grow, and C) Independent pharmacists and their partners need to tell the story better to stakeholders. The future is bright if we work together to do A, B and C.

pharmacy edge

United States of Allergic Disease By Robyn O’Brien, author, analyst, founder of AllergyKids.com A study released in the Journal of the American Medical Association says that living in the United States increases your risk of allergic diseases “significantly.” According to the research, living in the United States for a decade or more may raise the risk of some allergies, reports the Journal of the American Medical Association.

Food allergies have been skyrocketing in the United States in the last fifteen years. Not only has the CDC reported a 265% increase in the rates of hospitalizations related to food allergic reactions in a ten year period, but the sales of EpiPens, a life-saving medical device for those with food allergies, has also seen record sales growth according to the New York Times. Mylan bought the brand in 2007 for about $200 million, and it is now worth over $1.2 billion.

“Living in the US raises risk of allergies,” says the headline.

So what’s going on?

“These data indicate that duration of residence in the United States is a previously unrecognized factor in the epidemiology of atopic disease,” it said.

The study aimed to find out. Allergies reported in the survey included asthma, eczema, hay fever, and food allergies.

In other words, the longer you live here, the more likely you are to develop some kind of allergy, asthma, eczema or other related condition.

“Children born outside the United States had significantly lower prevalence of any allergic diseases (20.3%) than those born in the United States

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Food allergies have increased tremendously (34.5%),” said the study led by Jonathan Silverberg of St. Luke’s-Roosevelt Hospital Center in New York.

pharmaceuticals is $4,184 per child per year, costing our economy $25 billion, including lost productivity.

Let’s restate that:

So what is triggering this escalating, US allergy epidemic?

Children born in the US have more than a 1 in 3 chance of having allergic diseases like food allergies, asthma or eczema, while kids born in other countries around the world had a “significantly lower prevalence” of 1 in 5. On top of that, “foreign-born Americans develop increased risk for allergic disease with prolonged residence in the United States,” it said. In other words, if you move here, your chances of developing any one or more of these allergic diseases increase. The study went so far as to say that children born outside of the US who moved here showed “significantly” higher odds of developing these diseases. What’s driving this? Is it really Purel and intense hand washing? And the hygiene hypothesis?

According to Reuters report on the study and Dr. Ruchi Gupta, who studies allergies at the Northwestern University Feinberg School of Medicine in Chicago but wasn’t involved in the new research, “This is definitely something we see clinically and we’re trying to better understand, what is it in our environment that’s increasing the risk of allergic disease?” said “Food allergies have increased tremendously,” she told Reuters Health. “We do see people who come from other countries don’t tend to have it.” The cost of food allergies is burdening more than just the families dealing with them, it’s burdening our schools, our health care system and our economy. It has become a billion dollar business in less than a decade for the company making EpiPens.

Or are we allergic to food or to what’s recently been done to it?

Just as cancer isn’t a niche, food allergies are no longer a fad, and it is critical that consumers have a competitive marketplace and affordable access to many epinephrine and life-saving devices.

Because genetics don’t change that quickly, and the environment does.

With lives on the line, there couldn’t be anything more critical.

There are plenty of questions, as now more than two kids in every classroom, have food allergies, but not enough answers. On top of that, the epinephrine auto-injector space is dominated by Mylan, which has secured over a 90% market share, leading to consumer outrage around the pricing in what is now known as #epigate.

Robyn O’Brien has been called “Food’s Erin Brockovich” by Bloomberg and the New York Times. Her TEDx talks have been viewed by millions and translated into Traditional Chinese, Simplified Chinese, Japanese, Korean, Spanish, French, German and Hebrew, catalyzing a global conversation around food. She has helped lead a food movement and regularly appears in the press. Robyn’s work has been recognized by political leaders around the country, in Congressional hearings, by Annie’s, Applegate, General Mills, Target, Chipotle, Coca Cola, Chili’s Restaurants, investors and others in the food industry. You can learn more at www.robynobrien.com

This presents a risk not only to American children, but also to our economy, as the financial burden of these conditions and their associated health care costs impact not only families but also our country, our military and our productivity. Researchers reporting in the Journal of the American Medical Association states that the costs of food allergies, from medical care to food to

pharmacy edge

How to Guide for

Sales Success

in Specialty Pharmacy Part 2 We’ve written a free eBook to help foster sustainable sales success in specialty pharmacies of all shapes and sizes. In the eBook, we discuss how to develop the tools and resources necessary to support your sales team, how you can grow your team to capitalize on your pharmacy’s success, and, most importantly, how this can encourage the patient’s journey. Below is the next section in our How to Guide for Sales Success in Specialty Pharmacy. For the com-

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plete eBook download, visit CSIgroup.net/SalesBook. No Two Specialty Pharmacies Are Alike Every specialty pharmacy is like a fingerprint; each one is unique and no single solution or sales team is right for every specialty pharmacy. Who you hire is dependent on the type of your business, your goals, your organizational culture and how the people you hire will, ultimately, fit into your plan.

To put it simply, if you’ve seen one specialty pharmacy... well, you’ve seen only one specialty pharmacy. This is what makes the transition into specialty pharmacy so challenging and unique. To Hire or Not to Hire a Pharma? That is the Question. The dilemma that many pharmacy managers face is, “Do I hire pharma?” There are some great people in pharma; however, every pharmaceutical rep is not necessarily going

to be right for your specialty pharmacy. It takes a unique breed with a diverse skill set to be successful in this segment of the industry. Understanding that there’s a big difference when you work for an established, multinational, billiondollar company, is key to making the right hire. Large companies have more resources, bigger budgets and additional red tape. Small and upcoming organizations, including mid-sized specialty pharmacies, don’t have separate business divisions to handle expenses, or the money to provide a car. Resources for smaller enterprises are limited and, as such, sales reps can often be left more to their own devices. In other words, you’ll need someone who is accountable, dependable, motivated and honest. Individuals working in big pharma are used to having everything readily available to them. This doesn’t

mean that they’re not talented they may be highly skilled - but, their expectations may not completely align while working with an entirely different business model. Finding the right person isn’t always about simply being a good fit. It’s important to sit down and take your time to find the right person. Once you find them, you’ll need to take action and ensure you make them part of your team from the word “go”.

3 Steps in Developing a Sales Strategy There are three things every healthcare organization should do to develop a successful sales strategy. These include: 1- Understand the Market Understand the market and what you need to do to penetrate that market, both from a structural and a knowledge perspective.

2- Have the Right Team Get the right people onboard and take your time to identify the right individuals. Don’t waste your time making offers to people who are unlikely to fit in with your organization’s goals. 3- Have the Right Talent When breaking into a new or expanded market, it’s critical to source and hire the right talent. Often you’ll want to find a partner who has an understanding of your specific business segment, and who can help you acquire the right talent to succeed. Having a partner who knows this industry can be a big asset and give you a significant advantage over your competitors. In the end, it’s all about execution. Having and developing a plan is crucial, and you’ll need to put together a team that can deliver and execute your strategy in the marketplace.

For the free eBook download visit CSIgroup.net/SalesBook pharmacy edge

How to Market Your Pharmacy:

Public Relations One of the most common questions we get ask by our clients, is how can I market my pharmacy without spending a lot of money? Now there are multiple ways to do that, but one way is through Public Relations, which consists of activities designed to build good relations with the pharmacy’s various publics – customers, prospective customers, prescribers, community leaders, etc. This medium can be used to promote products, services, staff, ideas, events and more. It does not necessarily have to be new to your pharmacy, you can promote something anytime if the general public is not aware of it, even if you added a new service six months ago, for example. PR can have a strong impact on public awareness at a much lower cost than advertising. When using it, the pharmacy owner does not pay for the space or time in the media, so it is often considered more believable to the public. Because you are not paying for it

though, the media staff does have discretion on what they publish. When writing a Press Release, keep it around 300 - 500 words, and try to include as many facts as possible, a quote or two, and not a lot of “selling” words. The goal of the PR is to educate your audience. And while you do not want to inundate the media with Press Releases, there is no harm in sending one at least quarterly. A good rule of thumb is to have a staff or family member read it beforehand, did they find it interesting? If they answered, “YES”, to both questions, it’s a good story to send on. In the “old days”, a business owner would have to fax a Press Release to the media, hoping it would get picked up. Today the web has become a more important channel, because while the newspaper may not put the story in the paper, they may put it on their website, which the pharmacy owner can push out through his or her social media

(Facebook, Twitter, LinkedIn, etc.), thus reaching and engaging an even larger audience. Anytime you send a Press Release out, it’s important to alert your staff, in case they are asked about the story. It also gives them an opportunity to share it on their social media channels as well if you choose. Another benefit of using public relations to market your pharmacy, is it helps build positive relationships with the local media. A reporter may reach out to you first if a pharmacy or health-related story comes up, thus further increasing your exposure and positioning yourself as an expert in the community. Any articles you are a part of, can also be posted on your website and/or placed in your pharmacy for customers to read. Be proud of your pharmacy and what you have to offer! Share it with your community, by incorporating public relations into your 2017 marketing plan.

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What’s Your 2017 Marketing Strategy? Not Sure? GRX Marketing can provide various marketing services including but not limited to: strategic consulting, creative services, material development and execution, social media management, website development and management, and electronic communication development and execution. Join our program and we will: • Develop a plan unique to your goals and services • Implement Ideas - giving you time to spend with patients • Use our expertise as fellow pharmacy owners • Proactively reach out to you - we don’t wait for you to call us

Make 2017 Successful!

Contact Nicolle McClure at 515.280.2913 or nicolle.mcclure@grxmarketing.com to get started. 16 pharmacy edge

www.pharmacymarketing.com

GRX Marketing, a leading provider of marketing services to independent pharmacy owners, is pleased to announce that Nicolle McClure has been promoted to President of GRX Marketing. McClure served as Vice-President for five years. McClure replaces Greg Johansen, who stepped down in October. Johansen continues to serve as President of GRX Holdings, LLC, GRX Marketing’s parent company. McClure started GRX Marketing with a former colleague in 2010, and currently has 12 years of pharmacy marketing experience. GRX Marketing provides various marketing services including but not limited to strategic consulting, creative services, material development and execution, social media management, website development and management, and electronic communication development and execution. The company currently assists more than 85 independent pharmacy owners and pharmacy industry companies nationwide with their marketing services. Through the company’s comprehensive and individualized approach, clients have experienced up to a 14% new patient count increase. As President of GRX Marketing, McClure will be responsible for formulating additional partnerships and continuing to grow the company’s presence in the marketplace.

Nicolle McClure

Announced as New President of GRX Marketing

“Nicolle is one of the most experienced pharmacy marketing professionals in the country. She has proven that innovation along with effective planning and execution works. Since joining our company first to market our own pharmacies, and then branching out to create GRX Marketing, she has shown entrepreneurship to grow our business as well as our client’s businesses. In her role as president of GRX Marketing, Nicolle will continue leading her team to new heights. I am proud to have Nicolle occupy this important role,” stated Johansen. McClure currently serves as an Advisory Board Member for American Pharmacy Purchasing Alliance (APPA) and is a Co-Host for the Pharmacy Podcast. She started with GRX Holdings, LLC, as the Director of Marketing in 2008. McClure received a Bachelor of Arts in Advertising with a minor in Marketing from Iowa State University in 2001. GRX Marketing, part of GRX Holdings, LLC is located in West Des Moines, IA. The company is also the single overall owner of 20 independent pharmacy locations in the central Iowa area. For more information about GRX Marketing, visit www.pharmacymarketing.com.

pharmacy edge

The Impact of Unsafe Injection Practices: Just the Tip of the Iceberg for Payers

The documented number of patients affected by unsafe injections likely represents only the tip of the iceberg. Some diseases and infections spread through unsafe infection practices can take years to show up. By the time symptoms arise, the disease or infection can cause irreparable damage.

Protecting members from harm is one of your highest priorities, yet hundreds of thousands of patients have been affected by the misuse of single-dose/single-use and multiple-dose vials. This misuse, in both inpatient and outpatient settings, has resulted in exposure to bloodborne illnesses and associated infections, including hepatitis, HIV, and life-threatening bacterial infections. According to the Centers for Disease Control and Prevention (CDC), there have been at least 49 outbreaks due to the mishandling of injectable medical products since 2001. Twenty-one of these involved transmission of hepatitis B virus (HBV) or hepatitis C virus (HCV). The other 28 were outbreaks of bacterial infections, primarily invasive bloodstream infections. Approximately 90% of these known outbreaks occurred in outpatient settings. Pain management clinics, where injections often are administered into the spine and other sterile spaces using preservative-free medications, and cancer clinics, which typically provide chemotherapy or other infusion services to patients who might be immunocompromised, are represented disproportionately relative to the overall volume of outpatient care. These outbreaks can lead to costly infection treatments and hospitalizations. Although hundreds of patients became infected during these outbreaks, there was the additional burden and associated costs of the estimated 150,000 patients during 2001-2012 who required notification and testing after their potential exposure to unsafe injections.

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The Costs of Unsafe Injection Practices: A Payer Problem A 2008 outbreak of HCV at an endoscopy clinic in Nevada occurred because syringes used to access medication vials were reused for multiple patients. The resulting public health notification of approximately 50,000 people was the largest in the United States. The Southern Nevada Health District estimated total public health costs, including investigation, testing, and medical counseling, at $16 million to $21 million. Consider that the treatment costs of HCV alone can reach more than $95,000 for 12 weeks of therapy. A 2009 outbreak of HBV at an oncology practice occurred as a result of reuse of single-dose vials for multiple patients and use of a common-source saline bag for multiple patients. Twenty-nine patients were infected with HBV and the resulting public health notification affected 4,600 patients. Consider that the economic burden of HBV in the United States is estimated to be as high as $1 billion (total direct and indirect annual cost). In 2012, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred at an outpatient pain management clinic in Arizona, where multiple patients had been injected with a diluted contrast medium for radiologic imaging from a single-dose vial. Three patients were treated for severe infections, requiring hospitalization ranging from 9 to 41 days. In 2012, 7 patients who had received joint injections at an outpatient orthopedic clinic in Delaware contracted MRSA due to the reuse of singledose vials for multiple patients. The infected patients required an average hospital stay of 6 days to combat the infection. Consider that the median 6-month unadjusted costs for patients infected with MRSA were $34,657, which was driven primarily by inpatient hospital costs.

Single Use Injection Kits (SUIKsTM): A Potential Payer Solution According to the CDC, dedicating a single-dose/single-use vial to 1 patient is, in and of itself, a critical element of proper infection control The One & Only Campaign from the CDC and Safe Injection Practices Coalition emphasizes that medications labeled as “single dose” or “single use” be used for only 1 patient. Medications in single-dose/single-use vials may lack antimicrobial preservatives and are, therefore, at greater risk to become contaminated and serve as a source of infection when used inappropriately

Reasons for Misuse: Not Following Proper Injection Practices

• Failing to adhere to safe injection practices and aseptic techniques, including: »»For single-dose/single-use vials, 6% sometimes or always used vials for multiple patients. »»For multiple-dose vials, 15% used the same syringe to re-enter a vial numerous times for the same patient; of that 15%, 6.5% reported saving vials for use on another patient. »»Of the 51 providers who reported reusing a syringe to obtain an additional dose from a multiple-dose vial and then leaving it for use on another patient, 52% were in a hospital setting. • Attempting to prevent waste Preventing waste may be due to medication shortages or costs; however, any potential savings from stretching the contents of single-dose/single-use vials by healthcare providers can be quickly offset by the costs associated with viral hepatitis, bloodstream infections, meningitis, epidural abscesses, and other infectious complications.

Along with continued training, education, and evaluation of current injection practices, the use of prepackaged, single-use, disposable, injection kits may be a potential vehicle to help: • Complement injection protocols and guidelines • Promote improved patient safety • Actively reduce the risk of secondary infections

pharmacy edge

Pharmacist

Resume Trends for

A key to your professional success is ensuring that your resume remains current and in the format hiring managers understand. Employers receive 100’s of resumes for every position they post, so it pays to ‘wow’ them with your knowledge of current trends. Here are just some of the resume trends you will see for pharmacists in 2017. How does your resume stack up?: 1. Mobile Phone Compatibility: What does your resume look like if it’s opened from a cell? Like everyone, employers are busy. If they see something they like in your cover letter and want to see more, they’re inevitably going to click on your resume from wherever they are, including their cell. Ensure that your resume will be visually appealing anyway they try to view it. The

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best way to accomplish this is to keep the design simple but appealing and always send the resume in .pdf format 2. Maximize Space: Contrary to what you will hear about resumes for other fields, a Pharmacist’s resume will often be up to 3 pages. Still, given all the information that can be included on your resume, it’s important to include clear, concise and brief sentences that highlight your experience. Nobody has time to read your resume line-byline, so the content need to jump out at the reader, using the space available as efficiently as possible, with as few words as possible. 3. Key Accomplishments: In 2017, you’ll see more Pharmacist resumes with sections such as ‘key accomplishments’ as opposed to

simply listing day-to-day responsibilities. This is what recruiters are looking for: how you contributed to your workplace, what initiatives you spearheaded. No matter whether you are in retail, in a hospital, or long term care, etc, the employer will know what your essential general duties will be. They want to know what makes you different, and this is also part of maximizing the space you have. 4. Clickable Content: 2017 will see, more than ever, an increase in the amount of content that you can view online. Did you present at a conference and the paper is online? Add a link. Have you taken continuing education classes? A link to the course outline would be helpful. Include as much extra material as you can, because if the employer is really interested in you,

they will want to see the details that can’t be crammed into your 3-page resume. 5. LinkedIn is King: Speaking of clickable content, make sure your LinkedIn profile is current and complete. This will be a must in 2017. LinkedIn has become the social network to give your career legitimacy. Ensure that it is complete, includes all your relevant experience and information, and, most importantly, ask your colleagues to recommend you. The power of the LinkedIn recommendation will be the key to setting you apart from the other candidates, now that every pharmacist has a LinkedIn and is participating online. 6. Specialization: Do you have or want a specialization in your field? This is the time to highlight it in

your resume. Employers see 100’s of resumes that are generically drafted towards any job possible. If you’ve specialized in oncology, fertility, geriatrics, whatever it may be, this has to be the paramount focus of your resume. Employers would like to hire experts in their field, and being a ‘Jack of all trades’ will not attract employers anymore. 7. Applicant Tracking Systems (ATS): While ATS, especially in hospital settings, are not new, their improved use is. 2017 will most certainly see an increase in the use of ATS to sort through the 100’s of resumes received for each job posting. This means that your resume needs to contain keywords and phrases relevant to the job posting in order to get shortlisted. This means that all of those lines and unruly graphs need to be ab-

sent. To avoid having your resume be denied due to incompatibility with ATS, your resume will need to be in the right format. There are some important resume trends developing in the Pharmacist field in 2017. I have just listed a few of them that you should watch for. With technology advancing so rapidly, it is important for a professional Pharmacist to stay current and competitive. A further trend that we are seeing in the industry is more people hiring professional resume writers. This isn’t a shameless plug, but a fact. It is difficult to follow all of the trends and reflect your experience concisely without professional help. Your resume can make or break your career, so ensure that your stay focused on the upcoming trends in Pharmacist resumes for 2017.

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PBMs:

Why Theyâ&#x20AC;&#x2122;ve Become the Mafia of the Pharmaceutical World The healthcare costs in the United States have steadily risen over the years. This has made it almost impossible for ordinary people to obtain early and ongoing medical attention, properly manage their health conditions, and stay away from serious illnesses and even death that could otherwise have been avoided. This increase can be attributed to many factors but, in terms of the rise of pharmaceutical costs, a lot of the blame can be piled on pharmacy benefit managers.

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The Congress is currently looking into pharmacy benefit managers and will hopefully come up with laws that will regulate how these organizations behave.

These organizations (which are better known as PBMs) were originally formed in the 1960s to help process the prescription transactions of health plans. Over the years, their scope has expanded to include other services. Now, many PBMs are in charge of creating and updating formularies, liaising with drug manufacturers and partner pharmacies, managing patient compliance programs, and doing other tasks.

amounts and underpaying pharmacies, the PBM mafia can earn from many other ways. They can get huge discounts from drug manufacturers but refuse to pass on these savings to the insurers and patients. They can also reimburse pharmacies a certain rate for a certain type of drug, then charge employers and insurers a higher rate for the same drug — keeping the difference between the two amounts for themselves.

On the surface, it would seem that pharmacy benefit managers are assisting employers and insurers in reducing their expenses while helping patients get the prescriptions they need at lower prices. But, if you look closer, you’ll realize that things aren’t what they really seem: the organizations that were designed to help people have transformed themselves into the PBM mafia.

They can even accept deals from manufacturers to keep a certain drug on health plan formularies. Manufacturers usually need to pay a substantial amount to PBMs to push this deal through, but they can recoup this investment later on since customers under the health plan will be forced to buy their product. For the PBM cartel and big pharma companies, it’s a win-win situation.

PBMs and Overcharging Perhaps one of the most corrupt practices of the PBM cartel is overcharging. PBMs have the power to instruct pharmacies on how much copay they should charge customers; if a PBM decides to charge skyhigh copay, pharmacies can do nothing but obey. Customers, on their part, have no choice but to pay, just so they can have their prescriptions filled. Earnings from copay don’t stay in pharmacies, though. Pharmacy benefit managers can take back a portion of the customers’ copay after they have determined how much they would pay the drugstores. Sometimes, pharmacies are left with enough money to enjoy a profit; other times, they’re left with barely enough to cover the cost of purchasing and dispensing the drug. Other Dubious Practices Aside from charging exorbitant copay

The PBM mafia has the opportunity to pull these stunts simply because there are virtually no laws that regulate their actions. There are a few rules in place, but many companies simply find a way around them. Because of these, a lot of PBMs can include and exclude drugs from formularies whenever they want and change their pricing structure at will — leaving insurers, employers, and patients virtually helpless. What Can We Do About It? The Congress is currently looking into pharmacy benefit managers and will hopefully come up with laws that will regulate how these organizations behave. While waiting for these regulations, pharmacies, insurers, and employers can demand transparency from the PBM cartel they work with and perhaps even switch to smaller PBMs that charge a flat fee and have a transparent pricing model.

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American Pharmacy Purchasing Alliance (APPA) named

Steven H. Collis, CEO of The Year in the 2016 Industry Awards. For more information about the APPA Industry Awards go to: http://joinappa.com/industry-awards/

Steven H. Collis is president and CEO of AmerisourceBergen Corporation, a global healthcare solutions leader, currently ranked No. 16 on the Fortune 500. Under Mr. Collis’ leadership, AmerisourceBergen has experienced tremendous financial growth, as well as increases in both employee population and geographic reach. The company’s annual revenue has jumped more than 70% during Mr. Collis’ tenure as CEO. Its number of employees has risen 65%. And today, AmerisourceBergen’s presence extends to offices in more than 50 countries worldwide.

Steven H. Collis President and Chief Executive Officer, AmerisourceBergen Corporation

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Looking beyond the numbers, though, Mr. Collis has forged a clear path for extending AmerisourceBergen’s reach and partnership in market-shaping ways. AmerisourceBergen’s agreement with Walgreens Boots Alliance in 2013 marked an industry first—with

a national pharmacy chain turning over all its pharmaceutical distribution to a wholesaler and collaborating on a global basis for generic product sourcing. The company’s 2015 acquisitions of MWI Veterinary Supply and PharMEDium further reflect AmerisourceBergen’s ability to deliver value in broadening markets. It’s no wonder, then, that the Wall Street Journal named Mr. Collis as the best performing chief executive in the Philadelphia region for 2015. Mr. Collis’ career with AmerisourceBergen spans more than two decades and includes time leading the company’s two largest divisions: AmerisourceBergen Drug Corporation and AmerisourceBergen Specialty Group. He helped found the Specialty Group business in 1994 and grew it into the undisputed market leader in specialty pharmaceutical distribution and product commercialization services. An avid supporter of charities, Mr. Collis is a founding vice chairman of the American Cancer Society’s CEOs Against Cancer – Pennsylvania chapter. He also spearheaded the creation of the AmerisourceBergen Foundation, the company’s first enterprise-wide, nonprofit charitable organization, which supports health-related causes and educational opportunities. Mr. Collis earned a Bachelor of Commerce with Honors degree from the University of Witwatersrand in Johannesburg, South Africa. In addition to serving on AmerisourceBergen’s board of directors, he is a board member for the International Federation of Pharmaceutical Wholesalers.

SO THEY SAY Our nosiness and desire to solve mysteries can sometimes get us into dangerous situations, hence curiosity’s reputation as a serial cat-killer. When we just have to know something, we can get off on wild tangents, which often lead us off track. The placebo effect is real and has been shown to repeatedly occur in controlled tests by leading scientific studies. As long as our brain believes that our medication will work, it likely will. Scientists understand how magnets work to a degree, but what they don’t understand is why natural magnets always have a north and a south pole. Why are there no ‘B’ batteries? While spending time with a child, see the world through their eyes, and when you can’t answer all their ‘whys’, share in their bafflement.

A child in a simulating environment, has a 25% greater ability to learn. Throughout life, mental activity promotes the production of new neurons in the brain. Curiosity is a willing, a proud, even an eager, confession of ignorance. Walk without purpose. In the eighteenth century situationists would take psychogeographic walks; walks with no direction and no destination. The only differences between a rut and a grave are the width and the depth. By knowing things, we only deal with ideas and concepts. When something is a mystery it hits deeper, into one’s soul, and can fully encompass us.

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Learning More about the Largest Pharmaceutical Pharmaceutical GPO’s GPO’s in in the the Country Country Learning More about the Largest “There’s power in numbers.” You’ve probably heard this phrase thousands of times and think of it as a cliché. However, this statement has never been truer particularly when it comes to the pharmaceutical industry, and it’s brought to life by group purchasing organizations or GPO’s. Pharmaceutical GPO’s allows independent pharmacies to group together and use their numbers to buy drugs at lower prices. This, in turn, helps them reduce their overheads and maximize their profits. GPO’s can even use their power to negotiate discounts from drug manufacturers and demand fair treatment and transparent prices, which can further help individual pharmacies in improving their business. GPO’s are also greatly helpful when there are drug shortages. On their own, pharmacies have no choice but to either pay higher rates for drugs that are low on stock or quit including these drugs in their product line. But, if they’re a part of a GPO, they’ll have someone who will look for alternative drugs, secure exclusive deals with manufacturers, or even help manufacturers to look obtain raw materials and speed up the production of these drugs. Over the years, many pharmacists have realized the importance of belonging to a group purchasing organizations, and this has resulted to the increase in the number of pharmaceutical GPO’s in the country as well as to their rise in popularity. There are more or less 600 GPO’s serving the healthcare industry, although it’s important to note that not all of them are created equal and that some of them offer better services than others.

28 pharmacy edge

Two of the largest GPO’s in the country are MedAssets and Novation. MedAssets had more than 500,000 affiliate beds in 2013, and it served more than 4,000 hospitals and over 120,000 non-acute healthcare providers. Novation had almost 300,000 affiliate beds in 2013 and was handling over 600 suppliers with contracts worth $49 billion, and it was named as one of the World’s Most Ethical Companies in 2014. MedAssets and Novation now both belong to the same parent company Vizient, which is one of the leading healthcare services company in the U.S. Another excellent GPO is Amerinet, which has almost 400,000 affiliate beds. Established in 1986, the company had four subsidiaries that focused on different fields like non-acute marketplace solutions and healthcare market analysis. Amerinet has rebranded itself as Intalere in 2016 and remains to be one of the leaders in the industry. Still anther great option is PBA Health, which offers a wholesaler negotiation service called ProfitGuard. It provides a set of business intelligence tools that help you manage your purchases, maximize your rebates, and ensure you get the best possible value for your money. Many pharmacists swear by ProfitGuard, pointing out that the service has helped them greatly especially in seeking out new generic drugs and choosing those that are available at the most reasonable prices. These are some of the largest pharmaceutical GPO’s in the market. They’re definitely not the only options out there, but they’re a good place to begin particularly if you’re new to the world of group purchasing. Do your research now to see which GPO best suits your needs!

Source: www.digitaledition.chaindrugreview.com

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